Its unfavorable ranking was due to social and economic factors, such as poverty and violent crime, combined with health behaviors like obesity and smoking.
The County Health Rankings & Roadmaps report was based on health outcomes and health factors documented by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Putnam County has the worst health factors of the sixty-seven Florida counties. It has the third worst health outcomes, which include premature death, low birthweight and poor mental and physcial health. Only Union and Washington counties scored worse for health outcomes.
Obesity can lead to coronary heart disease, type 2 diabetes and liver and gallbladder disease, among other conditions that the report listed. Cigarette smoking is the leading cause of cancer, including cancer of lung, esophagus, mouth, throat and kidney, according to the U.S. Department of Health and Human Services.
Dr. Anand Kuruvilla is Putnam’s only radiation oncologist. He said he’s not surprised by the county’s low ranking.
He said he thinks poverty – 43 percent of Putnam’s children are poor compared to a state average of 25 percent – correlates to the high rates of smoking and obesity, because people in impoverished areas can lack proper education about health, on top of not having insurance.
According to the report, 33 percent of Putnam’s residents are obese, compared to the state average of 26 percent. Twenty-seven percent are smokers – compared to the state average of 18 percent.
“It’s kind of a vicious circle: patients can’t come in because they don’t have insurance, there are no doctors to see them, or they can’t afford to pay a doctor,” said Kuruvilla, who is the director of the Cancer Center of Putnam. “So we’re trying to remove that barrier.”
He said residents can’t get access to health care because they can’t afford health insurance.
“Our level of cancer care here is actually excellent if you have insurance, but if you don’t get in to see me, you’re going to have a problem,” he said. “So that’s why we’re trying to remedy that by at least making it easier by removing barriers to access.”
Kuruvilla is president of Putnam First Cancer Fund, a charity that helps Putnam residents receive cancer diagnoses or helps diagnosed patients receive funds for treatment. He said said diagnosing the disease can make a resident more eligible for aid from state agencies.
Kuruvilla said that some patients aren’t even eligible for Medicaid. He said there’s no office in Putnam County where someone can apply for Medicaid and receive assistance.
Compounding the problem is that fact that those who earn too much to qualify for Medicaid and too little to afford medical insurance cannot buy insurance on the health care exchanges, because lawmakers refused to expand Medicaid under the Affordable Care Act.
There are also no safety-net hospitals available to Putnam county residents, which Kuruvilla said hurts their chances of getting treated if they have no insurance.
“Now how is a patient, who can’t put food on his plate, be expected to reach this place?” he said. “So it’s all kind of stacked up against these people. So it’s very sad.”
Hollister nurse Melissa Callender was surprised when she found out that obesity was an issue in her county.
“Obesity is a little surprising because I’m seeing a lot of people with a need of food to eat,” Callender said
Callender also noticed that the lack of health insurance is a problem. She said she was recently working in Palatka with a company that helps get health care to residents and was surprised by how much it costs for residents to have health care.
“It’s a little concerning to me because I do have a skill, and I am able to work, and I am able to take care of my family, as opposed to the majority of the people that I see are struggling here in the county,” she said.
On her days off, Callender goes to nearby impoverished neighborhoods and takes old women out to do their shopping because they can’t afford their own vehicles.
“I definitely think that the (county officials) need to get out in the county,” Callender said. “They don’t get out and talk to the people.”
On the other side of the rankings list, Alachua County was ranked second healthiest county for overall health factors and No. 1 in clinical care due to how many residents are insured and how many primary care doctors it has.
CEO of Gainesville Medical Centers, Jen Hernandez, wasn’t surprised by Alachua’s high ranking.
“Gainesville is the benchmark,” Hernandez said.
Hernandez said that the reason for high rate of insured residents is because many employers provide health care benefits. She said that Putnam providers could do more outreach to get the community involved in education.
Hernandez said that after finding out about the results, she’s interested in helping Putnam County through mobile outreach, which the center does to facilitate health education.
Kuruvilla said the state needs to provide tax credits or other means of promoting education in Putnam County, in order to help lower the obesity and smoking rates and help residents get access to health care.
“You improve the economy, you have to provide jobs, and you have to educate,” Kuruvilla said.