Last year an annual health survey of all 3,100 counties in the United States found Flagler to be the 14th healthiest in Florida. This year, Flagler jumped to ninth place. It had been a long-term goal of the Flagler Health Department to see the county break into the top 10. Health Officer Robert Snyder called the change in ranking a major accomplishment.
“We are delighted that Flagler County continues to move in the right direction from a health perspective,” Snyder said. “Our rankings for length of life improved relative to other counties, while our rankings for health behaviors and quality of life remained high with little change. These findings give us confidence that, as a community, we’ve made considerable progress since being ranked 27th five years ago. Most importantly, the data allows us to determine which behaviors and outcomes we need to address and improve going forward.”
Nevertheless, the higher ranking masks several poor health indicators with little or no improvement.
Some highlights: 8 percent of children were born with low birth weight, the same proportion as last year. Teen births are down to 21, from 23 last year. But sexually transmitted infections are up slightly, to 314, from 301 last year. Among adults, 16 percent smoke, same as last year, and 25 percent are obese, an increase from 24 percent last year, reflected in a 2-point increase in the 27 percent of the population that reported physical inactivity, even though 81 percent reported access to exercise opportunities (a decrease from last year’s 86 percent). Out of all the driving fatalities in the county, 31 percent involved alcohol, a decline from the 40 percent reported the previous year. The proportion is still higher than the Florida average of 25 percent. But those reporting excessive drinking remain at 17 percent.
The proportion of the uninsured is down to 15 percent, from 16 percent last year–and 27 percent before the Affordable Care Act kicked in. Flagler’s ratio of residents to primary care physicians is 2,010 to 1, exactly half the national average of 1,050 to 1. The ratio of residents to dentists is also alarmingly low, at 2,830 to 1, compared to a state average of 1,700 to 1. So is the ratio of mental health providers. (The full rankings are available here.) The 2019 rankings are based on data that may be a few years old.
Flagler ranks poorly in length of life and premature deaths, coming in 23rd in that category.
Specific health behaviors like obesity, smoking, better nutrition and physical inactivity that continue to trend higher than the state average and showed little improvement over the past year will be included in the 2019-2022 Community Health Improvement Plan, a community-focused document developed by the department and implemented in conjunction with community partners.
Carrie Baird, executive director for Flagler Cares who also facilitates both the Community Health Assessment and Community Health Improvement Plan for Flagler County, pointed to a few clinical care indicators that continue challenge area residents. “We need to keep making strides to ensure our community members have access to the medical health they need,” said Baird. “We need more physicians, we need more dentists, and, as we know all too well, we need many more mental health providers to keep up with demand.”
One of Flagler Cares’ committees, Flagler Lifeline, is focused on suicide prevention and sharing information about what few mental health resources do exist in the community.
“We want to make sure people who need mental health services are able to get help,” Baird said. “With help comes hope and Flagler Lifeline is doing what we can to change the conversation about suicide in our community.”
DOH-Flagler Medical Director Stephen Bickel referenced sexually transmitted infections as another key area of focus for Flagler, given that rates continue to track higher statewide and throughout the community.
“The local rate growth for sexually transmitted diseases is an issue that we continue to address through our clinics,” Bickel said. “STDs pose complex and daunting challenges for public health. There are many types, some more serious than others, and a lot of factors at work. The challenge is not only in treating patients when they present with STDs, but reaching the community at risk to educate and motivate them to adopt safe sex prevention practices. Clinicians, scientists, and educators are tackling these challenges on the local, state, and national levels to get this problem under control and we are hopeful for a meaningful breakthrough soon.”
Bickel described the health department’s approach to health as population-based, and to address local issues, the department has launched clinics to treat HIV, Hepatitis C, tuberculosis and Hepatitis A over the past few years. Most recently, the department introduced a diabetes self-management education program and diabetes prevention program to help patients manage and prevent the chronic disease.
“We are identifying needs and coming up with health solutions that support our residents today and in the future,” Bickel said. “We’re proud of the progress we make each year and resolve to continue improving health in Flagler County.”
The rankings are produced annually by the University of Wisconsin and the Robert Wood Johnson Foundation as snapshots of counties’ health and to underscore the importance of partnerships between various community agencies to continually improve outcomes. These rankings use data related to health behaviors (tobacco use, exercise, healthy eating), social and economic factors (income, education, employment), access to clinical care and physical environment, as influences on health.