How will health care reform affect Big Island residents?

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HILO — This week’s Supreme Court decision upholding the majority of President Barack Obama’s health care reform package could play a large role in improving the health of Hawaii Island residents. So say the administrators of two efforts focused on tracking health outcomes and improving access to health care in Hawaii County.

HILO — This week’s Supreme Court decision upholding the majority of President Barack Obama’s health care reform package could play a large role in improving the health of Hawaii Island residents. So say the administrators of two efforts focused on tracking health outcomes and improving access to health care in Hawaii County.

However, they added, the Big Isle has a big hole to climb out of, with recent county rankings showing Hawaii lagging behind the rest of the state in a number of key areas.

“(Thursday’s) Supreme Court ruling could help Hawaii County improve the health of its residents. I am more optimistic today that the relatively poor health in Hawaii County could improve over the next 10 years,” said Sharon Vitousek, director of the North Hawaii Outcomes Project and current chairwoman of the Hawaii Island Beacon board. The board oversees the use of a $16 million federal grant awarded in 2010 with the intent of improving access to health care in Hawaii County.

“Of course, improvement will take lots more work in addition to implementing health reform. The good news is that much of that work has already started.”

Vitousek said Friday that one of the biggest advantages that the reform package provides is its focus on primary care providers and their reimbursement.

“It will help us retain more primary care providers, and if we have more primary care providers, then chronic disease can be detected at an earlier stage when it is treatable. Then it won’t progress to more severe problems that would require hospitalization or surgery,” she said.

Susan Hunt, CEO of the Beacon Project, agreed that attracting primary care physicians and health workers is a common goal her organization shares with the architects of the president’s health care reform.

“(Thursday’s) ruling confirms that the Hawaii Island Beacon Project is on the right track with its island-wide effort to improve access to primary care by supporting providers in becoming effective users of electronic health records, which in turn helps them become more effective in managing the care of their patients.”

New data released in the last few weeks shows that Hawaii Island residents’ health continues to lag behind that of others in the state. Measures of the island’s death rate, and rate of chronic conditions like diabetes and obesity, show that more needs to be done to prevent chronic diseases from becoming bigger problems.

One good example is that of high blood pressure, Vitousek said. While the number of people who have been diagnosed with high blood pressure on Hawaii Island is the same as the state average, at 30.7 percent, there is a clear difference between the number of people who report that they are currently taking medicine to keep their blood pressure in check and those who are not. In 2009, only 72.9 percent of Hawaii County residents with hypertension reported taking medication, while 78.7 percent of hypertensive patients statewide did the same.

Meanwhile, the county’s coronary heart disease death rates are significantly higher than those of the rest of the state. In 2009, the Big Isle’s death rate was 93.4 per 100,000 people, while the state average was 77.6.

“It’s going to take five to 10 years to see substantial changes,” Vitousek said. “It’s not going to happen with just reform alone. We need to make sure we have more primary care providers on the island, and I think if the family residency program goes through, I think that will help.”

Hawaii Island’s residency program is an effort to attract young doctors as they are launching their careers. By providing a training ground for them to complete their residency requirements, organizers hope that the program will convince doctors to stay and set up shop on the island once they are done. Getting the program off the ground has been a central goal for the Beacon Project and groups like the Hawaii Island Healthcare Alliance and the North Hawaii Outcomes Project.