The High Cost of Poor Health in Prowers County

Jacqueline Brown, Primary Care Director, Southeast Mental Health Services

Lamar, Colorado – Prowers County’s Health Ranks Near Bottom in State

Prowers County has the sad distinction of ranking near the bottom when it comes to health according to the National County Health Rankings http://www.countyhealthrankings.org.  The health rankings, which look at health statistics for each county and compare them to other counties in the state, paint a picture of poor health for many of our residents.  People are living longer, but they are living with more preventable diseases caused by lifestyle choices such as smoking and sedentary lifestyles.

Meet Alicia.  Alicia is a single young woman who lives alone and works part-time at a local fast food restaurant.  Since starting her job 6 months ago, Alicia has gained 30 pounds, moving her from the “overweight” category to “obese.”  Alicia was recently diagnosed with Type-2 diabetes and her doctor started her on insulin.  Alicia says she is tired all the time, and when she is not working, she tends to watch movies, chats on Facebook or plays video games on the computer.  Since she lives by herself, she eats a lot of microwave-ready food and doesn’t feel comfortable going out after dark.  She visits her mother once a week and sees her doctor occasionally, but feels bored with the rest of her life.

The cost of poor health is high, both in terms of medical expenses and loss of the ability to enjoy life.  For example, residents in Prowers County are almost twice as likely to have diabetes as the Colorado state average. When it comes to being obese, Prowers County numbers are dismal: One-third of adults in Prowers County are considered obese and are not physically active. Almost 25% of the population smokes, compared to the state rate of 17.8%.  Smoking, lack of physical activity, and obesity contribute to the chronic diseases that impact our health statistics and to the cost of medical care for Prowers County residents. 

For people with multiple chronic health conditions, such as diabetes, substance abuse and heart disease, health behavior changes can mean the difference between a satisfying life and a painful, premature death. For young healthy people, setting goals to maintain your health as you age will help ensure that you can enjoy your later years.

While the statistics seem stacked against the county, Southeast Mental Health Services is working to help improve the health of those in Prowers County utilizing Patient Navigators funded through an award from the Centers for Medicare and Medicaid Innovation. Through this funding, Southeast Mental Health Services has hired and trained six bachelors prepared Health Navigators to serve all residents of Prowers County who desire assistance from a Health Navigator at no cost to the resident.

Health Navigators will work to engage Prowers County residents in hopeful, respectful, and supportive relationships and create an environment where change is possible. With a focus on health rather than disease, the new program addresses the need to prevent disease across the population. A strong relationship can be a big motivator for change.

Alicia signed up to work with a Health Navigator during her last visit to her doctor.  They met and talked about what Alicia thought she was missing in her life.  She admitted that the extra weight she was carrying around made her feel sluggish and achy, but she didn’t have any motivation to exercise or lose weight.  She remembered her favorite childhood pet and thought that maybe if she had a dog who needed to be walked that she would be more motivated to get up and get moving.  She also admitted that she didn’t really know how to cook.  Her doctor told her to eat less sugar, fat and sodium, and more whole grains, but she wasn’t sure if she was making the right choices when it came to the microwaveable foods she ate.

Health Navigators help people with chronic health conditions to capture a healthy vision for themselves. They recognize the ways in which the person has already changed, even in ways they may be unaware, and honor the hard work that change entails. By finding out what change is most important to the person and exploring concrete strategies and resources for change, Health Navigators can be an important cheerleader or coach throughout the change process.

 Small changes matter. You cannot run a marathon without first being able to walk around the block. For some people, change can start with just walking across the room five times a day. Health Navigators help people see that change is possible when approached in small, incremental steps. They explain the change process and plan for success by setting specific weekly goals. They provide support by regularly checking in to see how it’s going, celebrate successes, or discuss alternatives if the individual is having difficulty.

Alicia and her Health Navigator put together a plan to make a few small changes that, over time, have helped Alicia to lose the 30 pounds she gained.  Alicia adopted a dog from the local shelter and walks it around the block a few times every morning and evening before dark.  She plays with the dog throughout the day, which gives her a wonderful sense of companionship.  The Health Navigator helped Alicia find a healthy cookbook that showed her how to make simple, healthy meals from scratch.  She also taught Alicia how to read a food label, so that when she didn’t have time to cook from scratch, she could make healthier choices in the frozen food aisle. 

 In addition to supporting patients by exploring behavioral changes, Health Navigators also support healthcare providers as part of the primary care practice team, and provide links to community resources. The Health Navigator helps the patient to communicate with their primary care provider to support self-management. They also help remove barriers to care by providing resources such as transportation, access to benefits, and patient education. As patients begin to “own” their health, they realize they have the power to impact their health through their behaviors, rather than just popping another expensive new pill.

 In all cases, the Health Navigator supports the patient in their self-management and reinforces provider recommendations that may include adopting healthy lifestyles, taking medications as prescribed, self-monitoring, making and keeping doctor’s appointments, and accessing preventive screening. The Health Navigator provides crucial integration with the Patient-Centered Medical Home to assure continuity of care and smooth transition between the community services and various components of the healthcare system.

Alicia signed up for a class in Chronic Disease Self-Management at her doctor’s office.  In the class, she met other women who had the same health concerns that she had, and learned new ways to manage her everyday health.  Because of her weight loss and change in eating habits, she no longer needs to take insulin to control her diabetes.  She took the money she used to buy insulin and saved up for a fancy new dog sweater so that she could continue walking her dog when the weather turned cold.  The Health Navigator congratulated Alicia on her success.

Health Navigators are now located at High Plains Community Health Center, Prowers Medical Center and Southeast Mental Health Services. There is no cost to any resident of Prowers County for Health Navigation Services. For more information about how to access Health Navigation services in Prowers County, call Jackie Brown, Primary Care Director at Southeast Health Group, (719) 336-9154.