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Town takes charge of its future health

[photo] Salem, in Dent County sits 30 miles off the nearest interstate. About 13,780 people live in Dent, some 8,900 of them in Salem. The area's average annual per-capita income is $8,845 -well below national poverty lines.

Those are the county's vital statistics and they paint the picture of an area in need of several boosts, from health care to the economy. But those numbers don't tell the story of the people of Dent, a community that decided to take charge of its future and change its nagging ails, from improving access to physicians to luring industry.

"The concerns facing Dent residents are the same concerns facing other rural Missourians," says Gail Carlson, state specialist in continuing medical education. "How Dent is handling these challenges can serve as a model for the rest of the state."

How is Dent handling these challenges? For one thing, it's starting at a grassroots level and working up. The town of Salem formed the Salem Area Community Betterment Association (SACBA), to address the area's most pressing needs. One sub-group of the association is looking at improving access to health care, a major concern for a county that is heavily populated with low-income elderly residents. Child and family development extension specialist Bryan Adcock is a member of the group, known as Healthy Communities 2000.

"Health care is a big issue, a major issue for people in this area and our goal was to get them involved in the process, get them talking about what needs to be done," says Adcock.

To get the process rolling, Adcock applied for and secured a sought-after affiliation with the National Rural Health Association's program known as Community Solutions for Rural Health (CSRH). Salem was one of only 17 counties nationwide to receive a seed money grant of $7,000 from the national organization.

[photo] The effort was pure grassroots. Town hall meetings were held to assess the community's needs and moods toward health care. From there, Adcock and other organizers formed Salem's Healthy Communities 2000 Volunteer Council, a coalition comprised of health care providers and consumers working in partnership.

"At our town hall meeting was where the real work happened," said Adcock. "The community identified its most pressing needs."

The needs include:
  • An after-hours physician program.

  • Aggressive physician recruitment efforts.

  • Community education and referral system.

  • Affordable health care program.

What makes Salem's efforts so outstanding is that the community didn't stop once needs were addressed. They moved full-force to solve them, applying for grants to help fund initiatives and forming committees to oversee the process. Reaching some goals will be more manageable than others. For example, finding physicians, while a challenge, will be more attainable than creating an affordable health care program, which is a national problem as well.

"Already we've worked toward one of our goals," said George Gruendel, who the coalition hired as a community encourager. A former instructor, Gruendel, who has a doctorate, works closely with Adcock and others to bring as many people as possible into the effort.

The group has already tallied its first accomplishment: The Dent County Health Center has been deemed the primary health care delivery site for the area's new doctor-after-hours program, which will be staffed from 5 p.m. to 10 p.m. Monday through Friday.

[photo] But the group's successes don't stop there. They received a $100,000 grant through the state department of health's Primary Care Resource Initiative (PRIMO) to help the community meet those needs they identified as critical during public meetings.

Adcock knows that improving access to health care has economic ramifications as well. The area is actively pursuing new industry and organizers hope that working to improve health care services helps entice prospective employers.

"In seeing us promote wellness, social services and health, an industry will say, 'This is a motivated community,'" says Adcock.




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