FirstHealth of the Carolinas (FirstHealth) is a not-for-profit health system serving a largely rural 15 county area in south Central North Carolina and northern South Carolina. In 2003, FirstHealth commissioned random survey of residents in its service area to determine health status, behaviors and needs in a defined region. Included in the survey were its core service areas of Moore, Hoke, Montgomery and Richmond counties, as well as the Pembroke area of Robeson County. This project was a follow up a similar survey conducted in 1999. The key findings of the 2003 survey reflect that local residents report poorer health status on a number of indicators, as compared to the results of a comparable national survey:
- General physical health. Respondents were more likely to report "fair" or "poor" health.
- Mental health. Respondents reported a significantly higher prevalence of chronic (prolonged) depression. They also were more likely to report experiencing three or more days per month of poor mental health.
- Cardiovascular disease. Respondents reported a higher prevalence of exhibiting at least one cardiovascular risk factor. Respondents also had higher rates of diagnosis of hypertension or high cholesterol.
- Diabetes. Respondents were more likely to report being diagnosed with diabetes.
- Disability. Activity limitations due to disability were at a higher rate.
- Obesity. Respondents were more likely to report being overweight.
- Tobacco Use. A significantly higher rate of tobacco usage was noted.
- Access to health care. Respondents were more likely to report that cost prevented them from obtaining a needed prescription medication in the past year, as well as difficulty in obtaining medical care for their children. African Americans and Native American respondents were significantly more likely to report difficulty in obtaining routine medical care in the past year than White respondents. Native American respondents also report a higher rate of being uninsured than respondents of other races.
Notably, in many of the measures on the survey, the findings indicated no improvement over the 1999 FirstHealth community survey findings, and in several instances the measures were worse. This was despite all the community service and outreach efforts of FirstHealth, as well as other private and public health care organizations. These findings demonstrate that private initiatives alone are not enough, policy makers must make addressing the health status of all North Carolinians a high priority if strong and productive communities are to grow and be maintained.
FirstHealth policy priority areas include support for implementation of universal and affordable health coverage by some means for the estimated 44 million Americans, including the more than one million North Carolina residents, who lack coverage. In this way, the major economic barrier to health care access would be mitigated. Additionally, if all Americans were covered by health insurance, systematic efforts could be made to understand the causes of disparities in the health status in different populations, and how such disparities can be eliminated. Furthermore, efforts to educate all population groups about modifiable health risks could be intensified. Appropriate incentives and competent support for those who need help modifying risky behaviors could readily be made available.
View the full report: A Community at the Crossroads.