WATERTOWN — About four months into the ongoing COVID-19 pandemic, the North Country Health Compass Partners and the Fort Drum Regional Health Planning Organization conducted their annual health survey of the north country in an effort to continue to better understand current situations and monitor any changes in healthcare and health habits among residents in the tri-county region. This survey, conducted on June 30, has been completed every year since 2016 with the intent to support and plan future initiatives and monitor changes within the community, as well as raise community awareness through the process of surveying. The sample size in the 2020 survey was 2,436, resulting in an average margin of error of ±2.5%, according to FDRHPO.
The report of findings from the 2020 Community Health Survey of adult residents in the tri-county area is now available. As could be expected with a year quite unlike any other, many results of the survey differ from last year. In addition, some of the survey questions themselves featured COVID-specific and telemedicine angles, a contrast from years past.
Megan V. Donato, a FDRHPO data analyst, has worked for the organization through the 2019 and 2020 surveys and was even involved with the calling and surveying while she was still in school.
“I’d say given the circumstances of this year, I am happy with the findings of this year,” Ms. Donato said. “Taking into account how hard our community has been impacted by COVID, the findings are still optimistic and still positive.”
Measures that were not expected to be impacted by COVID-19 included the percentage of those who have a primary care provider and the safety of one’s neighborhood, neither of which differed from previous findings. Four out of five — or 81% — of north country residents in 2020 have one person or medical office that they think of as their personal doctor or healthcare provider. According to FDRHPO, this rate has not significantly changed between 2016 and 2020.
“As far as the primary care visits, emergency room visits and hospital admissions, it makes sense to us that the rate of people seeing their primary care provider in the past year hasn’t really changed even though the pandemic has been happening this year,” Ms. Donato said.
New to the community survey this year were questions pertaining to telemedicine. With almost one-third of surveyed north country residents saying they’ve participated in a telemedicine visit, nearly half indicated that if given the option to see a healthcare provider for a routine or follow-up appointment using telemedicine, they were likely to choose telemedicine in place of an in-person office visit.
“In 2020, with the pandemic we felt it was vital to ask some questions around telemed since it seems not only is it currently so prominent, but it also is likely to continue to be used moving forward,” Ms. Donato said. “What we have noticed is that our partners’ telemedicine encounters have definitely increased this year compared to previous years.”
In 2019, telemedicine encounters for FDRHPO partners totaled 4,761 for the entire year. As of June 30, total encounters were 32,858.
Seven potential barriers to patients choosing to use telemedicine were studied this year. For quality of care in telemedicine, 68% responded that it was a major or minor barrier. Technical problems connecting received 53%, concerns with insurance coverage came in at 51% and security and privacy received 49%. Less than 40% of participants reported access to reliable internet service, doctor does not offer telemedicine and lack of access to a smartphone, computer or tablet as barriers.
“People can still do telemedicine appointments with their primary care doctor and have those routine checkups, but we do know that people were avoiding going to the hospital, people were avoiding going to doctors’ offices, worrying that these healthcare facilities could be a possible exposure to COVID,” Ms. Donato said.
While 75% of adults in the north country still report having been to their primary care doctor’s office at least one in the past 12 months, including both routine check-ups and occasions when they were ill, only 16% reported having received care at an emergency room at least once in the past 12 months, and 7% report having been admitted to a hospital at least once in the past 12 months. Both values are at an all-time low, falling from highs in 2016 of 30% and 15%, respectively.
According to FDRHPO’s survey, 79% of north country residents in 2020 agree with the statement, “I am actively working to improve my health,” a decrease from 91% in 2016. Forty-two percent continue to be somewhat optimistic about their personal physical health, down from 50% in 2018, with 53% continuing to be optimistic about their personal mental health, a decrease from 60% in 2018.
“I wish I could say that the decrease comes as a surprise, but we were kind of expecting that this year given the state of our communities in June,” Ms. Donato said. “We knew that people’s mental and physical well-being were being negatively impacted by the pandemic and the situation that so many of us found ourselves in.”
According to Ms. Donato, these findings and the decrease in self-reported mental and physical well-being reflect what national studies have shown as well. The Centers for Disease Control and Prevention and the National Center for Health Statistics have also done these types of studies and shown people’s mental health is at a low — that there’s more anxiety and depression right now.
“Even though the self-reported mental health and physical health have decreased since last year, as a whole, our region is still pretty optimistic about their health,” Ms. Donato said.
Compared to rates from previous surveys, the rate of alcohol consumption has increased in 2020. About 80% of adults indicated they drink alcohol, with about 61% indicating they drink alcohol at least 1-2 times per month or more, an increase from 52% in 2019.
About 19% of adults in the north country described their status as “current users” of tobacco, and 14% indicated “every day” cigarette use — an increase from 10% in 2019. On the other hand, current use of smokeless tobacco and e-cigarettes has declined since 2019, with only 4% of respondents reporting they currently use smokeless tobacco, either some days or every day, down from 7% in 2019. Current use of e-cigarettes has fallen to 4% from 9% in 2019.
“I think it really reflects the hard work that our partners have been doing this past year — that the current rate of use for e-cigarettes has decreased significantly since last year,” Ms. Donato said. “Other organizations and our partners have been doing campaigns and trying to get the message out that e-cigarettes aren’t safe and it looks like their work can be felt with the results of this survey.”
Another diversion from previous years, according to the survey, is that north country residents in 2020 seem very interested in obtaining testing for COVID-19. More than seven in ten adults — 71% — are interested in being tested for COVID-19 antibodies in order to determine if they were infected in the past. More than 57% are interested in being tested with the COVID-19 viral test to determine if they are currently infected.
The majority of north country residents seem to plan to continue practicing recommended healthy behaviors to reduce transmission of COVID-19, including frequent hand washing for 20 seconds or more, wearing a mask in public, social distancing, limiting in store shopping and limiting social gatherings. While the level of engagement in these recommended behaviors varied, just 6% were not planning to continue any of these behaviors.
“Every year the survey is conducted to help inform the healthcare partners in the region, to help inform their decisions as they are planning for the future as they’re evaluating the current initiatives that are in place,” Ms. Donato said. “So often we’ve noticed improvements in our measures, which are directly related to the incredible work being done in all three counties.
“We also will get new information that will shed light on something that hasn’t been considered before, maybe that’s the telemedicine questions or some of the COVID questions we introduced this year,” she added. “This data can help inform those strategies moving forward.”
The results for all survey questions, as well as more detailed findings, can be found in the full report by visiting www.ncnyhealthcompass.org.