Emerson Hospital opened its doors 105 years ago with the humble goal of providing basic care to area residents. Since then, the hospital has grown in size and sophistication, and the service area has steadily expanded. However, what never changes is Emerson's commitment to its community. Here is an overview of recent findings, familiar programs and new offerings.
A careful look at community needs — and a plan to meet them
Every three years, Emerson undertakes a community health needs assessment and compiles information from a number of sources, including the U.S. Census, Massachusetts Department of Public Health, the Centers for Disease Control, the hospital's own Youth Risk Behavior Survey, as well as input from interviews with community residents and representatives of Councils on Aging, housing authorities, schools and other groups. The most recent needs assessment was completed in September 2015.
"We're rigorous about analyzing the data, which we use to define priorities for community programs," says Christine Gallery, senior vice president for planning and chief strategy officer. "After review by the Community Benefits Advisory Group, which is a committee of our Board of Directors, the recent needs assessment was reviewed by the hospital's entire Board." This work led to the identification of the following five health needs in the 25 towns served by Emerson:
- Cancer prevention, detection and care. Five types of cancer account for 60 percent of cancer incidence in Emerson's service area: breast, prostate, lung, colorectal and melanoma. Because lung cancer is the leading cause of death, Emerson will continue to offer low-dose CT lung screening to detect lung cancer at the earliest possible stage and assist patients with smoking cessation through Freedom from Smoking classes. There is a specific need for skin cancer prevention education for youth.
- Behavioral health and substance abuse. Findings include an increase in opioid-related deaths, chronic or long-term heavy drinking among adults age 60 and older — found to be higher than the state average — and stress among teens. The goal is to promote mental health services, provide education and remove the stigma of treatment. Emerson sponsored a community forum on opioid addiction in May 2016.
- Care coordination for elderly patients. Isolation is the target issue for older individuals living in Emerson's service area, as transportation is a barrier to accessing care. Elderly patients also need better transition planning when they leave the hospital, as well as help with medication management. In addition, there is a need for caregiver respite programs.
- Domestic violence awareness and advocacy. Victims of domestic violence need legal services, transportation and mental health services. Domestic Violence Service Network training has been provided to 80 Emerson employees, with obstetrics services and pediatric patient care staff scheduled to receive it next.
- Health care services in the town of Maynard. There are minimal health services located in Maynard, a town whose population is projected to grow. Plans are underway to determine what health care services are most needed by the town's residents and to identify resources that can best support existing town services.
Emerson's community health needs assessment, including the implementation plan, is available at emersonhospital.org/chna.
Addressing stress in our kids
It is an accepted fact today: stress is everywhere, and children feel it. The Benson-Henry Institute (BHI) for Mind Body Medicine at Massachusetts General Hospital conducted research that led to an education initiative for schools. The goal: provide students with relaxation skills and life management tools that can benefit them now and throughout their lives.
Emerson stepped up to sponsor BHI workshops for teachers in 2014 and 2015. A total of 70 teachers in Concord and Westford have received training; 50 teachers at schools in Acton-Boxborough and Maynard are scheduled next.
"We have to help students find ways to manage their stress due to social and academic pressures, and stress that trickles down from parents and teachers," says Julee Vitello, a school psychologist and the school counselor at Willard Elementary School in Concord.
What does mindfulness for kids look like? Each Monday morning at Willard, a chime sounds to begin the school-wide "mindful moment" that reminds students of the reflection for the day. Each month brings a new theme, such as gratitude, generosity and friendship. First-graders take a cue from yoga adherents by practicing savasana — a relaxation exercise where one lies flat on the floor and breathes deeply. The art teacher holds silent classes for quiet creation. Teachers encourage students to take mini-breaks by putting their heads on their desks.
"The kids love the 'mindful moment' we offer," says Cheryl Shea, an art teacher at Concord Middle School. "They request it as a strategy for getting themselves into neutral. I find it counteracts their tendencies toward being overscheduled and overstimulated."
Enthusiasm for the Benson-Henry education initiative is growing, including among teachers who observe that the embrace of mindfulness helps their students stay away from their phones.
In Westford, providing specific care to seniors
Preventive care sometimes is the best kind. Emerson recently provided a $10,000 grant so that low-income Westford seniors can receive the shingles vaccine and basic dental care. Many elderly find that their insurance does not cover the shingles vaccine, while others cannot afford the required co-payment; those who lack dental insurance often forego preventive care.
Shingles awareness is growing, says Sandy Collins, RN, health director for the Westford Health Department. "With all the publicity, people 60 and older are looking for the vaccine now," she says. "They realize that one in three individuals will develop shingles during their lifetime, and people over age 60 are the most likely to have complications and debilitating pain." Anyone who had chickenpox can develop the painful, blistering rash associated with shingles.
The rest of Emerson's grant is earmarked for dental care — something that Bruni Fletcher says was long overdue. "I read about the free dental service in the senior newsletter, and I understood you need to qualify in terms of your income," says the Westford resident, who is 81 and took advantage of the shingles vaccine program last year. "I appreciated having a cleaning, which has been on the back burner."
Ms. Fletcher received the cleaning from Jamie Smagula, DDS, who practices with Thomas Schofield, DMD. "We are grateful to Dr. Schofield and his associates who have collaborated with us since the program began," says Ms. Collins, noting that the preventive care includes taking x-rays, performing cleanings and filling cavities. "We know that dental disease can lead to various medical conditions, and we know that many people don't have dental insurance.
"Without this commitment by Emerson and others, our residents would not receive these services," notes Ms. Collins. "We offer more in Westford than many other communities, thanks to our benefactors. We value, and greatly appreciate, this collaboration with Emerson and the continued financial support they provide for these services."
Sun protection in parks and playgrounds
Skin cancer is being diagnosed more often, and young adults are not immune. To address higher incidence rates of melanoma, the most serious type of skin cancer, and to educate the community about skin cancer prevention, Emerson will coordinate with public works departments in its service area to install sunscreen dispensers in public parks and playgrounds.
Ira Skolnik, MD, PhD, an Emerson dermatologist and president of the Massachusetts Academy of Dermatology, worked for the successful recent passage of legislation that bans individuals younger than 18 from tanning booths, which expose individuals to a dangerous level of ultraviolet light.
Youth Risk Behavior Survey provides a high-impact snapshot
For close to 18 years, Emerson's Youth Risk Behavior Survey (YRBS) has provided a valuable snapshot of the behavior of area middle school and high school students. The biannual survey is the largest of its kind in Massachusetts. Ninety percent of eligible students in grades 6, 8 and high school — a total of 10,578 students from eight school districts — participated in the 2014 survey.
Data from that survey indicated that area youth are experiencing high levels of stress due to their academic workload, as well as events at school. High school students in Emerson's service area report considering suicide at a rate equal to the state average. Fortunately, use of alcohol and illegal drugs has decreased from prior years.
Emerson is committed to its collaboration with local school districts to sponsor the survey so that mental health, substance abuse and other trends will continue to be understood and, importantly, programs developed to address specific problems. The 2016 survey was conducted in March, and results will be available in the fall.
Health and Wellness Expo is a perennial favorite
Each spring, Emerson opens its doors and invites in community members to take advantage of the Family Health and Wellness Expo. The popular event features free health screenings, cancer and general health information, conversations with health and wellness experts and activities for children.
Participants register for various screenings, including for skin cancer, cholesterol level, prostate cancer and thyroid function. Other screenings are for blood pressure, bone density, diabetes, oral cancer, respiratory conditions and posture problems.