SOUTHERN INDIANA — With Indiana ranking last in the country for residents’ access to comprehensive public health systems, local health officials think that increasing funding and education are essential.
A 2022 Trust for America's Health (TFAH) study showed that 25% of Indiana residents have access to a comprehensive public health system, according to the latest state-level data from 2018.
Indiana’s last place ranking of 25% can be compared to the highest rankings of 86% in D.C. and 77% in New York.
TFAH lists 20 “recommended public health activities” that are used to define a comprehensive system. The list varies from how a community conducts ongoing and timely investigation of adverse health events to how it surveys the population for behavioral risk factors.
In brief, LifeSpring Health Systems CEO and President Beth Keeney described a comprehensive public health system as one that includes significant prevention efforts around serious or chronic disease. She said it can include topics like clean drinking water and immunizations.
“When you have a public health system that’s fragmented and not well funded, you do have higher rates of poor health outcomes,” Keeney said.
Keeney has spent 14 years at LifeSpring working for a comprehensive system. The community health provider is concerned with primary prevention such as addressing trauma, providing immunizations and ensuring access to transportation and housing. Without proper funding, there are fewer opportunities to provide education about issues that result in those poor health outcomes, Keeney said.
Keeney said that to address public health in the community, education and primary prevention initiatives are needed.
A health department administrator at Clark Memorial Health, Doug Bentfield, said local residents need to have a baseline understanding of healthy habits.
He said the Clark County Health Department is looking at educational efforts to talk about issues like weight management, heart disease and blood pressure.
“I think a lot of the issues that we have is we don’t take care of these underlying conditions that eventually turn into these very serious conditions,” Bentfield said.
The TFAH study noted that there is a gap of access to comprehensive systems between urban and rural areas, which researchers attributed to a variety of factors, including rural health departments having less funding and staffing.
“When you don’t have funding for public health, it actually affects the economics of the area that you’re living in as well,” Bentfield said.
When it comes to staffing in public health, Bentfield said that the turnover rate is the biggest problem as rates of pay are not always comparable to the private market.
But, he said he is hopeful that change is coming through good discussion and additional funding.
The state has come up with a couple of different programs to address the shortcomings in public health across Indiana, Bentfield said.
Some of the most impactful changes that can be made in Clark and Floyd counties to improve public health outcomes revolve around transportation, housing and affordable child care, according to Keeney.
Without transportation to go get health care, it means that people are not going to go to get the help they need, Keeney said.
“If you have to work two jobs to be able to afford child care for the one job, you’re definitely not going to take time off when you’re sick. You’re not going to be able to go to therapy when you need it, because you’ve got children that you’re taking care of,” Keeney said.
While there are things the region can work on, Keeney said that through the COVID19 pandemic, organizations learned how to work together effectively and maximize resources.
“In safety net health care, we become experts at doing more with less,” she said.
Keeney said she hopes and expects that the community will continue working together in this fashion after the pandemic.
“We have incredible leadership in Indiana and locally in public health, really, really strong leadership, but it really does require significantly more funding than what it’s allotted by the state and communities,” Keeney said.
Bentfield also touted the networking in Southern Indiana and the ability for the hospital to tie resources together with other organizations.
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