Addressing substance use and the opioid crisis is the top health priority for the Philadelphia region, a coalition of nonprofit hospitals determined in a wide-ranging report on the area’s health released this week.
Tax-exempt hospitals around the country are required by the Affordable Care Act to assess their community’s health needs every three years. But in the Philadelphia region, hospitals tend to do that on their own. This year’s assessment, which included major health systems in Chester, Montgomery, Bucks, and Philadelphia Counties, was the first time the region’s hospitals collaborated on the project.
“It was more comprehensive than what we could have done by ourselves,” said Jeanne E. Casner, Chester County’s health director. “And it saved dollars and time. We would not have gotten it done that fast.”
Hospitals analyzed data on a number of health problems facing the region, including behavioral health needs, food insecurity, access to primary care, maternal mortality, and affordable housing. They also hosted 19 community meetings for residents around the region to discuss their concerns about their community’s health needs. Hospitals then used that feedback and data to rank health priorities, and submitted their lists to Philadelphia’s health department, which led the effort.
“With the criteria that the institutions used to do the ratings, you think about what issues are having a big magnitude in terms of impacting a larger number of community members. And then you think about what’s actually on people’s minds, what they are feeling the burden of," said Raynard Washington, the chief epidemiologist for Philadelphia’s health department.
The opioid crisis, he said, was at the top of both lists.
“It’s virtually impossible not to see it as a major health issue," he said.
At numerous community meetings, residents mentioned the crisis as a particular point of concern. In the River Wards, residents worried about open-air drug use in neighborhoods like Kensington; in South Philadelphia, where drug use is less visible but where overdoses have skyrocketed, residents said stigma was keeping desperately needed drug treatment programs from opening in the neighborhood.
In North Philadelphia, a frustrated participant called available treatment options “a revolving door.” In West Chester, residents talked of attending the funerals of friends lost to drug overdoses. In Lansdale, a neighbor raised concerns about how readily available opioids and other drugs are to young people in town.
“It’s pushed beyond all geographical, social, and economic boundaries. It’s no longer in the back alleys,” Casner said.
Besides laying out health priorities for the region — behavioral health treatment, affordable health care, chronic disease prevention, food access, and affordable housing all made the top 10 list — the report also looked at populations particularly in need of health-care resources, including people experiencing homelessness and housing insecurity, immigrants, people with behavioral health issues and disabilities, and Hispanic and Latino communities.
African Americans, the report noted, have worse health outcomes and lower life expectancies than any other racial or ethnic group in the region — largely, the report said, due to higher poverty rates and exposure to structural violence in their communities.
And here, too, the opioid crisis has made matters worse: African American residents told community surveyors that substance use in their communities was “prevalent,” and that “demand is high and resources are slim” when it came to drug treatment.
Health officials from several counties said that collaborating with hospitals and other health departments has helped them get a better picture of the region’s most persistent health problems.
“I’ve worked in three other states as a health director, and I’ve never seen that level of collaboration before,” said Brenda Weis, Montgomery County’s public health director.
Washington said the project’s aim was to help hospitals form ties for future work together.
“If you get the folks in the hospitals working together on assessing what the problems are, the idea is that they will then inherently work together on solutions,” he said.