Reflecting on the year in health care, a decidedly positive and gratifying theme is apparent: Islanders now have access to a range of locally grown, innovative solutions to longstanding and emerging problems through programs born largely of collaborative efforts among various Island health care providers, nonprofits, consumers, and local government. In just this past year we have seen the following come forward:
- The Island Wide Youth Collaborative (IWYC), providing information, referrals, coordination of services, and case management to Island youth in need and their families, under the umbrella of Martha’s Vineyard Community Services (MVCS);
- New space, room to grow, and Island-wide town support for the Center for Living, a supportive day program providing aging-in-place and community help for the growing senior population, people with disabilities, and their families, due mainly to County Manager Martina Thornton’s work in navigating and conquering the multiple town meeting/selectmen maze;
- The Healthy Aging Martha’s Vineyard (HAMV), formerly the Healthy Aging task Force, a committee of the Dukes County Health Council, and now its own program, recently undertook a wide-ranging survey of the 65-plus population with the help of consultants from the Heller School at Brandeis University, and works to identify, plan, and pilot solutions to meet the needs of our current and future elders;
- The Red House, a partnership between Martha’s Vineyard Hospital and MVCS, a behavioral and mental health crisis stabilization service on the hospital campus, still in development.
Even better is the fact that the model for producing such programs has taken root through the quiet, mostly off-radar work of the Dukes County Health Council over the past 20 years — work which has also produced the following:
- The Vineyard Health Care Access Program (VHCAP) — outreach, enrollment, and coverage-maintenance assistance with public health insurances and other public assistance programs;
- Island Health Care — originally designed to pilot a community-based health insurance program, now a federally qualified health center providing primary health care services;
- The Youth Task Force (YTF) — encouraging our teens to make healthy choices regarding alcohol and substances;
- The “Health Report of Martha’s Vineyard: A Population-Based Survey and Practitioner Survey” in 2004, in collaboration with the Foundation for Island Health.
In spite of an early commitment to act “merely” as a federation, forum, or roundtable for local health care issues, the Health Council clearly also knows how to get things done. It also knows, as demonstrated by its diverse membership (mostly from nonmedical organizations) what many studies and data have shown us for some time: that only 20 percent of what determines our health has a medical cause. The other 80 percent has to do with how we live, what we eat and drink and otherwise swallow or inject or smoke, the air we breathe, our ability to make ends meet, whether we have the social support we need, the quality of our relationships, whether we have health insurance. Taken together, this larger category is currently referred to as the “social determinants of health” (SDOH).
In part, this essay is a tribute to the Dukes County Health Council, its many members over the years, and its measurable contributions to our community. The Times also asked for comment on our future planning challenges, and it is in this area that I propose to challenge the Health Council to up its game a bit, and ask that it incorporate into its work — on behalf of all of us, and in its collaborative way— the very important task of conducting a periodic, comprehensive community-needs assessment and using it to develop a community-wide strategic plan to prioritize and address the identified needs (the 20 percent plus the 80 percent), and to repeat as necessary, every three to five years.
The Health Council has earned the credibility to be given charge over this critically important process. It has the broad membership, including major health care providers such as the hospital. The new CEO could perhaps provide assessment and health planning leadership to the community through the council. The “Health Report of Martha’s Vineyard” could be revised and regularly updated.
In short, our first and foremost planning challenge is deciding who will create the plan. The Dukes County Health Council, in my view, is the answer.
Cynthia Mitchell is CEO of the Island Health Care Community Health Center and a West Tisbury selectman. She has a long history of involvement in town and Island affairs and has served as chairman of the Martha’s Vineyard Hospital board and the Dukes County Health Council.