EDITOR'S NOTE: Quotes that were misattributed in the fifth paragraph have been corrected.

A community coalition will address the health implications of behaviors such as smoking, poor diet and lack of exercise after an assessment by Saint Francis Medical Center and Southeast Hospital of the top health needs of people living in Cape Girardeau, Bollinger, Scott and Stoddard counties.

Not-for-profit hospitals, such as Saint Francis and Southeast, are required to complete a community health needs assessment every three years and submit it to the Internal Revenue Service to maintain their tax-exempt statuses, as part of the Patient Protection and Affordable Care Act of 2010. After the assessment, they must develop and adopt an implementation strategy to address identified needs. Failure to do so could result in fines of up to $50,000 said Kevin Sutton, decision support coordinator at SoutheastHEALTH, which operates Southeast Hospital.

Felecia Blanton, spokeswoman for Saint Francis Medical Center, said the IRS suggests collaboration between not-for-profit hospitals that are in proximity, since they serve the same population.

"We just got together and said, look, we can do this," Blanton said.

Consulting companies quoted estimates of about $90,000 to $100,000 just to begin the research process, Sutton said. The hospitals did the work in-house for minimal cost, he said. The Missouri Hospital Association provided some guidance, Blanton said.

Cape Girardeau, Bollinger, Scott and Stoddard counties are home to the majority of both hospitals' patients, according to figures from the Missouri Hospital Association's Hospital Industry Data Institute. The local assessment's focus was on underserved populations, per IRS requirements, said Sutton, and more than 600 people from the four counties completed health surveys. Staff from both hospitals visited waiting rooms and traveled to community organizations to ask for input. A total of 118 surveys were collected in Cape Girardeau County.

Eight community focus groups made up of health-care and social services stakeholders, such as county health clinics, police departments, senior centers, churches and school nurses, also provided their input.

Added to information from the surveys, general demographic and statistical information was gathered from sources such as the U.S. Census, County Health Rankings and Roadmaps by the Robert Wood Johnson Foundation, the Missouri Department of Health and Senior Services and the Missouri Department of Elementary and Secondary Education.

Data from those sources showed that 32 percent of people in Cape Girardeau County die from heart disease, 21 percent from cancers, 7 percent from stroke or other cerebrovascular diseases, 5 percent from injuries and poisonings and 5 percent from chronic lower respiratory disease. County deaths from cancers were higher than the state average. Missouri ranks among the worst nine states in the nation for obesity.

With regard to behavior, 28 percent of Cape Girardeau County residents were rated as physically inactive, 72 percent ate fewer than five fruits and vegetables per day and 18 percent smoke cigarettes.

Among the greatest health treatment needs and related behaviors prioritized by the hospitals' assessment were cancer and chronic respiratory diseases associated with smoking and obesity from poor diet and exercise. Chronic diseases such as diabetes, heart disease and diseases that lead to stroke, the need for treatment for substance abuse and mental health conditions and the lack of affordable health care also were identified as top problems.

The hospitals said they will work together to implement strategies to address the community's health needs, within their resources and area of expertise. For example, they will host a joint obesity conference to provide county health departments with better tools to help promote a healthy lifestyle. Each also will take on initiatives individually throughout the three years until the next assessment, officials from both hospitals said. Areas such as mental health and substance abuse that are more comprehensively handled by other organizations will be addressed through making referrals and collaboration with other agencies, Sutton said.

One multidisciplinary effort already underway is a community coalition led by the Cape Girardeau County Public Health Center to support healthy lifestyles and good nutrition. Members include Jeremy Barnes, Southeast Missouri State University; Julia Thompson, Cape Girardeau Parks and Recreation Department; Shane West Anderson, Jackson Parks and Recreation Department; Dr. Matt Shoemaker, SoutheastHEALTH; Dr. Tom Diemer, Saint Francis Medical Center; Levi Olson, Old Town Cape and the Cape Riverfront Market; Kay Azuma, Community Caring Council; Jane Wernsman and Jennifer Volkerding, Cape Girardeau County Public Health Center; Beth Emmendorfer, Jackson School District; Deena Ring, Cape Girardeau School District; Tim Arbeiter, Cape Girardeau Area Chamber of Commerce; Brian Gerau, Jackson Area Chamber of Commerce; and Nate Saverino, Southeast Missouri State University Athletics Department.

There will be ongoing assessments to measure how effective the hospitals are in serving the community's needs, Sutton said.

Electronic medical records, as they continue to be implemented throughout the health care industry, will create a method of tracking patients and collecting data that has not been available in the past for ongoing evaluation, said Aaron Spratt, director of American Recovery and Reinvestment Act Program Implementation at Saint Francis. Sutton encouraged community members interested in getting involved to contact the county health department.

"The only way we can have an impact is for the community to be involved," Sutton said.

salderman@semissourian.com

388-3646

Pertinent address:

1701 Lacey St., Cape Girardeau, MO

211 St Francis Dr., Cape Girardeau, MO

1121 Linden St, Cape Girardeau, MO