Social Environment 8.2: Health and Human Services

The health of our community is determined not only by access to affordable, high-quality health care and social services, but more importantly, by overall wellness. Health depends on individual lifestyle and behavior; on inter-personal relationships within families, neighborhoods, and the community at large; on economic forces within a com­munity; and on the quality of the community’s environment. Health care providers are increasingly encouraging communities to focus on promoting wellness to prevent or minimize the need for traditional health care services - to create a healthy and supportive environment in which people develop physically, mentally and socially;.

The Vineyard is well served with a range of health and human service facilities and entities that provide high quality services.

·  The full-service, critical-access Martha's Vineyard Hospital is undergoing a 90,000 square foot expansion to a 22-bed facility and, became formally affiliated with Massachusetts General Hospital in 2007.

·  Martha’s Vineyard Community Services offers a broad array of education and health and human services for all ages, including mental health and substance abuse services, child development, services for the disabled, victims of domestic violence and sexual assault, and other treatment and prevention programs at their clinic, family center, schools, and in homes.

·  The Dukes County Health Council is a coalition looking at health issues. Its efforts helped create the Vineyard Health Care Access Program, helping residents obtain affordable, high-quality care, mainly assisting those with no health insurance, families with children, seniors, people with disabilities, and low-income residents.

·  There are multiple town agencies and non-profits focused solely on the needs and care of senior citizens.

·  The Vineyard has a network of physicians, nurses, and counselors, as well as an extensive array of alternative care providers.

Despite this rich array of service providers, the Vineyard institutions and community face particular challenges, many related to being a small, mostly rural island. 

·  Poverty, mental illness, and substance abuse incident rates exceed levels elsewhere in the Commonwealth.

·  The low population density leads to heavy car use, and less walking. It also means that many people live in isolated situations, making it more difficult to socialize and to get help in an emergency. Isolation can contribute to depression and substance abuse.

·  With an aging population, there will be a growing need for services. A 2006 retirement housing study showed half of the Vineyarders surveyed would prefer to age at home, yet with our dispersed development pattern, transportation is a huge issue for seniors and caregivers.

·  There is a counter-culture sector that is “outside the system” by choice – people who don’t immunize their children and who reject social services. There are also marginalized people – mentally ill and/or substance-using people -- who are not comfortable with the formal health care system.

·  The isolation and limited population make it difficult to offer a full range of medical services, meaning that people have to go off-Island for some specialized treatments.  It also makes it difficult to train staff, or let them upgrade skills. The high cost of housing and living makes it hard to attract and retain specialized personnel.

·  Year-round services and not-for-profits are heavily supported by the generosity of seasonal residents. The dependability of such funding and our ability to sustain the current level of services is uncertain.

Objective S2: Make Martha's Vineyard a healthy community with a mindset to promote healthy lifestyles and to improve human and infrastructure capacity to provide necessary health and human services that are seamless, complementary, coordinated, and accessible.

·  Strategy S2-1: Create a structure to address public health issues Island-wide: The aim is to complement the local-environmental-oriented responsibilities of town Boards of Health by focusing on specialized activities that may be more broadly based, such as the examination of Island-wide health data.

·  Strategy S2-2: Provide more support of family caregivers: There will be an increasing need for home-based services for an aging population and more family members thrust into the role of caregivers. Family members need to have easy access to information, training and support services to improve the quality of home care, but also to reduce the stress often associated with family care giving. Family caregivers also need periodic respite from the continuous demands of homebound care. Vineyard Village at Home is one community response to these needs.

Strategy S2-3: Create walkable neighborhoods and communities less dependent upon automobiles: For an island community known for its summer outdoor recreational activities, we don’t always make it easy for people to have healthy habits. Our pattern of development is most decidedly automobile dependent and even where sidewalks exist, they are frequently too narrow and obstructed with utility poles or mailboxes. We should provide and maintain adequate infrastructure for pedestrians. As we plan future growth, we should favor appropriately located higher density neighborhoods that promote physical activity and social interaction.