While there were a few bright spots for Mendocino County, such as low levels of suicidal ideation among high school juniors, high rates of smoking, drug overdose, homelessness, and firearm deaths outstrip state and regional averages. Poverty, drinking, and car crashes are rampant. Like much of rural California, Mendocino County has a shortage of healthcare providers, including a decline in public health staff.
Leigh Pierre-Oetker, a senior research analyst with the California Center for Rural Policy, presented the data, pointing out that many of the health outcomes can be traced back to one circumstance.
“Let's talk about poverty,” she suggested. “The entire Redwood Coast has significantly higher rates of poverty than the state as a whole. Mendocino at 16 percent versus the state average at 12 (percent).. And of course, we know poverty is linked to lower life expectancy, increased health risks related to obesity, smoking, substance use and chronic stress. If people are living in poverty and can't access services, their ability to be healthy people becomes very challenging.”
When it comes to the most extreme form of poverty, Mendocino County’s numbers are about three and a half times higher than the state average.
“In Mendocino, in the last point in time count that you did, you counted 1,124 people who were basically saying that they are our homeless,” she reported. “Menodcino does have the highest rate in the state for homelessness.” The state average is 352 homeless people per 100,000. Humboldt County is behind Mendocino, with 882. Lake County has a little over half the number as Mendocino, with 657.
The top three policy recommendations from the California Center for Rural Policy are to cut down on smoking and substance use and to prevent suicide by providing access to mental healthcare.
Dr. William Miller, the medical director and chief of medical staff at the Adventist Health Mendocino Coast hospital, said he saw opportunities in the report Pierre-Oatker cited, which is called California’s Rural North: Exploring the Roots of Health Disparities.
“The three major contributors were all ones that could potentially be prevented,” he said. “In Mendocino County, our accidental death rate, according to this study, is three times higher than the California average. And accidental death, by definition being an accident, theoretically could be potentially prevented.” The high number of cancer deaths are primarily lung cancer, which, again, can be prevented by not smoking. Another major mortality factor in the county is drug overdose, which is also preventable. “So once again, you can look at this and be demoralized, or you can say, well, wait a minute, we can actually do something,” Miller reflected.
Miller reported that the hospital has hired substance use navigators, who help people figure out how to get the medical treatment they need to quit drugs. The hospital provides Narcan, and tobacco cessation programs. Seven graduates of the residency program have now taken jobs as family practice doctors, and one has signed a contract to work in addiction medicine upon completion of a fellowship.
While Miller was surprised at the numbers of homeless people, Fort Bragg Chief of Police Neal Cervenka was not. He spoke about the department’s Care Response Unit, or CRU, which acts as a hub to direct people off the streets into the help they need for mental health and addiction. He reported that fentanyl deaths are down by 20%, though overdoses remain high and, he suspects, largely unreported. Still, “We have distributed over 500 doses of Narcan in our community,” he told the community. “We also hand out fentanyl test strips. I know that's unusual for police departments to do. I would rather have somebody be safe than be dead.”
The community also has a major drinking problem. Cervenka said last year, a Fort Bragg police officer made the second-highest number of DUI arrests in the state, with 116 in a city of 7,000 people. The highest number of DUI arrests, he reported, was made by a CHP officer in the Central Valley. “That's the only guy that beat him, by seven arrests in a population of 2 million,” he concluded. The grant for CRU is expiring, and Cervenka told the crowd that “I have begged on my knees for $300,000,” to no avail.
Lucresha Renteria, the Executive DIrector of Mendocino Coast Clinics, which celebrates its 30th anniversary this year, reported on a wide array of programs, all of them offered in English and Spanish. She said reports like the one from the California Center for Rural Policy are essential to getting the grants she needs for programs like prenatal care, teen depression screening, and medically assisted treatment to get people off of opiates. That program is expanding, both geographically and demographically.
“We have a couple of teenagers now that we’ve brought into our suboxone program,” she recounted. “It’s a sad statement to say that you need to dedicate that kind of resource to a 16 year old or a 17 year old, but that's where we're at in the community…And our program is currently looking at going down to the South Coast, because that area needs a little bit more support and our program is very well established right now, thanks to grant funding.”
Renteria said her clinics provide depression screening to ninth and tenth graders in Fort Bragg, and she’s planning to bring the service to seventh graders soon.
This may be connected to one of the few bright spots Pierre-Oetker highlighted in the health of the community. She said that Mendocino County is below the state average for 11th graders who are experiencing sadness or hopelessness, and who are considering suicide. “That’s where you want to be,” she offered.
And she reminded listeners that the point of the exercise wasn’t to demoralize the populace with depressing data. She acknowledged that, “It’s difficult to hear, but I think without the awareness of that, we can't do the big work that needs to be done, and we can't create good policy. When you do good policy, you bring in resources.”
A recording of the full two-hour forum, the report, and Pierre-Oetker’s presentation are available on the Mendocino Coast Healthcare District’s website.
