Kim Kelly of Berkshire Health Systems detailed the Community Health Initiative aimed to turn around the poor rankings seen in the data.
PITTSFIELD, Mass. — Berkshire County has dropped a spot in the county health rankings.
The annual rankings measure in two categories — health outcomes and health factors. The county ranks 13 out of 14 counties in Massachusetts in the former and 11 out of 14 for the latter.
Neighboring Hampden County was dead last in both categories.
The report was released by local health officials on Monday and will serve as the basis for efforts to improve the well-being of residents throughout the county. The data used was garnered largely between 2015 and 2017.
"Our overall rank is not where we'd like it to be. Berkshire County currently ranks 13th out of the 14 counties in Massachusetts. We were hovering around 11th for a number of years, fell to 12th last year, and this year fell to 13th," Public Health Program Manager for Berkshire Regional Planning Commission Laura Kittross said.
However, Kittross was quick to point out that while the county may be low in the state's rankings, Massachusetts as a state is toward the top nationally.
"Ranking near the bottom in Massachusetts still means we are ranking very well compared to a lot of the United States," she said.
Health outcomes are a particular issue with Berkshire County. It is partly measured by years of potential life lost before the age of 75, for which the county is last in the state. Kittross noticed a big difference between race and ethnicities when digging into the data.
"The lowest life expectancy in Berkshire County is the Morningside neighborhood here in Pittsfield at 71 years. The highest is in New Marlborough at 87.5 years. But even just a couple miles away from Morningside is Lanesborough, we see a life expectancy of 86.6 years," Kitross said. The national average is 79.1 years.
She said even in Pittsfield there is a 12.5-year difference in life span between those who live in Morningside and those residing in the southeast neighborhoods. Kittross called on health officials to look even closer at the data to determine issues in those neighborhoods to help "level the playing field."
The other factor in outcomes is the quality of life. The county is slightly better there while being ranked at 11. Kittross pointed out a measure of those reporting themselves to be in poor or fair health is on par with the rest of the state but the number of days people have self-reported as being poor physical or mental health days are above average. She said those measurements are good indicators of health.
In the second broad category, health factors, the Berkshires are 11th. This category measures health behaviors and that, Kittross said, is what local officials can specifically address to help change outcomes.
"We are trending in the right direction on smoking. We are still in the lower half as far as the state goes but we have been steadily moving up [in the ranking]," she said. About 15 percent of Berkshire adults smoke compared to 14 percent statewide; the percentage was 19 in the 2012 health rankings for the Berkshires.
Kittross credits the decrease in smoking to efforts such as municipalities banning smoking from parks and the raising of the smoking age to 21.
The county is "doing great" when it comes to alcohol usage. The Berkshires ranks at the top of the list for the lowest percentage of people who reported binge drinking in the last 30 days. Overall, though, about a fifth of Massachusetts residents reported binge drinking.
However, Kittross said it is a mixed bag. While the binge-drinking numbers are down, about a quarter of the motor vehicle deaths in the last five years were because of alcohol. That is twice the rate of the best performers in the United States.
"Our obesity rates have typically been below the U.S. as well as Massachusetts. We are trending up, however, which is the wrong direction. We are now just slightly above the Massachusetts average. That is an indication of limited access to healthy food," Kittross said.
The county is toward the bottom on the number of days residents have reported as feeling unwell mentally or physically.
The report also shows that the county lacks access to recreational facilities, even though the Berkshires is considered a prime natural recreational area.
"We're actually doing really well on sexually transmitted infections, we are third, which is good. We are doing less well on teen birth rate though this is another one where we see the trend upward, we are ranking better than where we ranked a couple of years ago," Kitross said.
The county isn't doing so well with motor vehicle crash deaths. Kittross said fatal accidents related to alcohol are in the"middle of the pack" but the overall fatal motor-vehicle crash rate is the worst in the state.
She said that is another area to focus on — is it the quality of the roads, the distance of travel, or what?
Access to care is another strength, which may be a surprise to many. The Berkshires are 5th in the state when it comes to access to primary care physicians, 6th for dentists, and 3rd for mental health.
"We rate extremely well in this measure but there is at least a perception that we don't have enough primary-care providers and dentists," Kitross said.
The quality of care also ranked high. Kittross said that measurement is the rate of hospital stays for things that could have been treated as outpatient care, which is another indicator that access to primary-care doctors is doing well.
However, "this is only based on Medicare data so only people 65 and older so we may be missing trends in younger people," she said.
In preventive care, Kittross said the data is somewhat deceptive as well because such things as vaccinations are taken into account through Medicare data but locally there are strong pushes to make sure younger generations are vaccinated.
Plus, "preventative care is an area Massachusetts does really well," she said.
The county ranks 11th in social and economic factors. That takes into account such things as unemployment, which has been linked to higher mortality rates, unhealthy behavior, and a lack of access to health care because of insurance coverage.
Kittress highlighted the number of children in poverty as another stark inequity.
"This is a place we see huge inequities. Only 11 percent of the white children in Berkshire County are living in poverty and 51 percent of black children and 36 percent of Hispanic children live in poverty in Berkshire County," Kitross said.
The county is also doing poorly in the rate of those who attend any type of postsecondary education. Kittross said those with more education tend not to smoke, are more likely to exercise, are more likely to earn more, and live a life with less stress. Only 64 percent of the county has some post-secondary education whereas the top performer, Norfolk, is at 82 percent.
"We're not doing too poorly on high school education. We are at the Massachusetts mean. But where we are not doing as well is with people without any postsecondary education," Kitross said.
Kittross added another area the county is doing well in is housing.
Local health officials gather Monday afternoon to discuss strategies and priorities toward improving the areas in which the coutny does poorly.
While the report seems bad for the county overall, there are some bright spots. And for the negative areas, county organizations are prepared to roll out a strategic plan for change.
"Our goal is to improve the health status of Berkshire County by fostering a healthy lifestyle environment and our vision, and this is a pretty amazing vision, is to become the healthiest county in Massachusetts and the nation. We have some ways to go in Massachusetts," said Kim Kelly, who is heading the Community Health Initiative.
The CHI, as it is called, has been in existence since 2015 and has been growing. The membership now includes the Northern Berkshire Community Coalition, the Pittsfield Health Department, South County Rural Health Network, Berkshire Opioid Abuse Prevention Collaborative, BRPC, Tri-town Health, Fairview Hospital, Berkshire Public Health Alliance, Berkshire County Boards of Health Association, Volunteers in Medicine, and Berkshire Health Systems.
Kelly, who is the director of community health and public health initiatives for Berkshire Health Systems, said the group plans to create and implement a county health improvement plan to address the target areas in which the county is performing poorly.
The process restarts now as the now larger group readdresses the priority areas identified in 2015. Then the group will identify best practices and support initiatives to drive those changes.
"We have many strengths in our community, many strengths that you folks work on, and we have some opportunities," Kelly told the audience at the Zion Lutheran Church on Monday when the health data was presented.
BRPC streamed the event live, which is can be watched in its entirety below.
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