PRESQUE ISLE, Maine — Aroostook County health care leaders gathered in Presque Isle, Houlton and Fort Kent Monday to learn about the region’s evolving community health needs.
Under the 2010 Affordable Care Act, all tax-exempt hospitals must complete community health needs assessments every three years to identify health trends in their region and tailor their services accordingly. Maine’s hospitals are in the second round of community health needs assessments, and they collaborate together with other health organizations to collect data on different health issues in a given region and track their progress.
Greg LaFrancois, president of The Aroostook Medical Center, said at the Presque Isle forum that the needs assessments have been valuable in looking ahead and helping guide planning.
“Do we have the kind of services necessary for the changing demographics in our area? Are we addressing emerging needs?”
TAMC, Aroostook County’s largest health care provider, has made changes that include increasing behavioral and mental health services in response to the opioid addiction crisis.
“We’ve been able to invest in behavioral health in between the two needs assessments, and doubled our provider staff in that regard,” LaFrancois said. The opioid epidemic has “ballooned since we did our first survey and our engagement there has really stepped up.”
A walker encounters a smoker across from the high school on the Presque Isle pedestrian trail in December 2015. Fifteen percent of Aroostook County high schoolers reported smoking at least once in the last month when polled for the 2015 youth health survey. (Anthony Brino)
Aroostook County’s report includes more than 200 health data indicators covering demographics, diseases, behaviors, and economic and social factors, said Natalie Truesdell, program manager with public health consulting firm John Snow, Inc., which prepared the report.
The reports, available for each county, shows how different parts of the state are fairing over time and how they compare to each other in terms of different health trends, Truesdell said.
One indicator is for preventable death, measured in years of potential life lost, she said.
“Years of potential life loss measures premature death before the age of 75. Aroostook County is showing an increase and it’s also significantly higher than the state. This helps call to attention preventable death.”
Aroostook County’s years of potential life lost per 100,000 people stood at 7,808 in 2016, compared to 6,529 in Maine and 6,658 across the United States.
Another indicator showing Aroostook County struggling is in food insecurity, the inability to access enough nutritional food.
“Aroostook County is one of the six counties in Maine where over 16 percent of households are food insecure,” Truesdell said. “It is well-documented how food insecurity is linked to poor health outcomes, including obesity.”
Other indicators also show disparities between Aroostook County and the rest of the state.
Aroostook County has 17.7 percent of the population living in poverty, compared to the statewide average of 13.5 percent, according to the report. Almost 24 percent of Aroostook County kids live in poverty, compared to 17 percent statewide.
Among health issues in Aroostook County that have gotten worse since the first assessment are high school obesity and suicide. The obesity rate among Aroostook County high schoolers increased from 14.7 percent in 2011 to 20.9 percent in 2017, compared to the statewide average of 15 percent.
Aroostook County’s suicide deaths increased from a rate of 13.7 per 100,000 people in 2011 to 21.4 per 100,000 people in 2016, compared to 15.9 across the state and 13.5 in the U.S.
In other areas, Aroostook County is making progress.
While Aroostook County’s adult smoking rate remains virtually unchanged, with 26 percent of adults smoking tobacco, the smoking rate among high school students is down from 16.8 percent in 2011 to 13.4 percent in 2017.
Over the last decade, Aroostook County cancer deaths have declined, from 199 deaths per 100,000 people between the period of 2007-2011 to 174 between 2012-2016. The statewide average is 173 and the nationwide average is 163.
Deaths from cardiovascular disease, heart attacks and strokes also have declined in Aroostook County, although they remain higher than the state averages.
Aroostook County also has seen progress in the environmental health factor of lead levels in children. The percentage of children with elevated lead levels in Aroostook County declined from 2.4 percent in the period of 2003-2007 to 0.7 percent in 2012-2016. The statewide average as of 2016 remains higher than in Aroostook County, with 2.2 percent of children showing elevated lead levels.
