Improving health in the Finger Lakes requires a new approach that goes beyond medical interventions, a regional commission on health has concluded. Recognizing that the majority of health outcomes are determined by behaviors and environmental influences outside the doctor’s office, the commission called for a community-wide focus on preventing chronic diseases like obesity and tobacco addiction and increased efforts to connect clinical, behavioral health and community-based services.

Members of the Regional Commission on Community Health Improvement listen to a Jan. 8, 2015, presentation on workforce needs by FLHSA CEO Trilby de Jung. (Photo by Brandon Vick)

“The epidemics of the last century were conquered in large part though the miracles of modern medicine,” said Stephen Ashley, chair of the Regional Commission on Community Health Improvement, which announced its recommendations July 14. “But today’s health challenges are in many ways more complex. We can’t immunize our children against obesity or write a prescription for homelessness.” said Ashley, CEO of The Ashley Group.

Convened by the Finger Lakes Health Systems Agency, the commission and its workgroups drew on the expertise of 150 regional leaders from public health, human services, health care, community-based organizations and other health-related fields. Over the past 18 months, the groups reviewed dozens of studies and extensive health data from the nine county region, identifying prevention, senior care, and mental illness and addiction as the most pressing health challenges and endorsing a series of collaborative, evidence-based solutions.

The 25-page Blueprint for Community Health Improvement, an executive summary and supporting research are available online.

“The power of the commission’s recommendations is not just that they are grounded in facts and proven interventions, but also that they represent the consensus of diverse regional leaders,” said Trilby de Jung, CEO of Finger Lakes Health Systems Agency. Such community-wide endorsement is key to helping our region attract federal, state and private funding for community health initiatives, she said, noting that the successful bid for the region’s $26.6 million Center for Medicare and Medicaid Innovation grant was based largely on such broad consensus.

To track progress on health outcomes going forward, the commission adopted 17 community health indicators that Finger Lake Health Systems Agency committed to report on for 10 years. The measures include rates for immunization, obesity, high school graduation, nursing home usage and emergency room visits for individuals with a mental health diagnosis.

Mental health should be an integral part of health care – not handled through a separate system as it is today. New York State Department of Health data show that behavioral health, which includes mental health and substance abuse disorders, was the primary or secondary diagnosis for 45 percent of all hospital admissions in the Finger Lakes region in 2011. Suicide also ranks as the fifth leading cause of years of potential life lost for our region. The commission recommends improving access to behavioral health care, using social media to decrease the stigma around seeking help and finding ways to bring mental health into primary care.

The number of seniors living with a chronic condition is expected to double between 2000 and 2030. At the same time, the ability of families to informally care for seniors is expected to decline due in part to smaller families, a higher percentage of women working outside the home and family members living far away. In our region, the ratio of family members available to care for aging parents is expected to decrease from 6.6 to 1 in 2007 to 5.6 to 1 in 2025. To handle the growing demand for senior care, the commission called for training more skilled caregivers and for using care teams to coordinate the complex medical needs of aging patients.

Health care workers are already in short supply and that problem will intensify without a coordinated response.  Along with the increasing need for senior care, the shift to preventative and integrated care calls for the creation of new types of professionals, such as care managers who can help patients prevent and manage complex chronic conditions. At the commission’s request, Finger Lakes Health Systems agency will bring together a regional consortium to coordinate local and state efforts around workforce, including the development of training programs for the health care jobs of the future.  

Sharing electronic medical records among providers is critical to creating better care. Many of the efforts to improve care through coordination and integration rely on the ability of multiple clinicians to access a patient’s medical records. The commission recognized a need for a collaborative approach to resolving software and regulatory barriers to the free flow of information among providers, while maintaining confidentiality and security of data.