A report examining the health and well-being of residents in Lake, Orange, Osceola and Seminole counties saw the need to improve access to affordable housing, equitable health care and mental health services.
“One of the most significant barriers to accessing health care in the Central Florida region is access to financial resources,” the report states.
These data are part of the Community Health Needs Assessment, a report released every three years by a collaboration including the Central Florida Division of AdventHealth, Orlando Health, and the Florida Department of Health in Lake, Orange Counties. , Osceola and Seminole. The data comes from a variety of sources, including surveys, focus groups, the Florida DOH, the US Census Bureau, and the Centers for Disease Control and Prevention.
The 2022 report, released Nov. 1, found adults in central Florida are particularly impacted by chronic health conditions and barriers that could be overcome with additional resources.
According to FDOH data from 2017 to 2019, death rates from heart disease and diabetes were above the state average in all central Florida counties except Seminole, which has the highest average income of the four counties with the highest proportion of college graduates.
The death rate from stroke in Seminole, Orange and Osceola also exceeded the state average, as did deaths from Alzheimer’s disease in Orange and Osceola.
Each county had a higher rate of cancer deaths compared to the Florida average.
The contributors to the overall health of each county are complex and multifaceted, but when stakeholders were asked to identify the top three challenges facing the community, they almost always pointed to housing.
Without affordable housing, a person’s ability to pay for health care, stay employed and not end up on the streets becomes exponentially more difficult in a “chain reaction,” a speaker at the collaboration said.
“We have seen a huge increase in the number of local families living in motels. It’s not a good place to live, and we’re hitting rock bottom to figure out where else we can send them. There are no shelters. There is no available and affordable housing,” another commenter said.
Central Florida is particularly vulnerable because many residents work in low-wage jobs in the hospitality and tourism industry.
“It’s not uncommon for theme park employees to live in their cars in the theme park parking lot because they can’t afford other housing,” one commenter noted.
One in eight participants interviewed for this report did not have stable housing. One in six people needed medical care but did not receive it, and about half were unable to pay for care.
From 2015 to 2019, federal data suggests that the percentage of residents with health insurance increased in the state and in Central Florida, reaching 87.2% statewide; 89.7% in the lake; 86.7% in Orange; 85.5% in Osceola and 90.5% in Seminole.
However, many low-income people still do not have insurance, and insured people may still struggle to pay for medical care.
“With health insurance, the cost of care is still very high. With insurance but low income, they simply cannot afford care. These are the same people who cannot eat healthy. There is a wrong cycle,” a public health system administrator told the collaborative.
Florida is one of 12 states that haven’t expanded Medicaid, leaving about 415,000 low-income people in the state without a way to get health insurance, according to the report.
More than half of uninsured people who would receive Medicaid coverage with this expansion are Latinos, blacks or other people of color, the report notes.
Income, also largely linked to race and ethnicity, is another important predictor of health outcomes.
For example, in most Central Florida counties, the percentage of residents with diabetes who earned $25,000 or less is double that of those who earn $50,000 a year.
Beyond housing and financial problems, other barriers prevent people from getting regular health care. On the one hand, health care is not always available in all the languages commonly spoken in the region.
“People who don’t speak English and those who don’t have papers are afraid to seek treatment. There’s not even material to share with them,” said a member of the Latin American community. “We need, at least, more print and social media messages in THEIR languages about how to get care.”
Central Florida, especially in rural areas, also faces a severe shortage of doctors.
“We have chosen to live in a rural area and don’t expect everything to be here. However, basic primary care in rural areas is at a critical point,” said a Lake County official from a community services site. “Especially with COVID, people just won’t travel as much and many don’t have internet access for telehealth.”
People with disabilities face a whole different set of challenges, in addition to the fact that they are more likely to be low-income as well.
Center for Independent Living focus group participants said it was difficult to get the COVID-19 vaccine because the vaccine registration site was not accessible to the visually impaired and transportation was difficult to access. navigate.
“Transportation requires planning. I can’t make an appointment at 9am or 10am because it takes a while to get ready. It could be longer because I am a chair driver,” a disabled community member said in the report.
The issue is most relevant in Lake County, which has a disproportionate number of people with disabilities.
Over the past 10 years, the percentage of Lake households that have a person with a disability has reached 17%, which is higher than the state average and nearly 50% higher than the national average of 12.7%. according to census data.
Florida faces a severe shortage of mental health care providers, and Central Florida is even worse in some categories, especially in Lake and Osceola.
Lake has about 170 providers per 100,000 residents and Osceola has 112, which is significantly lower than the state average of 247.5 per 100,000. Lake and Osceola also lack child and adolescent psychiatric beds, which means that children from these regions are sent to Seminole or Orange. These counties have limited capacity even for their own residents according to state monitoring data from 2019.
The lack of mental health care resources was highlighted during the pandemic when the region’s opioid crisis escalated along with other mental health issues.
Again, people of color are the hardest hit. Black and Latino communities are particularly prone to stigma related to discussions of mental health issues, but even if someone reaches out, options are few.
“A lot of black/African Americans [people] in my neighborhood might need advice, but are not likely to ask for it. Some do. Others — from what I hear — can’t find a counselor who is affordable and ‘looks like them,’” a black woman from Seminole County told the collaboration.
Substance use is often interconnected with other threats to people’s well-being.
“In all of my housing cases that don’t involve money, most of the others are that mental health or addiction issues are causing disruption,” said a service provider serving Lake, Seminole and Orange counties. .
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Rural residents have a harder time finding someone to talk to than city dwellers.
“There are a lot of counselors in Orlando, especially if you have insurance. Rural areas are in trouble. Of course in rural areas public transportation is not good and people tend to have less money I think,” a Lake County resident said in the report.
Lake, of the four counties, has by far the highest suicide death rate – about 20 per 100,000; the highest drug-related juvenile arrest rates per 100,000 youth; and the highest proportion of K-12 students diagnosed with an emotional or behavioral disability.
At the same time, many stakeholders interviewed for this report mentioned some positive aspects of living and working in Central Florida: the growing diversity of the population and its many collaborating nonprofits.
“There is a willingness from various partners to come together to tackle big picture issues,” a commenter from Osceola said in the report.
In response to the report’s findings, AdventHealth and Orlando Health plan to partner to address a need in Central Florida with a joint project: more details will come later, AdventHealth spokeswoman Melanie said. Ararat.
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