South Dakota Gets a Physical
By Peter Carrels
In the executive summary of the report titled “Focus on South Dakota, A Picture of Health” the following statement summarizes the scale and importance of this newly-released statewide analysis.
“South Dakota and other largely rural states face many challenges in meeting the healthcare needs of rural and underserved communities, in part because data to guide improvement is often limited or unavailable. The South Dakota Health Survey provides unprecedented statewide survey data on regional patterns of behavioral health prevalence and access to care.”
The sponsor of the report, The Leona M. and Harry B. Helmsley Charitable Trust, declared that the report’s findings can serve as a catalyst to start conversations between city, county and state governments, organizations, and individuals who strive to improve access to care, including mental health and substance abuse care.
To access the report online:
The Leona M. and Harry B. Helmsley Charitable Trust is a charity that contributes to nonprofits and other organizations in the fields of health, place-based initiatives, and education and human services. Since 2008, when the Trust began issuing grants, it has committed more than $1 billion. The Helmsley fortune behind the Trust came mostly from hotels and real estate in several states, including the Park Lane Hotel and Empire State Building in New York City.
Unprecedented is an ambitious word, but it is indeed likely that South Dakotans have never before been the beneficiaries of such a comprehensive analysis of their health and their access to healthcare. The ‘Picture of Health’ report includes graphs, charts, maps, and concise narrative throughout. The report’s scale is immediately impressive, even to the layperson. Trained public health officials will find limitless applications and usefulness from the data and information.
“The Helmsley South Dakota Health Survey is rich in detail,” says Mary Nettleman, MD, Dean of the University of South Dakota Sanford School of Medicine and Vice-president of Health Affairs at the university. “It provides a comprehensive picture of South Dakotan’s healthcare needs, highlighting the need for access to mental health services and underscoring geographic disparities.”
Included in the report is a county-by-county assessment covering dozens of health-related categories. Information is broken out that profiles the incidence of numerous maladies such as diabetes, asthma, depression, addictions, cancers, heart disease, and high cholesterol, among others.
County by county comparisons – made easy by the report – reveal interesting disparities and worrisome hotspots. Statewide data is compared to the county data, adding additional comparative usefulness. Subpopulation reports focus on the state’s two largest cities, Sioux Falls and Rapid City, as well as on the state’s American Indian population. Issues related to health, including homelessness, ethnicity, gender, age, and immigrant and refugee status are covered and described and are accompanied by valuable statistics.
To conduct this health needs assessment, 7,675 randomly-selected households from across the state were surveyed by phone, mail and in-person. An additional 519 surveys focusing on homeless, immigrant/refugee, and “housing insecure” populations were completed. Data was collected between November 2013 and October 2014.
The report identifies several “key” findings of special interest, including:
- South Dakota may have rates of alcohol misuse, anxiety, and post-traumatic stress disorder that are higher than national rates.
- Hospitalization use for mental health issues is high.
- Individuals utilizing hospital emergency rooms present high rates of mental health concerns.
- There are pockets of high rates of depression, heavy alcohol misuse, unmet medical needs, and adverse childhood experiences.
Here are some noteworthy statistical revelations from the report:
- 42.4% of respondents screened positive for alcohol misuse
- 5.6% of respondents screened positive for symptoms of depression
- 75.1% of respondents perceived a need for medical care during the previous year
- 79.5% perceived a need for prescription medications
- 9.7% perceived a need for mental health care
According to the report, uninsured respondents were more likely to perceive a need for mental health care, more than 50% of responders must travel more than 20 miles to receive mental healthcare, and 62.5% of responders must travel more than 20 miles to receive substance abuse treatment.
Adverse childhood experiences (ACEs), a term that includes conditions such as abuse, neglect and household dysfunction, affected 53% of respondents. ACEs are linked to many adverse short-term and long-term behavioral consequences, including depression, anxiety, and chronic health conditions.
Incidentally, survey results indicate that Buffalo, Lake, Lyman, Union and Yankton counties are the healthiest counties in the state. At the same time, surveys suggest that McPherson, Potter, Harding, Clay, and Fall River counties are among the state’s least healthy counties.
Report readers will also be able to study issues that impact health such as access to daycare and substance abuse treatment, and the relationship of such access issues and the prevalence of alcohol use, depression, anxiety and drug use are noted. A large collection of data related to American Indian health issues is a critical aspect of the report.
Dr. Michael Lawler is dean of the University of South Dakota’s School of Health Sciences, overseeing ten health-related programs ranging from addiction studies, social services, nursing and various therapies. Lawler says he is impressed with the report’s focus on specifics.
“Not only does this report affirm the need for reliable access to healthcare in rural communities,” he explained. “It also points out needs for serious conditions such as mental health and addictions.”
Shelley Stingley serves as the program director for the Rural Healthcare Program of The Helmsley Charitable Trust. From an office in Sioux Falls, the program identifies and aids healthcare needs in seven northern plains states, including Montana, Wyoming, Nebraska, Minnesota, Iowa, North Dakota, and South Dakota.
Though the program has only been serving public needs in the region for six years, the office has already awarded 220 grants totaling more than $260 million dollars. Much of that money has been directed at improving emergency services, telemedicine, and other technology needs in the region. Stingley says the research and information in the report addresses an unmet need for South Dakota.
“We determined that there was inadequate health data on a county or statewide basis in South Dakota,” said Stingley. “We view this report as an investment in improving healthcare for South Dakota. Good decision-making requires sound data, and this report furnishes policymakers and decision makers with excellent references and information for them to make better decisions for South Dakota.”
The report also gives local citizens and officials the opportunity to assess local issues and conditions. This unique set of information can help shape strategies and encourage appropriate emphasis in various communities. “The report provides data that local people can review to determine what is needed in their specific area,” explained Stingley.
But Stingley says even such a comprehensive report cannot be called successful unless it prompts others to find solutions for the problems that it highlights. It appears, based on the reactions from statewide health leaders, that this will be the case with the Helmsley research.
“The report shows that a number of communities have a high prevalence of mental illness and addictions with low access to services,” says Dr. Lawler. “To help these communities, we must develop practitioners who can work in interprofessional teams and address both behavioral and physical health.”
South Dakota’s Secretary of Health, Kim Malsam-Rysdon, agrees that the report is not just a collection of data, but also a call to action.
“The Department of Health appreciates the considerable work done by The Leona M. and Harry B. Helmsley Charitable Trust in producing ‘Focus on South Dakota – A Picture of Health,’ says Secretary Malsam-Rysdon. “We expect it will be very helpful as we collaborate with the Trust and other key stakeholders in ongoing efforts to address the health needs of South Dakotans, especially in our most rural areas.”
To obtain a copy of the report, you may contact the Sioux Falls office of the Rural Healthcare Program of The Helmsley Charitable Trust by calling (605) 361-9848.
Or you can access the report online by clicking here.