In Nassau, the top health concern was cancer, according to a...

In Nassau, the top health concern was cancer, according to a new survey of residents. Credit: Newsday/John Keating

Worries about mental health and cancer are among the top wellness concerns for Long Islanders, according to preliminary results from an ongoing survey.

While mental health, depression and suicide were listed as the top concerns in their communities among Suffolk County respondents, cancer topped the list in Nassau. Residents in both counties were also anxious about heart disease, stroke, diabetes and substance abuse.

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Worries about mental health and cancer are among the top wellness concerns for Long Islanders, according to preliminary results from an ongoing survey.

While mental health, depression and suicide were listed as the top concerns in their communities among Suffolk County respondents, cancer topped the list in Nassau. Residents in both counties were also anxious about heart disease, stroke, diabetes and substance abuse.

These were some of the early results from the Community Health Assessment Survey, which asks residents about their most pressing health concerns and those of their communities. The Long Island Health Collaborative — a partnership that includes several area hospitals, health departments and providers — compiled the findings based on roughly 400 survey responses. 

Experts say the results point to the increasing prevalence of mental health issues and the lack of available providers, and also reflect the realities of Long Island's high cancer rates compared with the rest of the state.

     WHAT TO KNOW

  • A recent survey showed the top wellness concerns on Long Island include mental health and cancer.
  • The survey said that residents are interested in more education and screenings on those topics.
  • Physicians say prevention in the form of screenings and a healthy lifestyle is the best advice they can give residents worried about cancer.

For Penelope Rudder, 73, of Greenport, mental health and cancer go hand in hand.

She said it “takes courage” to ask for help because "Everyone has this façade of trying to portray the fact that they are strong and doing well.”

Rudder was diagnosed with skin cancer in 2020 and has had five facial surgeries to reconstruct the left side of her nose using skin from her forehead. She said she could have used someone to talk to or someone who got similar treatment to better prepare her.

“Cancer can be extremely lonely. It’s isolating,” Rudder said.

Better cancer screening, education a goal

Still, physicians hope to take those thoughts and turn them into action, from providing better cancer screening and education to helping residents live a healthier lifestyle.

Dr. Richard Barakat, physician in chief and executive director at the Northwell Cancer Institute, said the analysis shows that physicians, in treating patients, and the general population must recognize and stress the risk factors for cancer.

“To me, what this does is it says, 'OK, we hear you. This is what you need to do,' ” he said.

The preliminary results — released by the collaborative as it continues the survey process — provide an important insight into Long Islanders' mindset, experts say.

When respondents were asked what health issue required more screening or education in their community, the top response was mental health at roughly 32% in Suffolk.

North Babylon resident and civic leader Joanie Zangerle, a uterine cancer survivor, said she has personally seen the need for better mental health services.

“Ever since the pandemic, I definitely feel that mental health seems to be something that people need help with,” said Zangerle, a Nassau BOCES teacher. “Either they’re not getting to the proper doctor or the coverage is not available to them. If there was an easier way for people who need it, to get it, then there wouldn’t be such a crisis.”

Cancer, with about 24% of the responses, was the second-highest answer to that question, according to the survey, which allowed respondents to have multiple responses to the question.

In New York, the all-cancer incident rate per 100,000 was roughly 585 between 2018 and 2020, state data shows. Long Island’s rate in that same time period was nearly 664.

Breast cancer, in particular, has historically been higher on Long Island. The incidence rate of breast cancer among females from 2018 to 2020 was about 170 per 100,000, according to the state. On Long Island, the rate was roughly 190.

Federally funded studies have been unable to come up with any one reason for the higher breast cancer rates on Long Island among those without a genetic marker for it. But experts say an aging population and one with certain demographic markers, as well as possible environmental factors, such as carcinogenic chemicals in groundwater, are all considered to be potential contributors.

Addressing risk factors, adding services

Barakat stressed that nearly 50% of cancers are associated with modifiable risk factors such as diet, exercise, smoking and alcohol. He also noted the importance of getting screened for cancer to detect it earlier.

“But at the end of the day,” he said, “prevention is the best.”

Bishop E. Edward Robinson of Manorville said he remains cognizant of his family’s history of medical challenges, which includes cancer on his father’s side of the family and diabetes on his mother’s side.

Robinson, 42, pastor of the Breakthrough Chapel in Selden, said he is in good health but he reminds himself not to assume that family history won’t repeat itself.

And he feels an obligation to remind his parishioners to receive regular medical checkups, especially because his congregation is made up of people of color.

"Normally health is a major challenge in our community, particularly because of [lack of] adequate health care,” Robinson said.

“Our community, particularly the brown community, we didn’t have a good introduction to health care in our history, so I think there is still a remnant of fear of doctors," he added.

“I think that plays a role in medical care because of our culture,” Robinson said.

Dr. Manish Sapra was not surprised by mental health being featured prominently in the preliminary findings. 

“We are seeing in our communities a growing need for mental health services,” said Sapra, executive director of behavioral health services at Northwell Health. “We have seen increased visits to our emergency departments [and] increased calls to our outpatient departments.” 

Reasons for the recent rise in mental health concerns include social isolation from the COVID-19 pandemic as well as social media. But there is a positive side: the reduction of stigma. 

“It used to be a more of a private affair … because of the stigma associated with mental health,” Sapra said. 

But even with the increase of people willing to talk about their mental health struggles, there is also a lack of providers to offer them care, physicians said.

“The supply and demand is … very skewed at this moment,” said Dr. Nikhil Palekar, vice chair for ambulatory clinical affairs at Stony Brook Medicine. “So there's a huge demand, but there's just not enough boots on the ground.”

Palekar said, in particular, there is a lack of specialized mental health clinicians on eastern Long Island, sometimes causing patients to drive an hour to appointments. Some providers, he said, won’t accept certain types of health insurance — creating another barrier to care.

Northwell has programs that include bringing mental health care providers into other specialties and to several schools on Long Island. At Stony Brook Medicine, many primary care physicians are screening all patients for suicidal ideation and anxiety. 

Yet there remain “real-life barriers to receiving care,” Palekar said. 

With Denise M. Bonilla, Carl MacGowan and Tara Smith

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