Health Survey Results in; Report Sunday

By JULIA WELLS

The people of the Vineyard are healthy - healthier, in fact, than the general population on the mainland. They have lower rates of obesity, they smoke less, they are conscientious about prevention and they visit their doctors regularly.

But this good health is not uniform. Vineyarders do not take care of their teeth, they have high rates of skin cancer and they are contracting tick-borne illnesses in numbers that are considered epidemic. Many Islanders, especially year-round residents, suffer from depression. Alcoholism is more prevalent in the two "wet" towns than in the other four towns.

This is a snapshot of the results from a wide-ranging scientific health survey recently completed on the Vineyard. Aimed at developing a comprehensive health report and called The Health Report of Martha's Vineyard, the survey is the first of its kind on the Vineyard.

The complete results of the survey will be released at a public meeting on Sunday, August 10. It begins at 7 p.m. in the Martha's Vineyard Regional High School Performing Arts Center. Billed as a town meeting, the public session will be moderated by 60 Minutes anchor and longtime Vineyard resident Mike Wallace.

Directed by Diane Becker, a professor of medicine and director of the Center for Health Promotion at Johns Hopkins University, the survey is a collaborative venture supported by virtually every health care organization on the Vineyard, including the Martha's Vineyard Hospital, Martha's Vineyard Community Services, the Dukes County Health Council, Hospice of Martha's Vineyard and the Foundation for Island Health.

In an interview with the Gazette late last week, Dr. Charles Silberstein, a Vineyard psychiatrist and president of the Foundation for Island Health, and Fred Rundlet, co-chairman of the health survey project, gave a sneak preview of the survey results.

The survey examined the medical, dental and mental health of Island residents, both year-round and part-time residents. Part-time residents who answered the survey spent an average of three months a year on the Island.

On the whole the survey found that Vineyard residents are health conscious - over 70 per cent of year-round residents and 84 per cent of part-time residents saw a doctor for regular health care last year.

But the survey also pinpointed the well-known problems with health care access on the Island, finding that in 2002 almost half the residents who responded left the Vineyard for health care. Reasons cited include:

* An inability to get an appointment with a doctor in a reasonable time (25 per cent).

* A need for specialty care not available on the Island (20 per cent).

* Privacy issues (5 per cent).

About 24 per cent of the respondents who left the Island for care said they thought the care was better on the mainland.

The survey shows that the hospital emergency room is widely used as a primary care clinic - 29 per cent of the year-round residents surveyed said they had used the emergency room in the last two years for care that was not an emergency.

The survey also reveals an acute need for more dental care - 80 per cent of the respondents said they currently need some kind of dental care, and 18 per cent said they couldn't get access to a dentist.

Two diseases stand out: tick-borne diseases and skin cancer.

In the survey, 85 per cent of year-round residents and 64 per cent of part-time residents reported they had found ticks on their skin in the last year. At the same time, 21 per cent of year-round and 11 per cent of part-time residents reported having a documented tick-borne illness in their lifetimes.

"Those are phenomenal numbers, and given what we are beginning to learn about chronic Lyme disease, this is a serious epidemic," said Dr. Silberstein.

Dr. Silberstein and Mr. Rundlet noted that the two most prevalent illnesses on the Vineyard are also preventable.

The survey also found a high rate of depression (17 per cent) among the general population, and high rates of stress and anxiety among year-round residents.

The survey was mailed to 5,700 randomly sampled full-time and part-time residents; 1,065 full-time and 702 part-time residents responded.

The survey also included in-depth personal interviews with a large number of health practitioners, including nearly every Vineyard doctor and many Island clinicians, nurses, mental health counselors and complementary, natural and alternative care practitioners.

The clinician results will be kept under wraps until the town meeting.

"We are going to learn a lot about the clinician attitudes toward health care," Dr. Silberstein promised.

Dr. Silberstein and Mr. Rundlet both said the survey is an important new beginning for health care on the Vineyard.

"The Vineyard is a place where we value education and the environment, but health care is not up there as a community value," Mr. Rundlet said.

"The real challenge will be how we use this. This should be the foundation for the beginning of a truly integrated health care system on the Vineyard," he added.

The good health enjoyed by Vineyard residents is also a good place to start, Dr. Silberstein and Mr. Rundlet said.

We want to maintain and enhance the health status of the community," Mr. Rundlet said.

The value of the survey is estimated at $1 million and much of the work that went into it, including all the work from Johns Hopkins, was donated. The Foundation for Island Health is now looking to raise $60,000 to defray its own costs associated with the survey.

Dr. Silberstein said there are many directions to pursue in the future, using the health survey as a baseline, including more in-depth study of the Brazilian, the elderly and the pediatric populations on the Vineyard.

The analysis portion of the survey will not be completed until the fall.

The August 10 town meeting will be structured in the following way: Dr. Silberstein will present the results of the population survey and Dan Munoz will present the results of the clinician survey. A fourth-year medical student, Mr. Munoz administered the clinician portion of the survey.

"We are hoping to have a really active discussion," Dr. Silberstein said.