Tennessee's problems with rural health care are closely tied to poor economic and educational performance, a group of regional government and health care officials heard Friday.
"By the time someone is 25, you can predict how many more years they will live based on their level of education," Dr. Randy Wykoff, dean of East Tennessee State University's College of Public Health, told attendees at a half-day conference on rural health care organized by the Southeast Tennessee Development District. "There is a 5- to 7-year difference depending on whether they drop out of high school or graduate from college."
Poverty has a similar impact, Wykoff said.
"A poor American is three times more likely to die before age 65 than a rich American," he said.
Wykoff noted that Tennessee ranks in the bottom 10 of all states in most health care rankings, with many more citizens who smoke, abuse drugs or are overweight, and those behaviors are even worse in the Appalachian counties of middle and east Tennessee.
If Tennesseans improved just to the national level of smoking and obesity, the state would save $900 million in health care expenses annually, Wykoff said. "Why should someone born in Appalachia in Tennessee be more likely to die than someone born elsewhere?" he asked.
The challenge is not just to improve health care but also to improve education and economic opportunity, Wykoff said. Whether students graduate from high school, for example, is closely related to their ability to read at the proper grade level, a problem that can start even before elementary school.
Having a well-educated workforce is also critical in convincing companies to move to rural counties, several county officials agreed. And decent access to health care can be the determining factor in whether residents stay or move elsewhere.
Joe Guy, McMinn County sheriff and president of the Tennessee Sheriffs Association, discussed how health care problems affect law enforcement as well as county budgets. Increasingly, he said, sheriff's departments are forced to deal with people with mental health problems, because the state is not spending enough funds on treating them.
"When we pick someone up who is mentally ill and has been committed to Moccasin Bend, they are placed in the back of a sheriff's patrol car and handcuffed," he said. "If we handcuffed a cancer patient and took them to treatment, somebody would lose their mind. And that is after they have sat in the emergency room or in jail for four or five days while waiting for a bed to open up at Moccasin Bend. We are not treating the mentally ill — their access to services is not there," he said.
He noted that when someone who is mentally ill or has other medical problems is held at a county jail, taxpayers pick up the tab, adding to the pressure on local government budgets.
The meeting was not all about the problems facing the state. There was also discussion of programs that seem to be working.
Kelly Hill, vice president of GoNoodle, explained her company's success in getting teachers and schoolkids to use videos to exercise in the classroom. The program is free to schools in Tennessee, courtesy of the BlueCross BlueShield Foundation.
Brenda Choate, human resources manager at Cormetech Inc., a Cleveland-based company that makes pollution control equipment, explained her company's wellness program that she said has helped workers lose weight and adopt a more healthy lifestyle. The company offers a $40 reduction in monthly health insurance payments, for example, to employees who earn enough points by exercising or attending health fairs.
Vickie Harden, senior vice president at Volunteer Behavioral Health Care Systems, said she hoped increased use of telemedicine, in which schools or family doctors use a video link to connect doctors who are specialists to those who need them, will allow more efficient use of limited resources. Volunteer, which owns the Joe Johnson Mental Health Center in Chattanooga, has done more than 10,000 telemedicine visits for patients with mental health issues, she said.
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