This the latest in a series of columns exploring the health concerns affecting Gloucester residents as identified through a 2005-6 Community Health Needs Assessment.
As food and gas prices rise, Cape Ann residents are feeling the pinch and worrying about the future.
Constant stress and uncertainty can lead to anxiety and wreak havoc with both emotional and physical health, so these difficult financial times may also present a health challenge to this community.
The recent Gloucester Community Health Needs Assessment revealed considerable anxiety levels in the local population and mental health concerns, as evidenced by high rates of hospitalization and substance use and reports of depressed mood. This anxiety was noted even before the current economic crunch hit.
Claudia Schweitzer, LICSW, a therapist in private practice and Gloucester Board of Health member, was encouraged that the GCHNA identified mental health as a strong health need in this region, because "it's an important part of overall health."
The needs survey is not a diagnostic test for psychological problems, but a self-reporting tool for the community to gauge its general well-being. It was not designed to ferret out cases of major mental illness, such as schizophrenia, bipolar disorder or depression. It does, however, present a portrait of what the population is feeling, and they are feeling somewhat blue lately.
More than half (67 percernt) of the adults polled felt worried, tense or anxious in the past month, although usually for no more than five days. However, 32 percent of these persons felt anxious more than five days each month, which could indicate a more serious problem such as depression. However, most of those polled seemed to be suffering from everyday stress, which may be growing worse because of the current status of the economy.
"There are a lot of 'worried well'," Schweitzer says, "more than before, which is fallout from the stress of living in 2008." She added that the anxiety about the future, and fears about paying high prices for housing, food and fuel "are things that many people in this country have not thought a lot about before. Families of four with kids are wondering how they will cope when a gallon of gas and milk are both $4. The uncertainty is affecting everyone, even those who have jobs."
So mental health problems, she continued, are not just the realm of "crazy people," but "your everyday, next door neighbor who is having a hard time coping."
Public Health Nurse Sunny Robinson of the Gloucester Health Department said the district does not have the same amount of data about adult mental health as it does for youth, "so we don't really have a good picture of the mental health needs of adults and whether they are being met or not. We asked kids if they had someone significant to talk to, but we didn't ask adults. We just assume adults cope."
Schweitzer fears some adults are coping in self-destructive ways, through substance abuse or overeating, which can lead to physical dependency and obesity, and "are not healthy. People are just trying to make themselves numb," she said.
The faltering economy is not helping people adopt good health habits, either. Robinson said socio-economic factors definitely affect mental health, and unrelieved distress can create or increase anxiety and depression.
"We live in a culture that chooses food as comfort in hard times," Robinson said. "Often, foods that are considered comforting in our society are also high calorie and high fat, and thus risk contributing to cardiovascular disease, hypertension, and diabetes. We know from the GCHNA that these three related health problems occur in a substantial proportion of our population, so we run the risk of literally eating ourselves sick in an effort to calm our anxieties."
Good stress management is an essential element of managing total health, and that unmanaged stress contributes to cardiovascular illness, mental health disorders, substance abuse and even some cancers. "The recent GCHNA helps us see that there may be an interrelated web of health problems — inadequate nutrition, insufficient exercise, lack of appropriate weight and stress management — that we need to address."
Schweitzer said healthy coping skills include walking and other types of exercise, talking to friends, and enjoying family time.
No one is fully able to avoid stress; and in fact, we may not want to since some stress, appropriately managed and channeled, can help us grow and become more skilled. Simple activities like exercise, talking and laughing with friends, deep breathing and tension release all help us manage our stress and cope in difficult times."
There is mental health treatment available for those who are suffering, but it is not in generous supply. Schweitzer said the local mental health care system is not adequate to meet the growing need, so "the increase in people experiencing mental health symptoms has been met with a real decrease in treatment. Everyone has a waiting list."
For those with insurance through MassHealth, waiting for access to a counselor can be an endurance test, and that it can be months before patients can access mental health services. This is a real problem which somehow we need to To locate a mental health provider in your area, look in the yellow pages under "mental health services", "counseling", or "social and human services, ask for a referral from your primary care provider, or check with your insurance carrier for the names of approved providers in your area.
For more information about the Community Health Needs Assessment, contact The Gloucester Health Department at healthdept@ci.gloucester.ma.us Watch for additional articles in this series every other week in this column.
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Sunny Robinson is a public health nurse. This article is part of a regular health education series provided by the Gloucester Health Department and Addison Gilbert Hospital.
