As a teenager in the 1970s in Farmington, I became accustomed to seeing nurse Sandy Record taking blood pressures at grange suppers and Dr. Burgess Record advocating for a community pool. We received our care in a community health center accessible to everyone, no matter what their income. It offered comprehensive services, including primary care, behavioral health and oral health.
The local community action program, schools, the university, churches and employers worked together with these and other health care providers to ensure it was easier for us to make healthy choices, to get screened for major risk factors and to get the care we needed.
In 1989, a number of these prevention efforts coalesced into a broad coalition supported by the hospital, the Healthy Community Coalition.
Preliminary data in the mid- to late-1990s of what had become known as the Franklin Model showed improved health outcomes. When Burgess Record and others shared their data with legislators, health advocates, then-Gov. Angus King, and those of us in Maine state government, they were compelling enough that we sought ways to expand this model statewide.
As Maine signed on with the Tobacco Master Settlement Agreement in 1998 in order to settle any potential lawsuits against the tobacco industry for recovery of costs incurred by taxpayers for tobacco, it seemed only appropriate that these funds be used to effectively address tobacco and related health care costs.
Partly as a result of the compelling data from the Franklin Model, Maine policymakers decided to appropriate funds to create the Healthy Maine Partnerships, a statewide network of comprehensive community health coalitions to address tobacco, obesity, chronic diseases and other health issues at the community level, working closely with local health care providers and many partners.
Meanwhile, Maine’s network of community health centers has expanded, and many of our health care practices, including those community health centers, have integrated behavioral health and oral health with primary care, similar to what was offered in earlier versions in the 1970s in Franklin County.
A recent Journal of the American Medical Association featured an article authored by Burgess and Sandy Record and others who started the Franklin Model. Their research shows a substantial reduction in hospitalizations, mortality, health care costs, as well as improved risk factors for chronic diseases, associated with the 40-plus years of this work. Although results elsewhere have shown the benefits of such prevention efforts, it is validating to have our own data from right here in Maine.
The results were so impressive that the journal’s editorial highlights this research and concludes that this report “should reinforce the importance of cardiovascular health promotion and disease prevention policies and practices at the community level … at a time when population health is increasingly important, the Franklin County program demonstrates that with an integrated, concerted effort based on good evidence, the cardiovascular health of a community can be improved.”
As a teenager in Franklin County, I did not realize how fortunate we were to have a coalition of partners and integrated health care working to improve the health of our community.
Today, we are all fortunate to have such community health coalitions (the Healthy Maine Partnerships) as well as community health centers and others offering integrated primary care, oral health and behavioral health across Maine. And we now have the research to show that these multi-sector, communitywide prevention interventions combined with access to integrated health care are associated with significantly improved health and reduced health care costs.
Dr. Dora Anne Mills is vice president for clinical affairs at the University of New England. She is a former director of the Maine Center for Disease Control and Prevention. Her column originally appeared in the Jan. 20 Bangor Daily News.
