Throughout the United States, African-Americans endure far worse health outcomes than other ethnicities for problems such as diabetes and heart disease. In the North Central Florida community, however, it is cancer outcomes for African-Americans that are among our region’s most pressing health issues.

According to a report by WellFlorida Council, a nonprofit health organization in Gainesville, the death rate of cancer in African-American residents in North Central Florida is higher than the Florida rates on all of the top ten cancer types. This is especially concerning for cancers where screening procedures exist, which include breast cancer, prostate cancer and colorectal cancer.

African-Americans in North Central Florida also have uniquely high death rates for lip, oral and pharynx cancer largely due to tobacco use. The death rate for African-Americans in this region is nearly 145 percent higher than the death rate for this cancer among African-Americans in the entire state of Florida.

“This level of disparity in cancer outcomes — i.e. the likelihood of surviving cancer if you’re African-American and live in North Central Florida — indicates a need for improvement in cancer screening, education, awareness, access to healthcare services and other systemic issues,” said Jeff Feller, chief executive officer of WellFlorida Council.

To address some of these needs, our community can turn to the Cancer Resource Guide of North Central Florida. This free online guide is available at www.CancerResourceGuideNCF.org and is a service of WellFlorida and North Central Florida Cancer Control Collaborative (NCFCCC), which is part of a statewide initiative to reduce cancer in Florida.

The website links residents to resources for low and no cost cancer screenings, cancer support groups and financial support services throughout the region. It contains a variety of information including: summer camps for children with cancer; sources for breast prosthesis and wigs; and medical assistance for individuals who are uninsured or under-insured. There is also an entire section devoted to tobacco cessation information, which is especially valuable given the burden that African-Americans in our area face when it comes to tobacco-related cancers.

The Cancer Resource Guide was created to act as a real-time database, meaning the resources in the guide are continuously updated by those organizations providing the listings. Local organizations are encouraged to add their own cancer-related resources to the site by visiting www.CancerResourceGuideNCF.org and creating an account. Once you have an account, you may log on to update your listings as needed.

To learn more about NCFCCC and local cancer resources, visit The Cancer Resource Guide of North Central Florida at www.CancerResourceGuideNCF.org.

Everyone’s Doing It, It’s Everyone’s Business and ARTAS are components of the HIP project, which is funded by the Department of Health.

Everyone’s Doing It promotes condom use and HIV testing throughout the three counties. Testing is confidential and teens do not need parental consent to be tested for HIV. Locate HIV testing sites and events at EveryoneStopAIDSNow.org.

WellFlorida is also offering free HIV testing Monday through Friday by appointment only. WellFlorida, is located at 1785 NW 80th Blvd., Gainesville. Call 352-313-6500 ext. 120 for more information.

It’s Everyone’s Business is a partnership between WellFlorida and local businesses that are interested in sharing HIV prevention messages and materials with their customers, employees and other neighborhood businesses. Some of these businesses provide free condoms and serve as HIV-testing sites. Businesses currently participating in the program include:

Alter Ego Fitness, 101 SE 2nd Place, Suite 210, Gainesville

Beach Break Salon, 630 W. University Ave., Gainesville


Civic Media Center, 433 S. Main St., Gainesville

Club 12/Decadence, 12 SW 2nd Ave., Gainesville

Lee Conlee House, Palatka

Ocala Pride, PO Box 83-1234, Ocala

Peaceful Paths, 2100 NW 53rd Ave., Gainesville

Rural Women’s Health Project, PO Box 12013, Gainesville, 32604

The Pub, 14 NW 5th St., Ocala

The Copa Nightclub & Tropix Restaurant, 2330 S. Pine Ave., Ocala

The House, 378 SE 3rd St., Ocala

University Club, 18 E. University Ave., Gainesville

Vicks Supper Club, 207 N. 18th St., Palatka

Wild Iris Bookstore, 22 SE 5th Ave., Suite D, Gainesville

“Getting businesses involved is really key to stopping the spread of AIDS in our communities,” said Shane Bailey, director of community initiatives at WellFlorida. “Businesses are in the community—they reach a lot of people. They can help get the word out about HIV prevention and reduce the stigma and complacency associated with it.”

Businesses interested in participating in the program can contact Naomi at naomiak@wellflorida.org or call 352-313-6500 ext. 120.

Individuals who have recently been diagnosed with HIV or who have HIV but have not received medical care in six months are encouraged to contact ARTAS. ARTAS, the third component of the WellFlorida project, stands for “Anti-Retroviral Treatment and Access to Services.” ARTAS links people to the care and resources they need. For more information, visit ARTAS at EveryoneStopAIDSNow.org or call 352-313-6500 ext 120.

Michael Perry thought he had food poisoning last summer. He doesn’t remember what he’d eaten, but he remembers cramps so bad that in the middle of the night he went to the emergency room in Keystone Heights.

Perry said he has an “old school” philosophy about his health: “If it isn’t broken, don’t fix it.”

Perry felt broken that night.

But it wasn’t from anything he’d eaten.

It was something he didn’t know much about: colon cancer. At 56, Perry knew he should have been getting screened for colon cancer for a while (recommended screenings start at age 50), but he didn’t have insurance. He also thought: “I never get sick besides a runny nose in the winter.”

This time, though, he was sicker than he’d ever been.

Perry was diagnosed with stage 3 colon cancer, which is not the worst stage of the disease but would need to be treated aggressively. So every week, he drove back and forth between Keystone Heights and the Community Cancer Center of North Florida for treatments.

Rural vs. urban

Perry is emblematic of many cancer patients who are treated in Gainesville but who live in surrounding communities.

“There really is a difference between rural and urban (patients),” said Dr. Laurel Warwicke, an oncologist at the Community Cancer Center of North Florida. Many of Warwicke’s patients are from rural communities. “They don’t want to go to the doctor. They could have a tumor growing out of their neck and think it will go away,” she said.

When they finally do go to the doctor, “they may have a dramatic change in weight or be coughing up blood. A lot of family members will demand that they come in,” she said.

They are also much sicker than they might have been — had they come to the doctor sooner, or even better, had undergone regular recommended screenings such as colonoscopies, PSA tests for men, and mammograms and Pap smears for women.

“I would say that 70-75 percent of patients come from rural areas, and they have a tendency to be diagnosed at a later stage — either because of lack of medical care or because it takes them some time to get to the office,” said Lucio Gordon, an oncologist at the North Florida Regional Cancer Center.

 Local cancer death rates high

A cancer report released at the beginning of the year confirms this daunting scenario. The North Central Florida Cancer Control Collaborative, which is part of a nationwide Centers for Disease Control and Prevention initiative that aims to reduce the cancer burden in states and regions, found that the death rates for the 10 most prevalent cancers in Florida are highest in the 11 counties that span North Central Florida. And rural areas are driving the high mortality rates.

“Clearly there is a mortality disparity in our rural parts of Florida, probably driven by behavioral risk factor … things like obesity rates, smoking rates, whether people are eating requisite fruits and veggies,” said Jeff Feller, the CEO of WellFlorida Council, which produced the report that was largely based on information from the National Cancer Institute.

According to NCI data, a number of the counties in the North Central Florida region — including Bradford, Union, Dixie, Levy, Suwannee and Putnam — have an increasing mortality rate that exceeds the U.S. average.

Dr. Eric Feuer, of NCI, said the North Central Florida data “sounds pretty dramatic” — especially for a part of the state “that everyone kind of drives through,” Feuer said.

“I bet if you go to other rural poor areas in other parts of the country, in Mississippi, for example, you would probably find similar rates,” Feuer added.

Poverty a key factor

Dr. Thomas George, an oncologist at Shands at the University of Florida, agreed. “What we’re seeing in Florida is a magnification of what we’re seeing in the rest of the country,” he said.

Or, at least, the Deep South.

“North Florida is really part of the Deep South. When you look across the Deep South, you find higher rates of just about everything,” said Dr. Barbara Curbow, professor and chair of the Department of Behavioral Science and Community Health in the College of Public Health and Health Professions at UF.

In this at-risk region, poverty and income inequalities are more endemic. U.S. Census Bureau data from 2010 show that the northern part of the state (including the Panhandle, which the cancer report excludes) has the second-highest level of income inequality in the U.S., second only to Louisiana.

The cancer report found 21 percent of the population in the North Florida region lives below the poverty line.

But the differences between the counties in North Central Florida really capture the health care problems often related to poverty.

In Alachua County, for example, there are 730 patients for every primary care physician. In Union, that jumps to 5,184 patients per physician.

“I know some excellent (primary care physicians) in rural areas, but they are overburdened,” Warwicke said. “We need more doctors in the rural areas, but they are not going to stay. It’s a Catch-22.”

“It’s impossible to make ends meet in rural communities between malpractice insurance, keeping up your license and overhead,” Warwicke continued.

A dearth of doctors is part of the problem; but other factors contribute to the lack of access to health care. The recent cancer report found that 28 percent of people in Alachua County don’t have insurance, so they just don’t go to the doctor.

In Alachua County, 71 percent of women reported getting mammograms, compared with just 51 percent in Union County.

“When it comes to putting food on the table for feeding kids and going to the doctor, who’s going to win?” Warwicke said. “I don’t have an answer for that, and I don’t think our government does either.”

Rural areas need special help

Certain initiatives aim to remedy the rural-urban cancer disparity. One, spearheaded by Henrietta Logan, a professor at the UF College of Dentistry and the director of the Southeast Center for Research to Reduce Disparities in Oral Health, focuses on head and neck cancers — not the most prevalent cancers, but those that are invariably diagnosed at later stages in rural areas and very expensive to treat.

“There’s work to be done because oral cancer is one of the most costly and disfiguring. It would be better if we paid for an examination at the front end. Prevention, or early detection, is always the best way to control costs,” Logan said.

In Levy County, three-quarters of oral cancers are diagnosed at later stages, she added.

“Overall, people go for symptoms, and most cancers don’t have symptoms until they are in late stages,” she said.

Many people have also never heard of oral cancers, which are closely related to smoking — and that’s where education comes in, she said, adding that Lafayette, Dixie and Hamilton counties have smoking rates that exceed 36 percent — double the state average.

“That’s like going back 20 years internationally, so we have some work to do in these areas,” Logan said.

“It’s critical that rural areas become a setting for cancer control efforts. We speak doctorese in Gainesville, and our doctorese is not easily translated to people who don’t hang out in hospitals like we do.”

“Why do you call it a ‘screening’?” Logan asked. “That’s what you put on your porch. Why don’t you just call it an examination?”

Logan said they have tried to tailor awareness campaigns to specific groups of people with posters and pamphlets for businesses or churches. One group they targeted was black men, since they die of oral cancers at twice the rate as white men. Their overall message about oral cancers, said Logan, was: “Don’t wonder — get it checked out.”

Logan said she found that “once you raise their concern about it, they intend to be screened.”

“The gap between intention and doing it is discretionary resources,” she continued. “If you don’t have financial security and are living on the edge all the time, then you don’t have those discretionary resources … It doesn’t matter if you’re black, Hispanic or white.”

Read the article on Rural areas drive region’s high cancer death rates Gainesville.com

African-Americans in the 11 counties comprising North Central Florida have higher rates of cancer mortality than other African-Americans throughout the rest of the state, according to the North Central Florida Cancer Control Collaborative Report released in January.

“Disparities between the races are well-documented,” said Jeff Feller, CEO of the WellFlorida Council, which produced the report. “We’re woefully worse off in our black population in almost every form of cancer.”

The overall age-adjusted death rate (which removes the confounding influence of age) was 234 per 100,000 people compared with 172 for Florida. The difference was most pronounced for lip, oral cavity and pharynx cancer: African-Americans in this region had a 145 percent higher death rate for these cancers compared with African-Americans in the rest of the state.

“When you look at the number of dentists and access to dentists in this area, it’s very, very low. If you look at the cost of the median household, you know that these areas are very economically depressed,” said Dr. Henrietta Logan, a professor at the UF College of Dentistry and the director of the Southeast Center for Research to Reduce Disparities in Oral Health.

“That tells you that the access to the primary care is just not there.”

These cancers can be detected with a standard dental checkup (through checking for swollen lymph nodes and signs at the base of the tongue and tonsils), but lack of awareness about the cancers is fairly pervasive, Logan said.

“They’ve heard of lung cancer, but they don’t know much about oral/pharyngeal (cancer).”

Like with lung cancer, smoking contributes to causing these cancers. The report didn’t distinguish smoking habits between African-Americans and whites, but it did find that smoking rates in all counties of North Central Florida except Alachua exceeded Florida’s average of 17 percent. And some counties, such as Lafayette, Hamilton and Dixie, have smoking rates that are nearly double the state average.

Apart from oral cancers, African-American men in this region have about a 10 percent higher death rate from prostate cancer compared with white men, and a slightly higher death rate among African-American men elsewhere in Florida.

“Prostate (cancer) particularly strikes African-American men hard,” Feller said. “Participation in screening programs is limited compared to whites.”

Folakemi Odedina, a UF professor of pharmaceutical outcomes and policy, added, “Not only do black men get it (prostate cancer) at an earlier age, compared to Caucasians, they also get a more aggressive form of it. The lifetime chance of surviving prostate cancer is worse for black men.”

Odedina recently received a $1.2 million Department of Defense award to conduct in-depth ethnographic research and analysis of death rates, treatment choices and coping mechanisms among black men with prostate cancer. The project aims to develop ethnically sensitive, specially targeted ways to encourage healthful behaviors.

Odedina added that for the past few years, she has been working on reaching African-American men for PSA screenings and general awareness of the disease.

“You have to get to the men where they are. Where do black men go? Barber shops, churches, clinics,” she said. “We are doing a lot more education and hopefully we will start to see the results.”

The mortality rate for breast cancer in African-American women was also higher than for whites. The higher mortality rates for breast and prostate cancer both reflect national trends, and genetics might have something to do with these.

For example, it is known that some African-American women are more predisposed to having the BRCA1 and BRCA2 mutations that feed breast cancer — as are women of Ashkenazi Jewish origin.

Read the article African-Americans in region face higher cancer death rates on Gainesville.com

ST. JOHNS COUNTY, Fla. — This prosperous community is the picture of the good and ever longer life — just what policymakers have in mind when they say that raising the eligibility age for Social Security and Medicare is a fair way to rein in the nation’s troublesome debt.

The county’s plentiful and well-tended golf courses teem with youthful-looking retirees. The same is true on the county’s 41 miles of Atlantic Ocean beaches, abundant tennis courts and extensive network of biking and hiking trails. The healthy lifestyles pay off. Women here can expect to live to be nearly 83, four years longer than they did just two decades earlier, according to research at the University of Washington. Male life expectancy is more than 78 years, six years longer than two decades ago.

But in neighboring Putnam County, life is neither as idyllic nor as long.

Incomes and housing values are about half what they are in St. Johns. And life expectancy in Putnam has barely budged since 1989, rising less than a year for women to just over 78. Meanwhile, it has crept up by a year and a half for men, who can expect to live to be just over 71, seven years less than the men living a few miles away in St. Johns.

The widening gap in life expectancy between these two adjacent Florida counties reflects perhaps the starkest outcome of the nation’s growing economic inequality: Even as the nation’s life expectancy has marched steadily upward, reaching 78.5 years in 2009, a growing body of research shows that those gains are going mostly to those at the upper end of the income ladder.

The tightening economic connection to longevity has profound implications for the simmering debate about trimming the nation’s entitlement programs. Citing rising life expectancy, influential voices including the Simpson-Bowles deficit reduction commission, the Business Roundtable and lawmakers on both sides of the aisle have argued that it makes sense to raise the eligibility age for Social Security and Medicare.

But raising the eligibility ages — currently 65 for Medicare and moving toward 67 for full Social Security benefits — would mean fewer benefits for lower-income workers, who typically die younger than those who make more.

“People who are shorter-lived tend to make less, which means that if you raise the retirement age, low-income populations would be subsidizing the lives of higher-income people,” said Maya Rockeymoore, president and chief executive of Global Policy Solutions, a public policy consultancy. “Whenever I hear a policymaker say people are living longer as a justification for raising the retirement age, I immediately think they don’t understand the research or, worse, they are willfully ignoring what the data say.”

A Social Security Administration study several years ago found that the life expectancy of male workers retiring at 65 had risen six years in the top half of the income distribution but only 1.3 years in the bottom half over the previous three decades.

In 1980, life expectancy at birth was 2.8 years longer for the highest socioeconomic group defined in a research study than the lowest, according to a report by the Congressional Budget Office. By 2000, the gap had grown to 4.5 years.

“Life expectancy has increased mainly among the privileged class,” said Monique Morrissey, an economist who focuses on retirement issues at the Economic Policy Institute, a liberal-leaning research organization. “For many people, raising the retirement age would amount to a significant benefit cut.”

Advocates of raising the retirement age say only a relative handful of older workers would be harmed and that the vulnerable could be protected by enacting hardship exemptions. Meanwhile, they say, with a wave of baby boomers moving toward retirement and health-care costs always on the rise, the retirement programs are sustainable only if people are willing to pay higher taxes or accept fewer benefits.

Overall, life expectancy has improved substantially since the first Social Security payments were issued in 1940. Then, a man who made it to 65 could expect to live 12.7 years, compared with 18.6 years in 2010. A woman who turned 65 in 2010 could expect to live 20.7 more years, compared with 14.7 in 1940.

That trend helped persuade lawmakers in 1983 to slowly move the age people could receive full Social Security benefits from 65 to 67, a change that will be complete in 2027. Now, as the cost of providing old-age benefits has emerged as the key driver of the nation’s long-term budget deficit, there is increasing pressure to again raise the retirement age — this time for both Medicare and Social Security.

But given the widening differences in life expectancy for people on opposite ends of the income scale, “that would mean a benefit cut that falls heaviest on people who generally are most reliant on Social Security for their retirement income. It is totally class-based,” said Eric Kingson, a Syracuse University professor and co-chair of Social Security Works, a coalition opposed to reducing old-age benefits.

The gap in life expectancy has widened as the country’s economic life has grown more bifurcated. The high-income Washington region includes two counties with some of the nation’s longest life expectancies. In Montgomery County, life expectancy was 81.4 years for men and 85 years for women in 2009. In Fairfax County, it was slightly lower — 81.3 years for men and 84.1 years for women.

In the District, where 18.7 percent of the population lives in poverty, life expectancy was 72.6 years for men and 79.6 for women in 2009.

Not only is life expectancy diverging by income level, but now some demographic groups — particularly low-income white women — are losing ground.

A study published last week in the journal Health Affairs said that in almost half of the nation’s counties, women younger than 75 are dying at rates higher than before. The counties where women’s life expectancy is declining typically are in the rural South and West, the report said.

Putnam County shares many of those characteristics. Forests, picturesque lakes and the beautiful St. Johns River, the longest in Florida, dot the area. But amid that rural splendor there are few good jobs and, officials said, little access to medical care.

Even people who have health insurance often struggle to make it to doctor appointments, complicating efforts to manage chronic diseases.

“I see a lot of people with uncontrolled diabetes or who haven’t had their high blood pressure treated in a year or more,” said Terrence Soldo, medical director for St. Vincent’s Mobile Health, which runs regular medical clinics in Putnam. “There are health-care deserts out here.. . . There is a lack of access because there are not enough doctors around.”

County health rankings by the Robert Wood Johnson Foundation show that there is one primary care physician for every 2,623 residents in the county. One county east in St. Johns, there are more than double the ratio of family doctors, one for every 1,067.

The problem goes beyond access. In St. Johns, residents are more likely to seek out information to bolster their health. Even when St. Johns residents do not search for health information, medical professionals say they are at minimum more likely to follow doctors’ orders.

“Being more affluent and educated, you are likely to have better access to information and you are also more likely to want it,” said Joe Gordy, chief executive of Flagler Hospital, which is in St. Johns County.

Jeff Feller, chief executive of WellFlorida Council, a state-designated regional health-care nonprofit organization, described Putnam as part of “the Southern disease belt.”

With 38 percent of its children in poverty and just 31 percent of its population with even some college education, there is little wonder why more than a fifth of Putnam residents are in poor or fair health, double the rate in St. Johns.

Adults also smoke at nearly double the rate they do in St. Johns, and they are far more likely to be obese and far less likely to be physically active, according to rankings developed by the Robert Wood Johnson Foundation.

“It doesn’t take a rocket scientist to figure this out,” Feller said. “You just have to look at the socioeconomic and demographic differences — unemployment, education levels, income between the two counties — to understand what is going on. This is fueled by poor economics and a lack of access to health insurance and health coverage.”

Those differences are compounded by the resource gap separating the two counties. With a healthy tax base that is recovering from the recession, St. Johns officials are in a better position than those in Putnam to address problems as they arise. When St. Johns officials learned of a change in the infant mortality rate, they quickly joined forces with local nonprofit groups to get information out encouraging prenatal care.

Cyndi Stevenson, a member of the St. Johns County commission, said the county has formed similar partnerships to tackle a wide range of problems. The result is a county ranked as one of the healthiest places in Florida. Putnam, meanwhile, is ranked near the bottom.

She added that the county’s relative wealth helps make life not only better for its residents, but also longer. “A good economy does a lot for a family,” Stevenson said.

Read the article Research ties economic inequality to gap in life expectancy

This article is also published in the St. Augustine Record.

See the whole story

Marion County partners are developing the Community Health Improvement Plan, also known as CHIP, which will raise health care awareness throughout the county.

This is not just another health care project, Ackerman insisted.

“The first thing we are planning to do is to bring together a group of people from a cross section of the community from education, law enforcement, parks, businesses and obviously the health delivery community … and come to a consensus on some of the things we can do first to move toward a more healthy community,” Ackerman said.

He explained how the quality of the health care in the area is not the issue, but other factors are to blame.

“These are things like income, education, employment, housing, access to parks, access to healthy food, which lead to a healthy community, and healthy people,” Ackerman said.

The program is continuing to grow in the Marion County community every day, working to raise awareness of the health conditions of the county, which is the program’s No. 1 goal.

“We’re not asking for funding, we’re asking for the community to begin to get together and talk about how we can be a more healthy community,” Ackerman said.

See the story

Officials with the Health Department, United Way, WellFlorida Council and other agencies gathered to talk about key health issues in Marion County.

A study showed that Marion County is ranked 17th in Clinic Care Delivery.
But in other categories such as death rates, Marion County came in at number 48.

These folks think that building partnerships and awareness can improve the overall health of Marion County.

“It’s not about more hours in the emergency room. It’s not about more disease management programs, those they are a big part of what we are going to do, but there has to be some other social interventions that will move us forward to bring down the bad rates that we see in some of these areas.”- (Jeff Feller, Chief Executive Officer with WellFlorida Council)

The committee pointed out that high rates of child poverty, lower percentages of residents with a higher education, and high unemployment rates are all factors that affect health issues.

See the story

The death rate of all cancers in the region is 28 percent higher than the rest of the state, according to the 2013 North Central Florida Cancer Report.

The report compared cancer death rates, incidence rates, emergency room visits and hospital discharge data from 11 counties including Alachua, Bradford and Levy counties.

Although the number of documented new cancer diagnoses is lower in the region than in the state, North Central Florida residents are dying of cancer more frequently, according to a press release from the WellFlorida Council for the North Central Florida Cancer Control Collaborative.

“This discrepancy indicates a need for improvement in cancer screening, education, awareness, access to healthcare services and other systemic issues,” said Jeff Feller, chief executive officer for WellFlorida, in a statement.

Lauren Pollock, a council associate planner for WellFlorida, said the percent of advanced-stage colorectal, breast, cervical and prostate cancers diagnosed in the region is higher than the state average.

“That statistic was the most shocking to me, because they’re all cancers that have regular screenings,” she said. “These are ones that can be caught in time, but these people aren’t being screened.”

The report suggests that rural populations experience higher mortality rates from certain cancers.

In some of the region’s more rural counties, 21 percent of residents live below poverty and the rates of uninsured residents are as high as 28 percent, according to the report.

Dr. Folakemi T. Odedina, an associate director for the UF Shands Cancer Center, said although socioeconomics and limited health care access is one part of the issue, getting regularly screened and living a healthy lifestyle can reduce the risk of cancer.

“I think the report is a wakeup call for the community,” she said. “We really have to work together hand in hand to solve the cancer problem.”

Read the published article State’s cancer mortality highest in North Central area

That was the conclusion of a team of more than 50 community organizations, health experts and businesses after a two-year study and meetings that addressed the county’s comparatively high mortality and morbidity rates — and the social factors that contribute to them.

Members of the group met on Monday at the United Way of Marion County to lay out plans to address those health problems, which have left Marion ranked in the lower third of Florida counties.

The objectives are spelled out in the Marion County Community Health Improvement Plan, which was formally unveiled at the meeting.

Group members said the best overall solution is to mobilize the community to improve the social determinants that often are the drivers of health: income, education, employment, housing and personal behavior.

“These (strategies) are made beyond the confines of the health care communities,” said Jeff Feller, CEO of WellFlorida Council and a member of the group’s steering committee. “There has to be some more social intervention to move forward.”

To accomplish that, an array of the community leadership needs to get involved and work together. That includes businesses, educators, law enforcement, county and city governments and the health care industry.

The county’s health problems are daunting. In the 2012 annual Robert Wood Johnson/University of Wisconsin County Health Rankings report:

• Twenty percent of Marion residents reported being in poor or only fair health. The Florida average was 15 percent.

• Twenty-two percent of adults smoked, compared with Florida’s average of 19 percent.

• Marion County’s motor vehicle crash death rate was 27 per 100,000 residents, compared with Florida’s average of 19.

• Marion County’s teen pregnancy rate was 57 per 1,000 female population. That was higher than Florida’s 44 per 1,000 female population.

• Thirty-two percent of Marion County adults had a Body Mass Index greater than 30, which is the threshold for obesity. Florida’s average was 26 percent.

• Twenty-eight percent of Marion County residents reported being physically inactive with no routine exercise plan. Florida’s average was 24 percent.

Marion County’s ills aren’t due to a lack of health care providers or hospitals.

Several studies rank Marion in the top 25 percent of Florida counties in terms of quality of health care available.

“Marion County has an excellent health care delivery system,” Feller said. “If you live in Marion County and get sick, you’re likely to have access to good medical care. This plan goes beyond improving medical care and charts a path to improving the health of the community.”

The Community Health Improvement Plan’s goals include creating community partnerships, convincing government agencies to consider health outcomes in their actions, and educating the community.

The next step is to address the social determinants that affect health in Marion County. The goal is to have some of the group’s members focusing on that by May.

The next goals:
• By August, the group should implement a community campaign to inform the public on personal health issues, behaviors and their costs to individuals and the public.

By that August deadline, the group also should develop a unified message and communicate those health issues and policies to government policy makers and community leaders. The goal is to organize campaigns to inform people about the costs of these community health issues.

• By November, the community should create and market a central source for health information and referrals for both patients and health care providers.

“This isn’t just a Health Department project,” Dr. Nathan Grossman, Marion County Health Department director, told the group. “No single organization owns this — the entire community owns this.

“Transforming the health of the residents of Marion County will happen as the entire community transforms itself to think of health as more than just health care,” he said.

Meanwhile, Marion residents can take a simple, immediate step toward better health: more physical activity, said Nicole Orr, Marion County YMCA Wellness director.

“Ninety-seven percent of adults do not exercise more than one hour each week, meaning that they are far from meeting the recommendations for physical activity,” Orr said.

“At the Y, we focus on healthy living because we know that most of these chronic illnesses are preventable through lifestyle change,” she said. “That’s why we have programs that teach people how to modify their behavior and make exercise a habit…” It will take many local organizations contributing to start solving the county’s health issues.

“I don’t think one organization can make that change,” said United Way of Marion County President Maureen Quinlan. “It’s going to take the community.”

“Changing behavior takes education. It’s also offering people opportunities,” she said.

Grossman said solutions will take time to take hold.

“We didn’t get here overnight. This is not going to be fixed by July. It’s not going to be a year from July,” he said. “This is a project that should, rightly, go on forever.”

Read the published article Shape up, Marion! New health report aims to help