MADISON AMONG THE HEALTHIEST COUNTIES IN NYS, OSWEGO, ONEIDA AMONG THE WORST

BY DEBORAH JEANNE SERGEANT

Of New York’s 62 counties, the County Health Rankings & Roadmaps 2022 ranked two counties in Central New York among the worst in the state when it comes to health outcomes. Oneida ranked No. 52 and Oswego No. 47. In the middle of the pack is Onondaga, which ranked No. 32. The healthiest county in Central New York was Madison, which ranked at No. 9 in the state.

The rankings — (www.countyhealthrankings.org) funded by the Robert Wood Johnson Foundation — were determined by health behaviors (tobacco use, diet, exercise, alcohol and drug use, and sexual activity), clinical care (access and quality or care), and social economic factors (education, employment, income, family and social support and community safety), and physical environment (air and water quality, housing and transit).

So, what sets Madison County apart?

Since 2016, Madison County has engaged in a community health improvement plan to assess and measure its markers of community health, which include mental health, substance abuse and cancer as top priorities. The county also stated health objectives, identified collaborative resources in the community, set goals and processes for meeting the objectives and the outcomes of these endeavors.

Erica Bird, quality improvement coordinator with Madison County Health Department, said that the plan gives officials health indicators to measure the county’s progress. “Through those, we can evaluate what we do well. There are several issues on there that we do well, which are attributable to our strong programs and partnerships with community-based organizations.”

One example of how Madison does well is its Healthy Beginnings Providers Network, a coalition that works with maternal and child health providers and community health organizations to follow child and maternal health outcomes. A few objectives include reducing the rates of preterm birth and low birthrates and increasing breastfeeding rates.

One of the innovative ways of assessing public health is wastewater testing. Bird said that the county began using this strategy to monitor infectious diseases but has more recently begun testing it for substances like opioids to “track a baseline and look for spikes,” she said. “We’ll have the ability to communicate that and connect people who are struggling with resources.”

Monitoring wastewater can provide more accurate feedback than self-reporting.

Another way in which Madison County has improved health outcomes is through education.

“Community awareness and promotion is one of our key roles in the health department,” Bird said. “Some of those hot-button or emerging issues, we do a good job of promoting and educating community members and making sure we’re relating it back to how it affects their life.”

Rebecca Shultz, director of community health for Onondaga County Department of Health, thinks that Onondaga County scores well in clinical care.

“We are fortunate to be relatively resource rich when it comes to healthcare services,” Shultz said. “We also tend to score above average with respect to our physical environment.”

But areas in which the county could improve include those associated with social and economic factors and health behaviors. Factors such as education, housing, employment, poverty and safety influence

“To address these issues, Onondaga County Health Department works closely with community partners to address disparities, advance health equity, and implement systems, policy, and environmental changes that facilitate improved health outcomes,” Shultz said. “In addition, the county has recently made significant investments in sectors that impact social determinants of health, including early childhood education, lead poisoning prevention, and mental health and substance use initiatives.”

Fostering motivation to engage in healthful behaviors plays a big role in health outcomes. That’s an area challenging some community members in CNY counties. The desire to participate in physical exercise represents one example.

“Everyone wants to be healthy and work out. However, not everyone does,” said Jill Murphy, certified personal trainer and co-owner of Mission Fitness E. Syracuse.

A large part of what she does as a trainer is keep clients motivated to move.

Paula Pacini, exercise coordinator at the JCC, has observed that motivators for exercise and other healthful habits vary among people.

“Some have appearance and weight,” Pacini said. “For others, it’s about the health risks of not working out, which is more important.”

An event such as a class reunion may spur the former to lose weight. That likely will not result in lasting changes to behav ior. For others, a serious health concern such as becoming prediabetic, may form the catalyst for lifelong improved health behaviors.

“People have to have the motivation to work out,” Pacini said. “I’ve been teach ing it 35 years and all different popula tions. What I’m finding is the pandemic has really slowed people down from com ing back to gyms. They have to motivate themselves. They need to find an activi ty they like. If your friend says, ‘Come to yoga’ and you don’t like it, you won’t do it. Instead, find something you like and stay with it.”

Pacini also views engaging in physical activity as a means of setting a good exam ple to children and grandchildren, since children establish behavioral patterns early in life. But starting healthful habits later is better than never.

The Centers for Disease Control and Prevention supports the physical activity guidelines for Americans: a minimum of 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity physical activity per week, or a combination of both.

“You have to want to do it,” Pacini said. “It does not take much time, but adds years to your life.”