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Column: Healthcare and ‘built environment’
Martin Cahn (2019).jpg
Martin L. Cahn

As I related in a story in Tuesday’s edition, around 50 people attended a special kickoff on March 27 at the National Steeplechase Museum in Camden for what’s known as a Community Health Improvement Plan, or CHIP. As I fully disclosed, I was not only reporting on the event, but participated.

Unfortunately, I won’t have the time to devote to any of the workgroups meeting this month on the top three issues we chose to focus on: access to care, obesity and mental health.

I completely agree that access to care should be the No. 1 priority -- the other issues are all affected by it. What we are questioning and, therefore, seeking solutions for, is whether or not enough of our residents have easy access to healthcare services in our county. Access can be physical (are there enough healthcare providers for them to visit and can they get to them?), financial (do they have enough insurance, or insurance at all, to afford to seek healthcare services?) and even time-related (can they be excused from work?).

In addition to access, obesity and mental health, the other issues we discussed March 27 included diabetes, hypertension, substance abuse and “built environment.” That last one is what I want to touch on today.

As I mentioned to my table-mates, I felt built environment needed to be adressed, at least in tandem with access to care. As related on an information page about the issue we were provided, “Focus group participants identified the county’s physical (built) environment as a number one factor of being healthy in the county. Built environment can include sidewalks, streetlamps and construction.”

In a recent survey, Kershaw County residents said there were not enough safe, convenient, nearby indoor and outdoor places to exercise, especially in rural areas. If you live in Camden, there’s plenty of places to go walking, biking and more. Out in the rural parts of the county, not so much.

There are not enough sidewalks, bicycle lanes or fully lit streets while some people complain there are too many dogs running loose for them to feel comfortable walking in certain areas.

Built environment includes access to healthy foods. We need healthier options at reasonable prices in our grocery stores and restaurants, and more of those types of options across the county rather than just centered in Camden, Lugoff and Elgin.

With all this is the notion that Kershaw County -- like far too many places across the country -- is built for cars, not people. Sure, people drive cars, but they could also walk or bike and there’s not enough of the built environment to allow that to be done safely. And there’s very little in terms of in-county public transportation.

There are also “food deserts,” where people living in certain parts of the county -- and I would dare say the North Central area is most prevalent when this comes up for discussion -- that don’t have enough fresh fruit, vegetables and other healthy foods to purchase because there are simply not enough shops in the first place.

That’s why I love the WISE-grant funded food cart at North Central High School I wrote about last October. Kids waiting for their afternoon bus rides home can grab a free, healthy snack to eat.

The school is also home to a School-Based Health Center that also serves North Central Middle School. Staffed by a nurse practitioner and a medical assistant, the clinic has already helped several hundred students right there at school so their parents didn’t have to take off from work to take them to a doctor.

It’s a solution that is being considered for expansion across the school district, as well as it should.

What other solutions tie into the county’s built environment? The CHIP kickoff included examples of things that have worked in other communities, such as community exercise/fitness programs, including neighborhood walking groups; a bicyclist/pedestrian master plan to include sidwealks, crosswalks, walking paths, bicycle lanes, traffic calming devices and lighting (which is already being addressed by the county); “farm to school” programs to incorporate locally grown foods into school meals, alog with school gardens; and something called a “safe routes to school” program.

There’s a lot of building we could do, to shore up healthcare in Kershaw County. Now, we need the will and the way to do it.