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MapNH Health underscores looming changes in state’s medical needs



Last modified: Tuesday, September 16, 2014
New Hampshire is getting older. It is also, by some measures, going to get sicker. Paying attention now to these and other demographic changes could help the Granite State avoid serious challenges in the coming decades, according to the recently released MapNH Health.

Drawing on data from the U.S. Census Bureau, the New Hampshire Behavioral Risk Factor Surveillance Survey and other sources, a team of experts outlined a host of indicators of the state’s well-being through 2030. MapNH Health was produced by the New Hampshire Citizens Health Initiative – in collaboration with other groups – and its findings can be explored in detail at mapnhhealth.org.

Citizens Health Initiative Director Jeanne Ryer said one thing is abundantly clear from the predictions: “We need to prepare for a different health future.”

The state’s overall age ratio, or the “ratio of people younger than 20 and older than 64 to the working-age population,” is projected to rise from just more than 60 percent in 2010 to just less than 90 percent in 2030, according to predictions outlined by MapNH Health. Birth rates, over the same period, are projected to remain stable statewide, but in some parts of the state – including Merrimack County – those will decline slightly. Statewide obesity levels are predicted to rise from 25.6 percent in 2010 to between 33.9 percent and 43.4 percent in 2030, while the rates of cardiovascular disease, Alzheimer’s disease, cancer and diabetes are also expected to rise through 2030.

The statewide percentage of the population living in poverty will, according to MapNH Health, remain mostly stagnant. But in Merrimack and Hillsborough counties, for example, the percentage of kids between the ages of 5 and 9 who are in poverty is on track to increase.

MapNH Health also predicts that, over the next two decades, demand for primary care will rise across the state. The number of “preventable hospitalizations” – or instances where outpatient care might have prevented the need for someone to be admitted to the hospital – is also on track to rise in areas around Concord, Manchester and Nashua

Preparation for the future, Ryer said, needs to be multifaceted. To her, the findings underscore a need to invest in kids and education, as well as to develop ways to support aging adults who want to remain independent in their home communities. The latter might be achieved by making towns more walkable, making street signs “that are easier for older eyes to see” and strengthening the network of community services available to help those who need long-term care, Ryer said.

Additionally, Ryer said, the state could benefit from more concerted efforts to recruit primary care providers and to build up the network of other medical professionals – such as nurse practitioners or physician’s assistants – who could tend to the growing demand for care.

Steve Rowe, the president of the New Hampshire-based Endowment for Health, echoed Ryer’s emphasis on setting kids up for successful futures, as well as supporting older adults. It will become increasingly important to make sure people have the flexibility to care for aging parents or relatives, he said, and for the state to support seniors’ ability to continue to “live with independence and dignity” as they age. The Endowment for Health was involved in advising the team that created MapNH Health.

When it comes to kids’ well-being, Rowe said the state should support high-quality early childhood education and programs that would provide support to help new parents give their children a healthy start.

“It’s in our collective best interest to make sure every single child enters kindergarten prepared to succeed,” Rowe said. “It will improve the strength of our workforce. It will reduce taxes over the long run. It will reduce poverty. It will reduce crime. It will reduce drug abuse. It will reduce mental health issues. It will improve the quality of life in this state.”

Improving the state’s transportation networks could also have wide-reaching benefits, said Patrick Herlihy of the New Hampshire Department of Transportation. Herlihy serves as the director of aeronautics, rail and transit, and he advised the MapNH Health team on the state’s existing network of transportation options.

Access to transportation is almost inextricably linked to health, Herlihy said: Someone who can’t drive will have a harder time making it to preventative care appointments, picking up prescriptions or otherwise connecting to medical providers.

Improving the state’s public transportation options and its network of volunteer driver programs, among other services that provide shuttles to people unable to drive, would make it easier for people to stay connected to their health care providers. And it also might, to some extent, help the state attract more young people – they tend to want access to more alternative forms of transportation when they’re looking for places to live, he said.

Some of the findings are cause for concern, Ryer and Rowe said, but they want this to be the beginning of a conversation about how to change the state’s future for the better.

“Let’s not see this as a doom and gloom scenario – let’s talk about how we want our health future to look,” Ryer said. “We can get there. If we just sit and wait, it won’t be what we want.”



(Casey McDermott can be reached at 369-3306 or cmcdermott@cmonitor.com or on Twitter @caseymcdermott.)