Dr. Jennifer Mullendore, medical director for Buncombe County, reflects on positive shifts in our local health and wellness culture.
- Larger focus on the social determinants of health: Up to 80% of a person’s overall health is driven by social and environmental factors — like housing, education and income — and the behaviors they influence. Policymakers, insurers and others are working to address these factors that go beyond the doctor’s office visit.
- Mothering Asheville’s efforts to eliminate disparities in infant mortality rates: In Buncombe County, black babies are four times more likely than white babies to die before their first birthday. This is unnatural, unacceptable and a result of structural racism. Mothering Asheville’s efforts center around building community capacity, addressing clinical bias and advocating for policy change.
- Upstream North Carolina: This initiative provides clinical training and support to increase access to contraception and patient-centered reproductive life planning. This will give individuals more control over their health and well-being by reducing unintended pregnancies.
- Increased support for harm reduction: Through ongoing community conversations and response to the opioid epidemic, I believe there is growing support for more harm reduction tools like medication-assisted treatment, naloxone and clean injection supplies. I am hopeful that more organizations and individuals will join these efforts to save lives and reduce communicable disease.
- Shield of Protection Immunization Coalition: Since 2018, parents, grandparents, nurses, doctors, childcare and school administrators from WNC have been working on strategies to improve immunization rates in our area. I am especially hopeful about peer-to-peer education of vaccine-hesitant parents.
What is most revealing about Dr. Mullendore’s assessment is what the assessment lacks. She fails to feel hopeful about the quality of healthcare provided to the region after the buy-out of the Mission Healthcare System by HCA. Already there are increasing complaints and reports of decreased services and staffing, high turnover of qualified staff, and diminished quality of care. Seeing what has been happening and reviewing HCA’s history, HCA does not offer me much hope, either.