Health study finds needs among immigrant, elderly communities

Even though doctors, nurses, and other health care providers in area communities are doing a good job, they need to think of new ways to help senior citizens and immigrants receive medical attention, according to a new study conducted by the MetroWest Health Foundation.

The Framingham-based nonprofit unveiled the 100-page study, called the 2013 Community Health Assessment, last week after a year of collecting data, conducting surveys, and holding focus groups with residents in 22 communities from Plainville to Stow. The MetroWest Medical Center, Marlborough Hospital, and other area health care agencies funded the report.

The study found that most local residents tend to enjoy slightly better health on average than residents statewide, with lower rates of asthma, diabetes, and poor mental health, and less frequently smoke or engage in binge drinking. Most communities in the study posted slightly lower levels of cancer than the statewide average, too.

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But immigrants often suffered health problems at a higher rate than other residents, and seniors often struggle to find rides to their numerous medical appointments.

“It’s a very healthy region but there are pockets of need,” said Martin Cohen, president of the foundation. “We know in lower-income communities, health needs are greater. We also know there are barriers to health care — language being one, transportation being another.”

The study found, for example, that teen pregnancies in Framingham and Marlborough occurred, respectively, 9 and 21 percent more often than the state average. The rate of chlamydia, a sexually transmitted disease, among Framingham residents was almost 3 percent higher than the Massachusetts average, while most of the communities in the study had rates that were roughly half as much as the state average or less.

Framingham and Marlborough also have the most non-English speakers, with large Brazilian and Latino populations, the study said. Around 35 percent of Framingham residents do not speak English at home, while more than a quarter of Marlborough residents speak another language, the study said.

There isn’t necessarily a direct link between immigrants and health problems, said Edna Smith, chairwoman of the Community Health Coalition of MetroWest, a nonprofit group of health care providers that helped produce the study.

The researchers found, however, that local health care providers need to adjust to the new diversity that has taken root in the suburbs, Smith said. Doctors, health board officials, and others should probably seek out more interpreters to assist patients, and translate family planning notices and other health literature into other languages in immigrant neighborhoods.

“We have several immigrant populations that were not here 40 years ago in any large numbers,” said Smith. “The needs then become very specific for these populations. In many cases, language is a real barrier to them getting adequate health care.”

Aging is another change sweeping the suburbs that health care providers need to confront, the study said. As baby boomers age, they are living longer through the excellent medical attention they can receive close to home or in Boston or Worcester. But commuting to those cities is not easy or inexpensive.

The study found that 59 percent of poll respondents were happy with their hospital care, while just 6 percent were satisfied with their transportation to their care facility.

The car-friendly culture and lack of public transportation in Boston’s suburbs has long been a cause of complaints among regional planners.

In medicine, transportation is especially nettlesome because federal laws ban hospitals from giving patients free rides, based on concerns that the practice might constitute an unfair incentive to attract patients, said Joe Nunes, chief executive of Southborough Medical Group (an affiliate of Atrius Health), a practice of 80 health care providers.

The law sometimes puts Nunes in a tricky position. He recently arranged to give a ride to a patient’s relative even though technically it was illegal, he said.

“Just recently, we paid for an elderly brother to visit his sister in hospice in the hospital because she was in her last days,” he said. “To say no to someone like that, when you know this was the last chance for them to talk together — you say, ‘Let’s do this.’ ”

Smith and Nunes said their organizations are partnering with volunteer groups, churches, and nonprofits to provide transportation. Patients at MetroWest Medical Center receive vouchers for taxis to get between its Framingham and Natick campuses, said spokeswoman Beth Donnelly.

But ultimately the region needs to develop a better transportation network to help patients reach doctors’ offices more efficiently, added Cohen. “Folks still have difficulty accessing care,” he said.

The study stemmed from requirements under the federal Affordable Care Act, or Obamacare, that nonprofit health institutions analyze the needs of their communities. But the foundation and other groups, including the for-profit MetroWest Medical Center, decided to pool their resources, said Cohen.

Hudson’s director of public and community health services, Sam Wong, said the study would be useful in his job.

It found, for example, that nearly 13 percent of Hudson residents smoked cigarettes, the highest proportion in the region, and the statistic started him thinking about his agency’s response.

“We need to work with the community on youth tobacco access, more antismoking measures, and working with physicians and hospitals for smoking cessation,” he said.