Thomas Breen photos
A community health mural created during one of the hospital’s public meetings about the 2019 assessment.
Bridgett Williamson.
The opioid epidemic is hitting the suburbs harder than the city. But New Haven is still struggling with PCP and crack addiction.
That was one of the key takeaways from a community conversation Tuesday night at the Wilson Library in the Hill following a presentation of the 2019 Community Health Needs Assessment by representatives from the Healthier Greater New Haven Partnership.
The assessment, which local healthcare providers like Yale New Haven Hospital must complete every three years in order to retain their nonprofit tax status, found that 26 percent of New Haven respondents reported personally knowing someone who misuses opioids, while 35 percent of Hamden respondents said the same.
The assessment also found that 22 percent of New Haven respondents reported knowing one or more people who have died from opioid overdose, as opposed to 26 percent of Milford respondents and 25 percent of respondents from outer ring suburbs like Branford, Madison, and Orange.
Healthier Greater New Haven Partnership image.
“What stood out to me is seeing New Haven not being the number one city of opioid use,” said Bridgett Williamson, a member of the Yale Program for Recovery and Community Health‘s (PRCH) Citizen’s Community Collaborative team. “It’s kind of weird that we’re talking about opioid use, because right now, that’s where all the money is going to. We forget about the PCP users. I live in a community where a lot of PCP smokers are smoking that, and it seems like there’s nothing being done. And we shouldn’t forget about the crack smoking, too.”
Tuesday night’s meeting.
Williamson was one of nearly two dozen locals to turn out for the community health assessment meeting and conversation. YNHH Community Benefits Manager Augusta Mueller and Health Equity Solutions CEO Tekisha Everette explained that, per the provisions of the 2010 Affordable Care Act (ACA), better known as Obamacare, nonprofit hospitals must complete an assessment and action plan for improving community health every three years in order to retain their nonprofit status.
The partnership, led by YNHH, started working on the 2019 assessment last winter, and must have it completed by Sept. 30, 2019.
Health Equity Solutions CEO Tekisha Everette.
Everette said the data behind the assessment pulls from 172 surveys of such “key informants” as hospital administrators, state and local health departments, nurses, and clergy that were conducted in March 2018, as well as from DataHaven’s 2018 Community Wellbeing Survey, which is based off of interviews with nearly 2,400 people from the Greater New Haven area, including just over 1,000 from New Haven city proper.
In addition to providing data on key health stressors in the New Haven metropolitan area, the assessment must also include a set of goals for improving community health over the next three years, as well as an implementation plan outlining how those goals will be reached.
Click here to download a copy of Tuesday night’s assessment and implementation plan presentation.
The assessment found economic instability to be the greatest barrier to residents receiving quality health care, with 41 percent of respondents to the key informant survey identifying like unemployment, unaffordable housing, and lack of insurance as having the greatest negative impact on area adults’ health.
The assessment found that 41 percent of respondents who make less than $15,000 a year visited the emergency room at least once over the past 12 months, while only 16 percent of respondents making $100,000 or more said the same.
And 18 percent of respondents who make less than $15,000 a year said they were unable to afford the cost of prescription medication, while closer to 5 percent of people making over $100,000 said the same.
The assessment’s Community Health Improvement Plan identifies its key goals for the next three years as reducing the rate of adults without a regular medical provider, or a “medical home,” by 2 percent; to reduce the combined percentage of adults who are obese or overweight in the Greater New Haven region from 65 percent to 62 percent; and to increase by 2 percent the number of adults in the region who indicate they are receiving the social-emotional support that they need.
Kim Hart (left).
After the hour-and-a-half presentation, Williamson said that what struck her most amidst the reams and reams of data was the urban-suburban disparity in opioid use.
Covering her grandson’s ears, she said that she herself suffered from over a decade of heroin addiction, which she was able to overcome in 1991.
But in predominantly black and brown working-class communities in New Haven today, she said, she sees more PCP and crack use than opioid use, despite the local, state and national rush to prioritize the latter problem. She said she would like to see some of that money going towards peer support and education groups in inner cities, so that black and brown people suffering from substance abuse disorders are not overlooked by government funds.
“I just don’t want to forget about the PCP smokers and the crack smokers,” she said.
According to a recent Bipartisan Policy Council Report, the federal government has spent nearly $11 billion over the past two fiscal years on programs designed to combat the opioid epidemic.
Kim Hart, a local activist with Mothers and Others for Justice, said that her biggest takeaway from the presentation was that more resources need to be spent on encouraging low-income city residents who struggle with addiction to seek out mental health care.
“It took me years to realize to talk to a professional counselor about what’s going on with me,” she said. “Because I’m not crazy. Because most people in my community think, ‘I am not going to a counselor, because I’m not crazy.’ I tried to find the answer in substance abuse. But’s that wasn’t the answer. How can we convince the people in my community, my neighbors, that it’s going to help to go to talk to someone.”
Mark Firla.
Mark Firla, a member of the city’s Food Policy Council and the Food Access Working Group, said he was most struck by how none of the plan’s three priority goals for the next three years include addressing economic insecurity. Even though the assessment identifies early in its report that economic insecurity is the largest barrier to good health in this community.
“The economic piece for me runs through all this,” he said, and yet there seems to be no clear plan for how to address it.
Tom Ficklin.
WNHH radio host Tom Ficklin called out the hospital as potentially acting in bad faith when it put together this proposal, and said that city residents will no longer stand idly by as money that could be used to address root causes of health disparity in the community is used instead for projects that may not have the deepest community buy in.
“People are tired of being sold a bill of false goods,” he said.
YNHH Community Benefits Manager Augusta Mueller.
Listening patiently throughout, Mueller promised those in attendance that the hospital will be accountable to the community for the data and goals set out in this 2019 report. She said that she would be happy to host meetings on an annual basis, or even more frequently, over the next three years to provide updates on how the implementation plan is going.
“I don’t want to stand here 10 years from now and see these results where they are today,” she said. “I really personally want to see them go down and see them change.”