The issues relating to health care aren’t new, participants at a state Department of Health town hall meeting said Thursday.
The issues relating to health care aren’t new, participants at a state Department of Health town hall meeting said Thursday.
Topping the list of challenges to managing chronic diseases was access to care, especially preventative care, and the need to educate people, particularly people with lower incomes and education levels, on the importance of preventative medicine.
“Lower income people have less awareness of these services,” Fern Forest resident Hannah Hedrick said. “A mother with five kids who has to take a bus to Hilo only goes when her kids are sick.”
The Department of Health’s Chronic Disease Management and Control Branch hosted the day-long meeting at King Kamehameha’s Kona Beach Hotel, asking people from across the health care provider spectrum for ideas to be included in a five-year, coordinated chronic disease strategic plan. The Kona meeting was the sixth of seven planned statewide, with department officials hoping to publish the end result in August.
In the realm of communitywide services, meeting attendees prioritized the desire to see help from nontraditional partners — food growers, restaurants, The Food Bank, grocery stores, for example. Incentives, including tax breaks, employer-subsidized gym memberships and health insurance discounts, might also increase people’s participation in health programs, attendees said.
Other things employers might do, said Chelsea Haina, of the John A. Burns School of Medicine HEALTHY Quit Smoking Program, might be offering healthier food options in a workplace cafeteria and schedule flexibility for people who want to avoid heavy traffic congestion or who want to walk to work.
One community effort to get people to eat more fresh fruits and vegetables already under way in Kohala, the American Cancer Society’s Maile Lincoln Carvalho said, are community harvests.
“Whatever you have in your yard you can bring in and share,” she said.
In return, people who bring their excess mangoes, for example, could take home something someone else brought, she said.
Coordination is also key, attendees said.
“We have lots of big groups and lots of small groups,” Kaiser Permanente’s Alison Welch said. “The idea is to coordinate who is doing what and when.”
Educational suggestions included having the Department of Health and Department of Education develop curriculum integrating healthy lifestyles into all content areas, such as incorporating movement into math.
“That we really think of creative ways that (movement) becomes part of content curriculum,” Krista Olson of Family Support Hawaii said.
Schools should work to continue to improve meals, using more locally grown food, she added. School food authorities should be created to help schools overcome barriers, including procurement requirements, to offering local fruits and vegetables, she said.
Health service providers need to emphasize disease prevention, attendees said.
“Recognize the health care system reimburses diseases and not prevention,” DOH public health nurse Kathleen Mishina said. “Insurance companies really drive the health care system. It’s not the providers.”
A top suggestion from that discussion was to find ways to use students in university medical care programs, like the University of Hawaii-Hilo College of Pharmacy, to provide health services while studying in the community.
“It takes a community, everybody, to get healthy,” Welch said.
Welch also brought up one concern voiced by several people during breaks in the meeting — meetings are fine, but many meetings don’t result in action or follow up.
“You have a right for a return on your investment (of time),” meeting facilitator Jeff Schwartz said. “You ought to hold the department accountable for following up.”