GREENFIELD — State legislators who sit on the Joint Committee on Public Health learned Friday after four hours of testimony that funding, transportation, housing and poverty are just a few of the social determinants that need to be resolved to make health care accessible to all in rural areas.
Sen. Jo Comerford, D-Northampton, brought the committee she co-chairs to Greenfield, because Franklin County and Western Massachusetts include some of the most rural areas in the state and she wanted to make it so more of her constituents could provide input.
The meeting was video recorded so that members of the joint committee who could not make it could watch from Boston. The legislative hearing hosted by the committee, Franklin Regional Council of Governments (FRCOG), Rural Caucus, Baystate Health and Cooley Dickinson Health Care was held at the John W. Olver Transit Center.
“We’re pulling Boston’s focus west and Western Mass. is showing up,” Comerford said to a full house with standing room only.
“We have a strong, productive public health committee and we want to go deep on issues that are critical to you, that are important,” she said.
Comerford said the joint committee will use what it learned on Friday to make policies concerning health care and public health.
Those who shared comments, either as a panelist or from the audience, explained that public health involves the broader issues of clean water, clean air, safe housing — anything that affects a community as a whole — as opposed to health care, which is experienced more on an individual level. In the end, it was decided that both need more funding and more attention when it comes to laws and regulations.
When it comes to public health, FRCOG’s Director of Community Services Phoebe Walker said that there needs to be more consistency and more qualified, certified staffs. She said in Franklin County, for instance, almost every town has a board of health whose members are mostly volunteer and have very little training.
“They have limited ability to meet accreditation and standards,” she said.
Walker said the state needs to establish workforce credentials, set higher standards, allocate appropriate resources and encourage shared services, while providing more funding for what regional health departments would need to do.
“We need to strengthen departments of public health,” she said.
Increasing the number of regional departments so that towns can share services makes the most sense, Walker continued, and would make things more consistent across the state.
Laura Kittross, public health program manager for Berkshire Regional Planning Commission, said there are also no standards for training people who want to serve on local health boards.
“There’s no schooling to be a public health agent,” she said.
Heath Board of Health Chair Betsy Kovacs said it is imperative that the focus be on public health — safe homes, water and air, disease prevention, communicable diseases, emergency preparedness and more.
“We’ve seen a reduction in smoking because of social marketing campaigns,” she said, noting that the county needs more campaigns.
Kovacs said small towns like Heath need more funding, training and personnel, and with dwindling and aging populations, are strapped financially when it comes to educating people about public health issues.
In terms of health care, several doctors, nurses and health care professionals testified that income, transportation, education, a decline in the number of primary-care physicians practicing in rural areas and other factors can be the difference between people getting the care they need and not.
They asked legislators to consider more funding for public transportation, because many of the county’s poorest residents can’t afford to own vehicles or pay for transportation to get to and from appointments. A couple of the doctors who testified said that on many occasions, a doctor is seeing someone for the first time in an emergency room.
Panelists said free medical and dental care also have to be considered, and undocumented immigrants need health care, too. They all agreed that more money should be put into prevention, because it is ultimately less expensive.
Reach Anita Fritz at afritz@recorder.com.