A month after the national wellness company Blue Zones pulled out of Charleston, a coalition of Lowcountry individuals and organizations has released a report outlining ways to improve the region’s health over the next five years.
“People have done needs assessments for decades,” said Mark Dickson, vice president of the mission department at Roper St. Francis. “Unfortunately, they usually sit on the shelf and collect dust. This one ... forced us to listen to the community, to find out what the real needs are in the community.”
The Tri-County Health Improvement Plan (.pdf), released at the end of October by Healthy Tri-County, prioritizes five topics that were ranked as most important by over 1,500 community members: access to health care; behavioral health; clinical preventive services; maternal, infant and child health; and obesity, nutrition and physical activity.
The plan took 80 volunteers and 60 organizations approximately 2,300 hours to develop over a 12-month period. Over half the organizations were nonprofits, but 24% of the organizations were businesses and another 24% were government entities.
“This is not a top-down plan that we are forcing on the community,” said Kellye
McKenzie, director of health for Trident United Way. “This is something that truly was forged in partnership with our community members with lived experience.”
The S.C. Department of Health and Environmental Control provided technical assistance on the plan, and R. Taylor Lee, DHEC’s public health director for the Lowcountry, said the department will continue to support the plan during its implementation.
“The ultimate goal of this initiative is improving the health and well-being of every person and community in the tri-county area,” he said.
Parallel to the five health priorities, the plan incorporates the promotion of equitable health outcomes in its recommendations.
“Health is more than just health care,” said Anton Gunn, executive director of community health innovation and chief diversity officer at MUSC. “The social conditions matter. ... Health is tied directly to the distribution of resources in our community. The single strongest predictor of our health is our position on the class pyramid — or another way to put that, the biggest thing that determines your life expectancy is your ZIP code.”
According to county health rankings by the University of Wisconsin’s Population Health Institute, Beaufort County has the highest health outcomes ranking in South Carolina and Marlboro County the lowest. In Beaufort County in 2016, 19% of children lived in poverty and the unemployment rate was 4.9%; at the same time in Marlboro County, 41% of children lived in poverty and the unemployment rate was 8.2%.
Berkeley County was ranked No. 7 in health outcomes by the institute; Charleston County was ranked No. 3; and Dorchester County was ranked No. 6.
‘Take action and create change’
Each of the five priorities in the report includes a set of goals and recommendations for achieving them in the next five years.
The goals are broad and mainly focus on increasing public awareness and access to services already available in the tri-county area, including the MUSC Center for Telehealth; Fetter Health Care Network, which provides health services regardless of someone’s ability to pay; and Help Me Grow South Carolina, a program that links families to resources and services for children at risk for developmental, behavioral or learning problems.
Several priorities also encourage advocacy for certain policies, including accurate, evidence-based sexual health education in schools and safer “active living routes,” such as bicycle and pedestrian trails.
Several priorities also end up overlapping in the plan, making access to health care an overarching theme across the other four priorities. For example, better access to health care helps improve cancer screenings and other clinical preventative services, as well as access to and knowledge of behavioral health resources.
In addition to the 28-page health improvement plan, Healthy Tri-County also released an eight-page community action guide (.pdf) to help community-based organizations and individuals take action by creating or joining support groups and using established networks to promote healthier behaviors, such as sharing recipes and promoting cancer screenings.
Gunn said the plan is “strategic and decisive” about the issues that it covers. “We know we can’t do everything. ... But if we make a decision to be strategic, we will have monumental impact,” he said.
Gunn said other regions in the country have developed similar plans — Healthy Tri-County based its plan’s framework off of the Maine State Health Improvement Plan — but the Tri-County Health Improvement Plan is the first of its kind for the Lowcountry.
Lorraine Lutton, president and CEO of Roper St. Francis, said the plan is “daunting but it’s inspiring, and I know we can do it.”
“We are committed to making sure that access is important to all of us,” she said. “With the rising uninsured rate ... we want to make sure that there’s no barrier to someone having access to care, and that is our mission and our commitment.”
Gunn said it’s up to every member of the community to “take action and create change.”
“You can have the greatest plan in the world,” he said. “You can spend all the time putting all of the right dots in the right places, crossing the T’s, lining up arrows, focusing on retention. You can do all of those things, but if you don’t take action, nothing will change.”
‘Spreading the gospel’
McKenzie said now that the plan is out in the world, the next step is letting people know.
“Over the next couple of months, we’re going to be spreading the gospel and sharing the word about the TChip (Tri-County Health Improvement Plan),” she said.
McKenzie said MUSC will work to educate the business community, academia and health care institutions; Roper St. Francis will work with health care institutions and faith-based communities; and Trident United Way will work with the nonprofit and social services sectors.
“We want to do a very concerted, strategic effort to ensure that this plan gets out into the community,” McKenzie said.
She added that the only way the plan works is if community members in Berkeley, Charleston and Dorchester counties feel ownership of the plan. With that in mind, Healthy Tri-County is releasing a campaign in January asking citizens to sign a pledge to live a healthier lifestyle.
Healthy Tri-County will also monitor health outcomes in the region over the next five years, releasing formal evaluations every six months about the progress of the plan.
“We’re committed to transparency,” McKenzie said. “We know some things are going to work and some things aren’t going to work, and we’re going to be working with you (the community) to course-correct and make sure that we reach the ultimate goals that are outlined in the plan.”
McKenzie said Healthy Tri-County is also actively pursuing grants and private funding to continue its work, as well as identifying other resources that could help implement the Tri-County Health Improvement Plan.