On Thursday, public health leaders who are part of the Ozarks Health Commission announced that addressing three community-wide chronic issues – diabetes, mental health and substance misuse disorder and recovery – will be prioritized over the next three years. The announcement is linked to the release of the commission’s Community Health Needs Assessment report, which officials said provides statistical backing to support the added focus on these issues in Springfield and across parts of the Ozarks. The messages were reinforced Thursday by community members who have either dealt with the issues or treated residents who are experiencing them.
That included Cecilia Greek, a 10-year-old who spoke about being born with a muscular disease and being bullied about it since she was 5. Before a standing room audience at the Springfield Art Museum, Greek shared how she received help from Burrell Behavioral Health counselors to navigate what once felt, she said, like a “world of hate” and unacceptance.
“I thought that I was not a person,” she said. “They treated me like I had no feelings. So I got counselors, physical therapists and psychologists. They helped me deal with those things, and I finally stuck up for myself. I remembered how good I felt after I got the help I needed. You can't keep those emotions in forever. Kids need to talk to their parents about how they feel. Never be afraid to ask for help. They will understand and get the help you need. It's important to talk to your kids. Do the right thing for your body and brain. Get all that negativity out.”
Jon Mooney, assistant director of the Springfield-Greene County Health Department, shared that he began pulling away from family and friends in 2020. Mooney said he felt at times like he had become a shell of himself while dealing internally with torment over his mood and struggles. After being screened and diagnosed with moderate depression, he started to take steps to improve, and also discovered a value in being vulnerable.
“I wanted to share my story because it is such a common thing,” Mooney said. “The more that I've had my own experiences with mental health, the more I've talked with others — along with the data — it points to, we have to normalize these conversations. We have to be able to talk about it, and I don't think my story is unique, unfortunately. But unfortunately, I think the talking about it is what's unique. And so that's what we're trying to do. That's what my whole goal was today, is to help to normalize that conversation to a group of community leaders and community members.”
Greek and Mooney were two of several speakers who received standing ovations upon sharing their stories on Thursday. They are two of thousands in southwest Missouri who have stories to share linked to the issues that are under the commission’s spotlight.
The three public health issues leaders from Greene, Christian and Webster counties vowed to prioritize Thursday morning are not new ones that residents of Springfield and surrounding communities face. The issues will be addressed with a newfound sense of urgency and unity leaders in public health, hospital systems and clinics developed in response to the COVID-19 pandemic, said Katie Towns, director of the Springfield-Greene County Health Department.
When the novel virus spread, public health workers pivoted to prioritize the response to COVID-19, Towns said. The hope, she said, is that the decisive ways health leaders responded can be a blueprint for addressing diabetes, mental health and substance abuse.
“You know how a crisis will bond people?” Towns asked. “That's what's happened. And I really feel like our partnerships across the board — the hospital systems as well as us, Burrell and Jordan Valley (Community Health Center) — we have aligned and we are in lockstep on these issues. And so moving forward, that just helps us to remember and recall how we focused on COVID and really put that same level of effort around these issues.”
Starting with data, commission builds towards solutions
Towns said developing the focal points to address over the next three years begins with raw data, and with commission members looking at what issues are prevalent in Springfield and the region. The new report includes numerous statistics that show Springfield and surrounding communities outpacing state and national averages in terms of people experiencing issues related to the three public health crises. For instance, a higher rate of residents in Springfield (15.3 percent) report poor mental health than the Missouri rate (14.5 percent) or the U.S. rate (13.4 percent), and the suicide mortality rates in Springfield and the region are both just above 22 per 100,000 people, compared to 13.8 across the U.S.
Along with compiling stats, the commission members conducted surveys, interviews and focus groups to learn more about which issues will resonate with people in the community, and which issues community leaders believe can be changed for the better.
Brandi Bowers, a clinical assistant professor who works as a pharmacist with Missouri State University’s MSU Care Clinic, said she could envision diabetic care in Springfield improving if people suffering from diabetes had better connections to the resources that can help them. The Mercy-affiliated MSU Care Clinic provides primary healthcare services for uninsured, low-income patients in the 18-64 age range. At the clinic, Bowers said, the staff is able to provide free insulin to some of its underserved patients, help adjust medications, work with a dietician team and direct patients to community resources where they can access healthy food. During the Thursday event, she said that a patient who came to her nearly straight from prison went from needing 20 insulin shots a week to one non-insulin shot a week, because she utilized the resources recommended to her. In the process, the patient’s life transformed. She got a job with insurance and housing. That life transformation, Bowers said, helps transform the community.
Bowers did not focus on the wealth of statistics available that show how blood sugar levels measured in lab tests can affect a person’s life. She focused instead on how diabetes affects the activities people fill their lives with.
“The thing about diabetes is it touches every aspect of a patient’s care,” said Bowers, whose full title is clinical assistant professor at the University of Missouri-Kansas City’s School of Pharmacy at Missouri State University. “And it bleeds into what we eat, how we move, how we feel. Blood sugars impact our energy levels, which impacts our ability to work. And what I spend most of my visits talking about with my patients, it’s not about what your labs are, but how do you feel. How are you interacting with your family right now? How are you interacting at work?
“I get (responses) like, ‘I couldn’t play with my grandkids like I usually do that day,’ or ‘I had to call in (sick) to work’ or ‘My people at work noticed I felt off and my boss asked me about it.’ Those are the things when they’re not going well, but what’s super exciting is when people come to us not feeling well and we get (diabetic problems) controlled, I hear, ‘I was able to get up and go walk with my daughter tonight when I wanted to.’”
In the MSU Care Clinic, more than one in four of the patients are diabetic, Bowers said, a percentage that is well above the estimated 8.2 percent of the national population with diabetes. Populations in both Springfield (11.2 percent) and the Ozarks (10.4 percent) outpace the state (10.1 percent) and the U.S. (9.5 percent) diabetes rates.
“I think as a community we can really double down on, ‘Are we connecting people with the resources that fit them?'” Bowers said.
Assessment hones in on significant, growing public health issues
Speakers Thursday said Springfield as a community made efforts to address the needs highlighted in the report, pointing out recent developments like the start of the Burrell Behavioral Crisis Center. But the needs keep growing.
“In the last four years, the number of patients that we're serving at (CoxHealth) Center for Addictions has quadrupled,” said Tressa Moyle, the center’s director. “We have seen significant increases in the last several years that just continue to exponentially grow, and we are fortunate to be able to continue to grow our services to meet those needs. But as you can see, the need just continues to expand year after year.”
While treating substance misuse disorder is different for each person who needs help, Moyle said that the ultimate goal with each person who enters treatment is to save their life. After Moyle spoke, one of the center’s clients did. Jeff Hannah said he started drinking in high school, grew more reckless during college and then learned to conceal his habits from his family and employers for years on end. A registered nurse, Hannah described in graphic detail how he was caring for a patient who was dying from cirrhosis of the liver and swore that would never be his fate.
“But within a few short years, it was my son that was weeping at my bedside as he wondered if I was going to live or die,” he said. “But I continued to get more out of control and I ended up losing my job, my career, my home, my marriage and almost my life.”
Hannah has gone through several treatment programs, including recently at the Center for Addictions. It was a step he took after being confronted about his addictions with his second wife, who he met during a period of sobriety.
“Treatment does work, when you’re ready,” he said. “And I came to believe about a couple weeks in. I heard these magic words for me that you have to believe that you can get better.”
At the end of the presentations, Towns thanked the audience for listening to people who addressed a set of heavy topics.
“I hope that each and every one of you have taken the pieces of hope that are offered here today,” she said. “Because we are rich with resources, and rich with a community of people who care.”
With the assessment report released, Towns said the next steps will be a set of plans that the health department, CoxHealth and Mercy will develop independently before reconvening to see where the plans align and how public health leaders can move forward in lockstep to address these issues.
