Measure Up Marion: Chronic disease, poverty, more addressed

August 31, 2015




Ocala Star Banner
By Fred Hiers

Improving the health of Marion County’s residents will not happen easily or soon.

But with a U.S. Centers for Disease Control $1.3 million grant for Marion County to focus on addressing avoidable chronic diseases, Maclyn Walker, project director of Measure Up Marion, hopes to make a dent.

Measure Up Marion was a product of Marion’s 2012 Community Health Improvement Plan. The study took comprehensive stock of the county’s health problems, such as the area’s high diabetes, obesity and heart disease rates, as well as poverty among children and a lack of access to health care.

Marion County’s health care standing has not improved since 2012, and in many areas, is far worse than Florida’s average.

Last year, the CDC awarded Measure Up Marion $1,349,638 to focus on addressing those problems. Thursday, the CDC came to Ocala to see how the money was being spent.

Walker said that it will take time to improve Marion County’s overall health.

“None of this is easy. If it were, it would have already been done,” Walker said.

Measure Up Marion selected three issues highlighted by the CDC:
*Increasing tobacco-free areas
*Increasing access to healthy foods and beverages
*Helping residents find help and medical support to combat chronic disease
*Measure Up Marion, in conjunction with seven local partners, is organizing efforts to address the three health care issues, which are a detriment to many residents. The goal is to reach 75 percent of the population.

Aisha Penson, project officer for the CDC’s Partnership in Community Health award, came to Ocala to evaluate Measure Up Marion’s progress and ensure the organization’s goals were consistent with those outlined by the CDC.

The goal is not so much a focus on the individual, she said, but rather effecting a societal change in which it is easier for Marion County residents to find and buy healthy foods, live and work in areas that are tobacco free, and have better access to medical help.

Penson also regularly communicates with Measure Up Marion and its seven partners: the Marion County Children’s Alliance, Florida Department in Health in Marion County, Marion County Public Schools, Heart of Florida Health Center, QuitDoc Foundation (for tobacco cessation), WellFlorida Council and Rural Health Partnership,

“I think that Marion County is doing the best it can in addressing the health of the county’s residents by understanding the chronic disease burden in the county and what contributes to those chronic diseases,” Penson said during a break at a Measure Up Marion meeting last week.

The goal is to “reach large numbers of the population at one time by looking at the (social) structures that are in place that are preventing people from (being) healthy,” she said.

The next step is to report Measure Up Marion’s progress to the CDC. The local group is eligible for two more years of grants.

The societal changes the CDC wants can be seen in Measure Up Marion’s approach to health problems.

Instead of trying to persuade people to not use tobacco products, the goal is to persuade multi-unit housing complexes to restrict or ban tobacco use on grounds, convince convenience store owners to discourage tobacco use on their premises and for restaurant owners to ban tobacco use at outdoor cafes.

Manette Cheshareck, who works with the QuitDoc Research and Education Foundation, which helps children stop using tobacco products, said during the meeting that about 68,000 Marion County residents have immediate access to tobacco-free areas. The goal is to increase that to 75 percent of the population, or about 250,000 people.

Apartment residents make smoking cessation a social endeavor and banning smoking in outdoor restaurants increases business by 2.5 times, said Lauren Walter, of QuitDoc, citing tobacco use studies.

Marion County ranked 42nd among Florida’s 67 counties this year in the latest version of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation’s annual county health rankings.

Fueling the problematic rankings are a slew of local social and health issues:
* Nearly 15 percent of Marion County’s adults are diabetic
* More than a third of residents are obese; almost half of school-aged children are overweight or obese
* Nearly a third of residents live sedentary lifestyles with no regular exercise
* Median Medicaid enrollment in Marion County, a sign of poverty, is higher than the Florida average
* There are fewer hospital beds per capita than the Florida average and more tracts of land without a place to buy healthy foods than the state average

Brianna Liles, a dietician and community health advocate for Measure Up Marion who also works with the Marion County Children’s Alliance, is working to convince restaurants, vending machine companies and convenience stores to offer healthier foods. She also is helping to organize nutrition lectors at schools and after-school programs.

Measure Up Marion also wants to help people with chronic diseases — such as high-blood pressure and diabetes — better control their illnesses and find resources for treatment and support. The organization is encouraging employers to offer workers health programs to participate in, and other health-based resources.

To accomplish that, Measure Up Marion is recruiting volunteers, often through churches and other organizations, to convince people needing help to seek it out.

“We want to make it easy for people to live healthy lives,” Liles said

In coordination with Measure Up Marion, the WellFlorida Council is encouraging health care providers to enter patient information into a shared data bank that allows health care workers to quickly access the information. Patients also have access and, through the system, can communicate with their health care providers.

Twenty-six doctor offices and clinics use the system, called MyHealthStory. Information for nearly 12,000 patients is stored in the system and patients regularly enter the database, said Kendra Siler-Marsiglio, during the meeting.

Ed Dean, a consultant for the Marion County Hospital District, said the enthusiasm of Measure Up Marion is a good start.

The Hospital District leases out Munroe Regional Medical Center. It recently invested about $212 million from the lease and plans to spend the earnings on county health-related issues.

“There are some wonderful initiatives,” Dean said of the Measure Up Marion meeting.

“The problem, as I see it, there is not a unified approach by every segment of the community to make good health a priority,” Dean said of the county’s overall approach to health care.

He said Measure Up Marion “has started the balling rolling and we’re going to take this energy and multiply it exponentially.”One of the after-school nutrition programs will be held at Lillian Bryant Park in northwest Ocala, which is surrounded by government subsidized housing. Children come to the center after school for a snack and organized play. Some of the children’s eating choices show that Measure Up Marion has its work cut out for it.

Trevion, 9, said his favorite snack in front of the television is Pop-Tarts with glazed sugar and sugar sprinkles.

He would eat fruit if offered, but the Pop-Tart best be part of the snack, he said.

Zarek, 11, said his favorite snack while watching television is bacon and cheese pizza.

And if offered some fruit instead, Zarek said, “I’m going to say no; I want some pizza. Fruit doesn’t taste as good.”
Reach Fred Hiers at and 352-867-4157.

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