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Survey: Long Island residents hurt by scarcity of doctors, lack of insurance

Among the findings: Nassau and Suffolk residents view drugs, alcohol abuse and cancer as the top health concerns in their communities, and they worry most about heart disease and strokes in their own lives.

Janine Logan, senior director at Nassau-Suffolk Hospital Council,

Janine Logan, senior director at Nassau-Suffolk Hospital Council, sought a survey designed to understand what are the biggest barriers to obtaining medical treatment for Suffolk and Nassau residents. Photo Credit: Newsday / Alejandra Villa Loarca

When Henry Molina searched for a doctor or dentist to treat his 15-year-old daughter suffering from severe tooth pain several weeks ago, the Huntington man kept getting the same response.

"They'd say they don't accept my insurance," he said.

Molina, 45, is not alone. Suffolk County residents said lack of availability of doctors was among the seven biggest barriers their communities face in obtaining health care.

The findings are part of a recently released survey of nearly 2,500 Long Islanders that is used by health departments in Suffolk and Nassau counties, and by hospitals, to help guide health care priorities.

The survey found that Long Islanders view drugs, alcohol abuse and cancer as the top health concerns in their communities, and they worry most about heart disease and strokes in their own lives, with obesity, cancer, diabetes and women's health and wellness other top personal concerns.

“Lack of availability of doctors” was a greater concern in Suffolk than Nassau, the survey found.

That jibes with the results of a study released last month that found a dearth of physicians in Suffolk: only one doctor for every 1,360 residents, versus one per 700 residents in Nassau. That national study was conducted by the Princeton, New Jersey-based Robert Wood Johnson Foundation and the University of Wisconsin Health Population Institute.

Héctor Alcalá, an assistant professor of public health at Stony Brook University, attributed the difference to the lower population density in Suffolk, especially eastern Suffolk.

"If you're starting a new practice, and you're getting out of medical school with a tremendous amount of debt, you're going to head to a bigger population center because it's going to guarantee you the patients," he said.

Molina said that, after 15 futile phone calls to health and dental providers, he ended up driving his daughter to Nassau University Medical Center in East Meadow to get care.

Joseph Dickson, 33, of Huntington Station, said he's never had a problem finding a doctor. But, after taking his sick 6-year-old son to an urgent care center, he said many people in the area — which has a poverty rate more than double the county's as a whole — don't have cars and may live far from a health care provider. The survey found transportation was among the top nine health needs in both counties.

Nassau and Suffolk residents listed "no insurance" as their top community health concern, with "unable to pay copays/deductibles" among the top three concerns in each county.

"That is a huge issue in the community," said Pearl Jacobs, a longtime activist in Uniondale, where the median income is far below the county's and the percentage of people without health insurance is three times higher.

The Affordable Care Act helped many residents obtain health insurance, "But here in the Uniondale community you have many people who are undocumented and don't qualify for the Affordable Care Act" or Medicaid, Jacobs said.

Many people who do have health coverage face steep copays for doctor visits and prescription drugs, she said.

Residents of both counties put "healthier food choices" at the top of the list of what is most needed to improve health in their communities.

In Wyandanch, there is only one supermarket with a wide selection of fresh produce, resident Pamela Usher said. Residents need greater access to nutritious foods, said Usher, who when she was school lunch director for the Wyandanch Union Free School District in 2014 instituted "meatless Mondays."

“Recreational facilities" was listed as the seventh-greatest health need in both counties.

As Norma Zegarra, 45, of South Huntington, watched her sons, ages 8 and 10, play on the swings at Manor Field Park in Huntington Station, she said there are good parks in the area but few indoor recreation options.

"In the winter, it's hard," she said in Spanish.

Zegarra's sons play in a private winter basketball league, but "not everyone has the ability to pay," she said.

The Long Island Health Collaborative, which includes county health departments, hospitals and community groups, has conducted the state-funded health survey since 2013. It is distributed online and at places such as health fairs and other public events, insurance enrollment sites, libraries and clinics, said Janine Logan, director of the collaborative, which is overseen by the Nassau-Suffolk Hospital Council. There is an overrepresentation of older and low-income people in the survey, but that lines up with a key priority of reducing income-based disparities in health care, she said.

Collaborative members such as South Nassau Communities Hospital in Oceanside use the survey, as well as comments gathered from focus groups and community leaders, to help put together state-mandated community service plans.

The second South Nassau Communities health fair on the Long Beach boardwalk in June will be shaped in part by community input such as the survey, said Joanne Newcombe, vice president for community health development at the hospital. Screenings for some types of cancer, blood pressure tests and body mass index calculations, which measure body fat, are among services to be offered, tracking with commonly selected topics in the survey, she said.

Due to incorrect data analysis and calculations by the Long Island Health Collaborative, some rankings and conclusions in an earlier version of this story were incorrect.

WHAT THE SURVEY SAYS

Among the highlights of a 2018 health survey of Long Islanders:

  • Drugs and alcohol abuse was the leading health concern in respondents’ communities in Suffolk, and the second-biggest concern in Nassau. Cancer was the top concern in Nassau, and the second-biggest concern in Suffolk.
  • Heart disease and stroke were the top health concerns “for yourself” in both counties. Obesity and weight-loss issues were second in Suffolk and third in Nassau. Cancer was second in Nassau and third in Suffolk.
  • “No insurance” was what most “prevents people in your community from getting medical treatment” in both counties. Inability to pay copays and deductibles was among the top three leading barriers in each county.
  • Healthier food choices were what was “most needed to improve the health of your community” in both Nassau and Suffolk. Drug and alcohol rehabilitation services was the second-most cited need in Suffolk, and clean air and water was the second-most common need in Nassau.
  • Nassau residents said blood pressure, diabetes and cancer are the “health screenings or education/information services” most needed in their community. Suffolk residents listed drug and alcohol, mental health/depression and “importance of routine well checkups.”

Source: Long Island Health Collaborative survey of 2,474 Long Islanders in 2018. The respondents roughly mirror the Island’s racial demographics, but there is an overrepresentation of older people and low-income people.

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