Health report highlights gaps in care

While Martha’s Vineyard is considered one of the most physically healthy communities in Massachusetts, there are holes in healthcare coverage and concerning statistics — the Island has the highest suicide rate in the state, there’s a lack of primary care and mental health physicians, and transportation is a limiting factor for getting adequate service. 

Those are the findings of a new report, the “2025 Community Health Needs Assessment,” which was released this fall, put together by Martha’s Vineyard Hospital and Island Health Care. The report compiled data from federal, state, and county sources, and relied on focus groups and responses from an Island-wide survey to produce the third of its kind since 2019, many of which pointed to similar issues. 

A lack of resources for the immigrant community, affordable housing, rising mental health incidents, binge drinking, tick-borne illnesses, and a widening gap in wealth disparities were noted as pressure points in a community that relies heavily on an economy of tourism, yet struggles to maintain essential workers. 

“Our top priorities really need to relate to getting people access to the care they need,” Amy Houghton, the hospital’s director of contracts and community projects, who helped author the report, said of the actionable next steps. She added that a big question healthcare officials need to be asking themselves is, “How do we look at brainstorming new ways to bring care here?”

Most of these pressure points aren’t news to Islanders, but this collection of facts is a means to understand top needs and address them accordingly. The information gathered will be used to create a health improvement plan, which, according to Houghton, will be “guiding principles” for the hospital from January 2026 to December 2029. That plan is still being drafted. 

One of the more alarming findings of the health needs assessment was that Dukes County has the highest suicide rate of any county in Massachusetts. From 2019 to 2023, a federal study found the rate of self-inflicted death was 18.2 per 100,000 people, which for a year-round population of more than 20,000, is about four people per year. The next highest county in the state was Franklin, with a rate of 14.2 per 100,000.

Also highlighted in the report was the lack of services on the Island, which is compounded by difficulties with transportation.

On a federal level, Dukes County is recognized as a health professional shortage area, meaning there’s not enough primary care, dental, or specialist providers for the population. Year-rounders have also been designated as a medically underserved population by similar metrics, which relates to the long-standing shortage of health professionals. 

In 2021, it was estimated that there was one primary care provider per 2,110 people in Dukes County, versus 990 per provider on average in Massachusetts — one of the lowest ratios in the state, and third behind just Nantucket and Bristol counties. According to the assessment, this is further exacerbated by the fact that one in three locals is over the age of 65. 

“Primary care resources are unable to meet the demands of residents, and are further complicated by an aging seasonal population with complex healthcare needs who require regular access to services while living on the Island for four to six months,” the report stated. 

The MV Times reported recently that the hospital has a backlog of more than 1,500 patients for primary care services.

This isn’t true only at the hospital. The wait lists at various providers, including at the newly opened dental care facility through Island Health Care, are extremely long, the report indicates. The new facility is the only dental provider on the Island that accepts state health insurance.

In the survey, residents expressed concern that Dr. Edward Caldwell, the Island’s only ear, nose, and throat specialist, is leaving the Island. It was recently announced that the building he operated out of in West Tisbury was purchased by the Martha’s Vineyard Hospital in an effort to bring more primary care physicians’ offices to the Island. 

High costs and increased wealth disparity have been discouraging for many locals. Data from the needs assessment showed that more than 50 percent of residents are cost-burdened by housing, meaning they spend more than half of their monthly income on rent or mortgage payments. 

Those same people said food, utilities, and transportation costs often sent them over the edge, and living from paycheck to paycheck is the stark reality of life on the Island, especially for those with dependents. 

With cuts to federal programs continuing, and health insurance subsidies likely coming to an end, many low-income Islanders are feeling the pressure of covering the costs of food, rent, and energy.

And although Dukes County is considered one of the healthiest in the commonwealth, with low mortality and premature death rates and a long life expectancy, the population of Islanders over 65 with different health needs from younger populations is higher than in some areas. 

Intensifying the lack of services on Island is the difficulty making trips to the mainland for appointments, and for Islanders who are disabled, elderly, or have high health needs or illness, those trips are both more frequent and more difficult. If someone doesn’t have a car, they can take a bus for seniors and disabled people called the Medivan. But the bus operates only on Tuesdays for three hours, and some locals spoke up in focus groups about needing more options. 

“I can’t take the Medivan, because the clinic I go to is a different day from the Medivan trip. I take a taxi to the ferry terminal; once across, I take a Peter Pan or Plymouth & Brockton bus to South Street Station, then a taxi to MGH, and the same on return. The trip takes me about eight hours, and costs about $100 in travel,” one local, who was anonymous, is quoted in the report. 

At an average cost of $93 for a round-trip ferry ticket with a car (at the Islander rate), and average airfare to Boston and back priced at about $430, the cost is prohibitive for many locals, especially those on a fixed income. 

“Frequent weather disruptions, mechanical issues, and crew shortages make travel for medical appointments unreliable. In the past three years, nearly 1000 ferry trips were canceled,” the report stated. 

While mental health and substance use have been top points of concern for hospital officials for a long time, the recent survey, like others in recent years, showed that residents are becoming increasingly restless about their needs not being met. 

With the impending lease end-date for the Red House, the Island’s only substance-use recovery facility, the amount of spaces outside emergency rooms and hotlines for people to find immediate and targeted care is dwindling, rather than growing to meet the needs. But efforts by health officials to do so are also evident in the report. 

A warming climate has increased concerns about the growing threat of tick-borne illnesses. The report cited a dramatic increase in several tick-borne illnesses since 2019, including Rocky Mountain spotted fever, Lyme disease, and alpha-gal syndrome. 

And in the midst of a yearlong campaign by the Trump administration to crack down on immigration, many people of color and immigrants in the community cited extreme, near-constant fear for their well-being and that of their families. According to the report, there was disagreement among health officials on how well the issue was being tackled in care settings. 

Some cited a lack of Portuguese-speaking representatives as a point of contention. Without communication and language, officials worried about being able to appropriately contact and serve populations who don’t speak English. 

“Diversity and resilience are still strengths of the community, but socioeconomic disparities and the high cost of living create barriers for residents and workers,” the report stated.