A recent survey by the Regional Medical Center shows residents continue to struggle with access to care and chronic conditions such as diabetes and hypertension.
The hospital's Community Health Needs Assessment 2019 report indicates Orangeburg, Calhoun and Bamberg county residents face serious health issues but do not necessarily see a doctor for the conditions.
The main reasons given for individuals not receiving health care are a lack of insurance/inability to pay, not having a family doctor, lack of transportation and fear of seeking health care, according to the survey.
More than 70 percent of the survey’s respondents said a lack of insurance prevented them from receiving care.
A lack of transportation and not having a family doctor affected over 40 percent of the survey respondents while fear of going to the doctor was in the 30 percent range of those surveyed.
The survey, which was conducted from November 2018 through January 2019, was presented to board members by RMC Vice President of Marketing and Strategy Carol Koenecke-Grant during the RMC's March board meeting.
Trustees unanimously approved the report, which saw public participation 80 percent higher than it was three years ago.
"We really increased our participation and reached into those levels that did give us a lot of good information," Koenecke-Grant said.
The hospital has to produce the report as well as an implementation plan, she said. "We have to say what ... we are going to address and if there are health needs that were identified that we are not going to address, then we need to give the reasoning behind that."
The assessment is required every three years under the Affordable Care Act.
The survey includes input from the hospital’s public partners and residents. The hospital worked with the Tri-County Health Network to do the survey.
The survey was also presented online, with about 220,000 people having access to the survey. Interviews were also done with stakeholders such as the South Carolina Department of Health and Human Services and physicians.
"I think there is a misperception that the hospital is solely responsible for the community's health needs and that is just not the case," Koenecke-Grant said. "The hospital is responsible for the survey, but we looked at partners in the community. The hospital can't do all things for all people all the time."
"These are issues we will be looking at and addressing over the next three years," Koenecke-Grant said. "The hope is when we do our next health needs assessment in 2022, we will move that needle some."
In addition to community response, the survey also included S.C. Department of Health and Human Services rankings of health indicators for all three T&D Region counties.
The health outcomes portion of the report took into account length of life and quality of life. The health factors portion included health behaviors, clinical care, physical environment and socio-economic environment.
In Orangeburg County, the county ranked 40th out of the state's 46 counties in health outcomes, down from 37th in 2016. In health factors, Orangeburg County fell from 37th in 2016 to 41st in 2018.
Of the 35 indicators mentioned in the SCDHHS rankings, Orangeburg County has gotten worse in three indicators, stayed the same in 29 indicators and improved in three.
The three indicators seeing improvement were a reduction of children in poverty, a reduction in the uninsured and a reduction in alcohol-related deaths.
The indicators where the county has gotten worse are an increase in premature deaths, the lack of access to exercise opportunities and an increase in air pollution.
In Calhoun County, the county ranked 10th in health outcomes in 2016 and 21st in health outcomes in 2018. In health factors, the county ranked 19th in 2016 and 12th in 2018.
Of the 35 indicators mentioned, the survey revealed Calhoun County has gotten worse in six indicators, stayed the same in 24 and improved in five.
The county has seen an increase in premature deaths, physical inactivity, air pollution and the number of uninsured.
The county has seen a reduction in adults smoking, an increase in exercise opportunities, a decrease in sexually transmitted diseases and an increase in high school graduates.
Bamberg County ranked 32nd in 2016 and 31st out of the state's 46 counties in 2018 in health outcomes. In health factors, the county ranked 39th in 2018 compared to 35th in 2016.
Of the 35 indicators mentioned, the survey revealed Bamberg County has gotten worse in eight indicators, remained the same in 14 and improved in 12.
The county has seen an increase in the number of premature deaths, alcohol-impaired driving deaths, single-parent households and sexually transmitted infections. It’s also seen a decrease in the number of individuals monitoring their diabetic conditions and college attendance.
The county has seen a decline in adult obesity. It also has seen increased exercise opportunities, more people being insured and an increase in mammography screenings.
Other improvements include an increase in the number of high school graduates and declines in unemployment, violent crime and deaths from injuries. Air pollution has improved.