That was one of the main messages emphasized Friday during the monthly Northern Berkshire Community Coalition forum, which focused this month on "Community Needs" in relation to health care. A second forum on "Community Solutions" will be held in January.

 

"The big central theme is participation," NBCC Executive Director Adam Hinds said to kick off the forum, attended by about 75 people. "It's really incumbent on us to make sure we get that right. … That's something that's hard to overstate. It's very rare that a community has an opportunity to do that."

 

That work has started on an institutional level with the restoration of many medical services that were lost when the hospital closed. Cathleen McElligott, director of the State Office of Rural Health, attended Friday's meeting to read off a list of services now offered in North Adams again, thanks to organizations like Berkshire Health Systems, the Brien Center and Community Health Programs. Those include 24-hour emergency care, laboratory drawing stations, outpatient surgery and new primary care services.

 

"It's just amazing. Lightning speed," said McElligott, who said the county has received a Rural Health Network Development Planning Grant designed to expand access to, coordinate and improve health care delivery in rural areas. "A lot of the new money has been attracted into this community. Maybe sometimes it seems a little quiet, but there's a lot going on."

 

McElligott echoed Hinds' sentiments that community participation in the process is crucial and also emphasized that building a healthy community is not just about providing medical services.

 

"We're not just talking about disease care. We're talking about health care. We want to make this a healthy community," she said. "Some of it rests with you to be healthy. But are you living in an environment to help you be healthier?"

 

That question was addressed by Ruth Blodgett, Berkshire Health Systems' senior vice president of planning and development, who presented the County Health Rankings as a starting point for discussion on what the community needs. These rankings are an update of an assessment done three years ago to compare Berkshire County as a whole to other counties in the state as well as to other states.

 

Right now, Berkshire County ranks 11 out of 14 in terms of health outcomes, based on an equal weighting of length and quality of life. (Nantucket ranks number one.)

 

In terms of health factors, Berkshire County ranks seventh out of 14; health factors include health behaviors, clinical care, social and economic factors, and the physical environment. (Norfolk ranks number one.)

 

Overall, Massachusetts rates third in the country when it comes to health rankings, so the fact that Berkshire County is No. 7 and No. 11 in the state that's No. 3 bodes well.

 

"We have this audacious goal to be the healthiest county in the country," Blodgett said. "Can we do it?"

 

Cheers exploded throughout the room.

And while top-ranking Nantucket and Norfolk are wealthy counties, and "income affects health," Blodgett said, it's not the only factor and shouldn't discourage areas like the Berkshires where per capita income is lower.

"There are tons of things you can do independent of income to change," she said, adding that 40 percent of premature deaths are related to behavior such as smoking. "It's in our hands. We can do something about this."

 

And while she said that kind of change is not easy, changing behavior is an important step.

 

"Chronic diseases account for 75 percent of health care costs. Most of these are preventable. We can change them," said Blodgett, who said there has been a lot of exciting new research in the last decade about how behavior and health are related. "We can turn on and off the genes we may have inherited by how we live. … This is 10 years of research saying this power is in our hands."

 

And that's why the forum ended in the hands of breakout groups where people could brainstorm what the needs of the community are, and what some challenges to health care, like transportation and access. Polly MacPherson, former program manager at REACH for Community Health at North Adams Regional Hospital, said the ideas generated in these groups will be part of the data collected for the next step: finding solutions.

 

"Key with this is gathering the data and maing sure we talk to everyone," said MacPherson, who said she already has a vision for how Berkshire County could look on the rankings in one year. "We're not 11 anymore, we're nine, or eight, and in some ways even one, because we worked together."