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Health chief: South Carolina faces range of wellness challenges

By Christina Knauss //May 17, 2024//

Maya Pack is executive director of the South Carolina Institute of Medicine and Public Health. (Photo/South Carolina Institute of Medicine and Public Health)

Maya Pack is executive director of the South Carolina Institute of Medicine and Public Health. (Photo/South Carolina Institute of Medicine and Public Health)

Maya Pack is executive director of the South Carolina Institute of Medicine and Public Health. (Photo/South Carolina Institute of Medicine and Public Health)

Maya Pack is executive director of the South Carolina Institute of Medicine and Public Health. (Photo/South Carolina Institute of Medicine and Public Health)

Health chief: South Carolina faces range of wellness challenges

By Christina Knauss //May 17, 2024//

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South Carolina has changed dramatically in the past 15 years. The population has surged with an influx of retirees, people who moved to the state during the COVID-19 pandemic and workers following job opportunities, and the economy has also surged with an influx of new companies and industries broadening the state’s business landscape.

For the past 15 years, Maya Pack has witnessed those changes and what it means for the health of South Carolinians in her role as executive director of the South Carolina Institute of Medicine and Public Health, an independent nonprofit organization focused on collectively informing public policy to improve health and health care statewide. As she reflected on her 15th anniversary with IMPH, Pack took time to reflect on the state of public health in South Carolina and some major initiatives IMPH has pursued to improve the health landscape statewide.

While public health has made great strides in some areas, Pack said, the state’s public health still lags behind in many areas because of poverty, a lack of readily available health care in rural regions and a shortage of health care providers and workers adequate to serve the growing and rapidly aging population. The COVID-19 pandemic also took a toll on not only the physical but mental health of many South Carolinians, particularly adolescents and senior citizens, and many rural residents face long drives to get the care they need because rural hospitals and doctors’ offices in many rural areas have either closed or dialed back their services for a wide variety of reasons, ranging from the impact of natural disasters like hurricanes and floods to financial concerns.

“We’ve made a lot of strides in a lot of areas, especially where we as a state have come together and made concerted investments in programs to prevent illness or care for people who are ill,” Pack said. “However, because of COVID-19 and the trend over the last decade of record numbers of deaths due to opioids and suicide, we’re actually facing a decline in our life expectancy, not only in South Carolina but in the U.S. as a whole.”

The state has made improvements over the past 15 years in some areas, ranging from increases in programs that help people gain access to preventative care and healthy food to a decline in the rate of childhood poverty.

There are other hopeful signs, including an increase in the number of women statewide who have access to mammography services to detect breast cancer. This is one of the areas where South Carolina, which regularly ranks low in many health care studies, beats the national average – 48% of women on Medicare in the state are receiving adequate mammography testing as opposed to a national average of 43%. The state still needs to improve its averages on the number of people receiving other preventative screening tests and on efforts to treat and prevent chronic diseases such as heart disease, high blood pressure diabetes and cancer, Pack said.

A lot of work needs to be done across a wide range of issues, Pack said, especially in improving access to behavioral and mental health for all residents, especially young people.

Some major public health issues IMPH has focused on in recent years include:

Improving the health care workforce. The state’s health care workforce took a hit during and after the COVID-19 pandemic when many health care providers left the workforce, and not enough young people are seeking health care careers to serve the rapidly growing population.

“All the insurance access in the world doesn’t matter if there aren’t enough clinicians to address the population,” Pack said. “Statistics sometimes look like we have enough providers for our population, but what we have is a lot of physicians living in our urban areas, and not in our rural areas. The question is how can we have other health care professionals working to their maximum capacity so that people can access primary care services locally and only have to travel for specialized care?”

One answer to the problem is to increase the number of professionals like nurse practitioners in rural areas, while another is to increase the number of non-clinical workers in areas like social services and non-profits who can also have an impact on improving residents’ access to health care and other initiatives to improve health in general.

Opioid settlement funds. In February 2022, the National Prescription Opiate Litigation Plaintiffs’ Executive Committee finalized $26 billion in settlements with three of the nation’s top wholesale pharmaceutical drug distributors — AmerisourceBergen, Cardinal Health and McKesson and opiod manufacturer Johnson & Johnson. South Carolina Attorney General Alan WIlson worked with the state’s 46 counties and eligible municipalities to allocate more than $360 million from the settlement over the next 18 years, with 92% of the funds set aside for requests from the counties, 43 municipalities and the Health Services District of Kershaw County. More than $100 million will also be available for disbursement to entities such as nonprofits, state agencies and others working to help address the epidemic.

Approved uses for the funds include expanding access to NARCAN and other approved medication to stop opioid overdoses, providing recovery and support programs for those recovering from opioid addiction, and increasing education about opioid addiction and expanding prevention programs.

Social isolation and mental health. IMPH did extensive studies on the impact of COVID-19 on the state’s population, and discovered that mental health problems such as depression and anxiety related to the pandemic have had a lingering effect on much of the population. Out of those studies came the realization that an increased focus needs to be placed on improving access to mental health care statewide, particularly for young people.

IMPH also looked in depth at the effect social isolation had on the aging population, particularly those with little or no access to transportation to health care appointments or other activities.

“I think the silver lining of the pandemic of COVID-19 is that we realized how important social connection is not only to mental health but also to physical health,” Pack said.

IMPH brought together experts to study ways to improve social connection and transportation for the state’s senior citizens, particularly in rural areas. In many areas, volunteers from nonprofit organizations offer rides for older people to access medical appointments and other needs. But there are insurance concerns with volunteer drivers.

“We just published a policy brief about volunteer drivers because our state doesn’t have any policies to protect volunteer drivers when it comes to insurance, and we’re exploring opportunities to change state law to better balance the needs of these drivers with those of the aging adults they’re transporting,” she said.

Business owners can play a big part in helping to improve public health in the state, Pack said. The most important thing they can do is to provide health insurance for employees when possible, and as much as possible also offer assistance in navigating the often complicated health care system. She also encourages businesses to do what they can to offer on-site opportunities to improve physical and mental health. Ways to do that can range from designing a company’s campus to offer green space for outdoor exercise or walking during lunch hours, or something as simple as providing a quiet space where employees could go if they need some down time.

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