Kimball County least healthy in the state

A recent report has declared Kimball County to be the least healthy in the state of Nebraska.

The report, conducted annually by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, ranks the overall health of Nebraska’s counties based on several factors including adult smoking, adult obesity, birth weight, college attendance, physical activity, and access to physicians.

Out of the 93 counties in the state, 79 were ranked in the report with the remainder, including Banner County, being too small in population to provide useful data. Kimball County was ranked 79 out of the counties in the report for the second year in a row.

However, the county has shown some improvement over last year’s figures most notably in the adult smoking category, decreasing by three percent from 28 percent in 2013 to 25 percent in 2014. Low birth weight has also decreased slightly from last year resting at 9.3 percent, a 1.2 percent difference from the 10.5 percent of the previous year.

Though the county has started to make progress in some key areas, adult obesity has risen to 31 percent over the 28 percent found last year.

Some might see the results of the study as disheartening. However, Ken Hunter, Kimball Health Services CEO, sees it as a wake up call and a tool that the hospital can use to better address the health needs of the county.

“I think it was a good wake up call for us. We’ve been busy. We know that not all of the statistics were accurate but certainly there was enough to indicate that we needed to be more proactive. That’s been a good thing,” Hunter said.

In moving forward with a proactive approach since last year’s report named Kimball least healthy, the hospital has started to offer smoking cessation classes along with starting a pre-diabetes group in order to address the two main issues revealed by the report.

“That’s been very successful. Of course, one of the goals, there are several, but one of the goals is to lose weight. I can’t remember how many pounds it was total that the group lost, but it was substantial. It involved exercise, and it was kind of neat to see the interrelations of the group members. Because they really rely on each other,” Hunter said.

The hospital has also expanded the hours of the clinic in the past year in order to increase the availability of health care to local residents and hopefully cut down on emergency room visits.

“Our emergency room visits are down by 25 percent. We think that perhaps it partly is a result of being able to come to the clinic sooner because of expanded hours but also we think that maybe we’re preventing some of those emergency room visits. We certainly hope we are,” Hunter said.

They are also participating in new programs and using new models to address both individual needs along with addressing and identifying the greater needs of the community.

“We are now participating in a program called Patient Centered Medical Home where you look at individuals with their diagnosis but also the whole community and make sure that you’re utilizing best practice. If you’re not, why aren’t you? Sometimes there’s a reason not to be,” Hunter said.

In keeping with the Patient-Centered Medical Home model, the hospital has set goals within the community for how to utilize the hospitals resources for the betterment of the local community.

“We purchased the school, and we had three goals for the school. There are more than three, but we didn’t want to try everything all at once. One was community daycare and after school program, and I’ve heard that’s going well. I’m on the board. That’s actually ran by Volunteers of America. We just lease the space to them,” Hunter said.

Along with focusing on the physical health needs of the community, the hospital is starting to push to address mental health issues through seeking to offer counseling to people in need of such services throughout the county.

“We are interviewing counselors now. We’re looking for a licensed social worker, and we need to contract with a site nurse practitioner. We’ve signed a contract. We’ve got all the equipment to do telepsych with Cheyenne, and they’ve got five psychiatrists on staff. Conceivably, we can have a child in the Kimball school system that we could evaluate and actually have them meet their parents and child with an adolescent psychiatrist via telemedicine. Healthy body, healthy mind. You’ve got to have both,” Hunter said.

The hospital is also currently offering group counseling through the Circle of Security program.

“We have it at north campus. Referrals can either come through the school or through the courts or we publicize it too. What they found is that obviously parents need some guidance. Often, they don’t have the parenting skills. And so in this Circle of Security, we utilize the dynamics of group therapy which work with a lot of different things. You learn that you’re not the only one and other people have problems and try to build a network of people to help each other. It’s gone very well ,. Robin Tjosvold runs that program, and she went for training and is actually trained to even be a trainer now,” Hunter said.

They have also started strengthening relationships with other medical centers throughout the region in order to expand their reach and resources.

“The needs of the community, one of the things we’re working on right now is to have a relationship where we’ll do women’s health here at the hospital, yet either have a relationship with an OB (obstetrician) that will come down and see our patients or, in fact, have one of our providers actually have privileges somewhere else and deliver the child there. We don’t have that person as of yet, but we are looking for a person to do that,” Hunter said.

Hunter has also met with medical professionals at the hospital in Sidney in order to coordinate treatment for patients that get their medical needs addressed at both facilities.

“A lot of people actually get care at both places. They may go to the clinic over here but then for more serious things go there. For instance, they do oncology over there. So I’ve got a meeting with the hospital over there to talk about referrals and working together. And there’s a lot of growth in the Sidney area. We’re actually seeing some people move here that are actually working at Cabela’s and can’t find housing at an appropriate cost in Sidney,” Hunter said.

The hospital is also expanding into Cheyenne County by opening a rural health clinic in Potter.

“It’ll be staffed two full days and one half day. We’ll staff it mid-level with a physician assistant,” Hunter said.

Along with addressing the needs of the community by looking at the key factors and findings of the report, the hospital is also preparing to do their own study and needs assessment of the community.

“We are meeting with the health department this week, and we will participate with the health department to do a new community evaluation. It will take us probably nine months. We’ll gather information for at least six to nine months, and it’ll take us about a few months to put it together. It’s under the direction of the health department, but it is community needs assessment to make sure that the things we have started are the right things to do and to also address some of the other issues that we haven’t yet,” Hunter said.

Though the current report leaves much to be desired, Hunter takes it as a positive step and a tool to use in addressing the needs of the community.

“Realistically, it’s a good report. That’s what we’re here for is to meet this community’s health care needs. We felt like we could make positive changes as a result of that report. It has helped us. I think it was a wake up call for the health department too. We’ve not had representation here. Even today, there’s not a worker assigned to Kimball from the Department of Health. They come over. They’re good to work with. They’ve certainly paid a lot more attention to us than in the past,” Hunter said.

Hunter is also optimistic about the impact that the current and planned future programs will have on the community.

“Everything we’ve started we’ve had good participation in. The daycare, my understanding is that they’re doing fairly well in their numbers. The diabetic group did extremely well. The Circle of Security Group has done very well. And so the initiatives that we started we’ve done very well with. I think we gave more flu shots this year than we’d ever given before,” Hunter said.

Hunter also states that many of the problems stem from a rural location. However, the hospital staff are not overly concerned with the findings of the study or any impact the findings would have on the hospital or area as a whole.

“There’s no question that in this area we have some issues that are related to, frankly, not being a metropolitan area. There are not as many services, and when there are, they’re a number of miles. When you’re 60 miles from the nearest hospital, you’re going to get to take care of that population. We’re keeping our head above water,” Hunter said.

Residents interested in reading the report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute can do so by visiting http://www.countyhealthrankings.org.