Elbert County: Public Health and the Environment

Saying Goodbye to Elbert County

2009-05-05T13:05:00.004-04:00

The time has come to say goodbye to Elbert County - at least as a reporter.

Thinking back to my first journey out to the granite capital of the world, I feel like I've made strides in not only improving my writing but also in discovering the parts of public health that I find most personally engaging. And this is where I think community beat reporting really helped out.

Although always an outsider, I think I started to form a bond with my community. Not necessarily to particular people but rather to the idea of this rural Georgia region, rich with its own history, notoriety and even famous landmarks and plagued by the same challenges that touch similar communities throughout the country, just down the road from my own hometown. And in 30 years, I’d never even bothered to visit.

I liked thinking about large-scale issues on such a local level. Looking through the lens of Elbert County when considering the significance of medical trials or the relevance of fitness guidelines provided some concrete and grounded context as a jumping off point. It helped define issues that I might have otherwise overlooked completely.

So I guess my obligation as I continue on is to remember Elbert County. To remember that, for me, it can represent the millions of nameless folks who deserve good information. As long as I keep this as a goal in mind, I don't think my efforts will be in vain.

The Georgia Guidestones

2009-05-03T14:00:00.006-04:00

Elbert County was featured in the May issue of Wired Magazine. I won't go into the story because you can read it for yourself here. The article is thorough in its investigation and well-written to boot.

And it peaked my curiosity enough to go check it out for myself. As it turns out, the Guidestones already exist as a landmark in the iPhone Maps application and I followed the directions accordingly. I had to travel along a gravel road and across a creek - although as it turns out, it's just a couple miles off the main drag in Elberton, and had I just driven my normal route - on dry, paved road - I would've made it just the same. But the backwoods route added to the mystery so I thank my slightly misguided iPhone for that. I took some photos but unfortunately, I left the house without my zoom lens (only a fixed lens) so I was somewhat limited. You can see (I think) the polyurethane paint that was referenced in the Wired article - used to deface the surfaces. Also, as mentioned in the article, some feel these stones are satanic and left graffiti suggesting such....
The Georgia Guidestones

Extension Agent Superhero

2009-04-28T10:28:00.001-04:00

I have to admit, before being assigned to Elbert County and being supplied with the name of the county's extension agent, I had no idea what an extension agent actually did. And I still don't know the full extent of his/her responsibilities but from what I've observed, the extension agent is basically expected to know everything.

And I think, also from observation, Elbert County's extension agent Christa, does a pretty good job of pulling that off.

It seems like a great, albeit underutilized and definitely not fully understood, service that the University offers the various counties of the state. I believe extension services were first established by the Congress as a mandate for all land-grant universities across the country. Initially their main function was to "help keep farmers abreast of the latest agricultural technology, research and marketing strategies." From there responsibilities grew to "help parents cope with the pressures of balancing home, work and children" and also to "help keep families healthy with information on nutrition and food safety."

That's a lot for one person to handle. It's also a very useful resource, especially in rural counties, for county residents to access. Christa tells me she gets calls about proper methods for canning fruits, removing stains of various sorts and recipes. Additionally, Christa has programs for both young and old to address matters of nutrition, physical activity and really anything about which any Elbert County resident can generate enough interest.

So it would seem that Christa would have no time to help a community reporter track down sources and stories but, on the contrary, she has been the single-most helpful and knowledgeable Elbert County resource for me this semester. Helping me went above the call of duty for her and, in her doing so, I was able to see more of and learn more about Elbert County than I ever could have on my own.

Thanks Christa.

Elbert County, Public Health & the Environment

2009-04-25T13:30:00.003-04:00

Being a graduate student in ecology, I really set out this semester with an ecological focus for my investigations in Elbert County. I think I came into the process with a pretty narrowly defined idea of what it means to write about environmental issues.

One thing that I walk away from this class and from Elbert County with is a much broader understanding of the umbrella of public health and how many seemingly divergent subject headers can find their way beneath its shelter. Which brings me to the even bigger point that so much of public health - and covering public health-related topics - is an exercise in interdisciplinary investigation. There are so many sociological, cultural, environmental and economic factors that go into every person's story of their own health that it is often challenging to cover just one aspect without feeling that you're doing a disservice to the rest.

I think specifically back a particular episode we watched from the PBS series Unnatural Causes. The name of the episode was Place Matters and it focused on how your street address can successfully predict your health. So within this, of course, are embedded matters of soci-economics - for example, areas around polluted sites are vacated by those who have the means to move elsewhere and left behind is a population financially anchored to a place that's making them sick - but also the program addressed factors of community and environmental design. For decades now, we have been building communities to best fit our need for four wheeled mobility, abandoning asthetic and health-promoting principles of design for "convienence".

But I'm not sure how to translate these ideas into information that is pertinent to an average Elbert County resident. The connections between community design, cohesiveness and health are nebulous at best and may not inspire well-grounded, rural citizens to take action. Especially without sounding condescending or politicized. Although, in theory, re-adopting a lot of the lifestyle choices of rural America and re-localizing our communities might be just what the doctor ordered.

Farming in Elbert County

2009-04-23T20:03:00.004-04:00

Elbert County, given its rural status, has, not surprisingly, a lot of farmland. Today I had the opportunity to visit two of these farms - both of which are trying to employ innovative farming techniques to improve their respective levels of sustainability. Sadly, I forgot my camera on this particular outing so you'll just have to use your imagination.

The first farm was Flatwoods Farm. Dr. Tim Heil and his wife, Lucy, are just getting this organic farm off the ground. Dr. Heil is on the verge of retirement from his position as a professor in the physics department at UGA. Once he retires he plans to become a fulltime organic farmer and really increase production on his farm. Dr. Heil showed us (myself, Christa, Christa's husband Kevin - a Livestock & Forage Agent with Clemson University, and Clay Talton - Elbert County's Agriculture and Natural Resources Agent) all of the pastures on his 150 acres of land. He and Lucy are still in the experimenting stage, trying to find the right combination of crops, the best cover crops and the most effective (and natural of course) way of warding off unwanted critters. The Heil's land is absolutely beautiful, transitioning several times between pastureland and dense forests. The Heils felt like farmers' makets or other local options for selling their crops were not really viable (mainly because there aren't any options) so they are currently supplying both Whole Foods and Earthfare with small batches of specific types of produce. Currently the Flatwoods Farm is not home to any livestock although plans for the future may include some.

The second farm we visited was Nature's Harmony Farm. Farmers Tim and Elizabeth Young are doing an amazing (if not labor intensive) job of rotational grazing. The have cattle, sheep, hogs, turkeys, chickens and ducks (and several farm dogs who watch over things) which they rotate from pasture to pasture to allow for grazing - minimizing the impact of a particular animal on the land, allowing the animals to naturally "clean-up" after each other, and improving overall soil quality by allowing the animals to excrete fertilizer. The process is really interesting to see and Tim and Liz seem to have a really good system going. They also have a chicken processing facility on their property so they do not have to ship their chickens elsewhere once they are ready for slaughter. The Young's adhere to a strong commitment to sustainability. They will not ship any meat - the products are available only to those customers who are within driving distance of the farm.

Stroke Follow-Up

2009-04-17T23:21:00.000-04:00

In the 2008 Georgia legislative session, the issues related to stroke in rural locations did get some attention. Senate Bill 549 , the Coverdell-Murphy Act (named after two well-known Georgia politicians who were both victims of stroke), passed the state senate and the house and was signed by Governor Purdue last May.

The bill addresses several broad concerns related to stroke - certified stroke centers, identification of primary and remote stroke treatment centers, assessment tools. A small portion of that bill establishes a grant program that could potentially help programs like REACH extend beyond its current limitations - creating new hubs as well as equipping more rural medical facilities with the technology to best utilize the program.

Section 31-11-114 specifically addresses the proposed grant program: "In order to encourage and ensure the establishment of stroke centers throughout the state, the department shall award grants, subject to appropriations from the General Assembly, to hospitals that seek identification as remote treatment stroke centers and demonstrate a need for financial assistance to develop the necessary infrastructure, including personnel and equipment, in order to satisfy the criteria for identification as a remote treatment stroke center pursuant to subsection (b) of Code Section 31-11-113."

By September 1, 2009, the hospitals receiving grants and the monetary amounts going to each will be finalized by the Governor, President of the Senate and Speaker of the House.

There is some potential here for rural hospitals to update their facilities and perhaps provide a more sophisticated level of care for stroke patients in remote locations. Money is tight, however, and investing time and effort into producing just the grant proposal may stretch these small medical centers beyond what they can reasonably accomplish.

Crowd Sourcing 1.0

2009-04-15T15:34:00.001-04:00

I think one challenge for Elbert County, and likely most other rural areas, is a lack of information. And I don’t really mean this in specific terms or in a way that places the blame in a single person’s lap. As these counties continue to lose their cohesiveness, as people become more and more decentralized and less localized, information begins to fall through the cracks – as do feelings of civic pride and community.

People don’t talk to each other or share common spaces as much as they used to and I think something of great benefit is lost in this trend. It really hit me when I was hanging out with Christa at the Elbert County Boys and Girls Club. The people involved in the project put the word out to the high schools and middle schools (although there was an issue of keeping the two separated because the topic of birth control was involved) and no one showed up. Parents probably didn’t ever even know about it and if they did, it’s possible that they were not aware of the health department’s underlying goal.

It just seems to me that if people were a little more connected and the avenues by which information travels were stronger and little less diluted, people could help each other much more. It’s kind of like the crowd sourcing 1.0. And of course there are elements of community and environmental design that relate to this but on a far less drastic level, getting people to reconnect with and invest in the community and more importantly each other would go along way in improving information exchange.

Access to Care

2009-04-07T12:59:00.000-04:00

Most Elbert County residents who have the means to do so travel either to Athens or Anderson, South Carolina for medical care. It’s hard to say which came first – Elbert County residents seeking healthcare outside off the county or medical professionals closing up private practices in Elbert County in search of greener pastures.

I understand it is unreasonable to assume that every rural county across the county would be able to support very specialized medicine but pediatricians, family doctors, professionals of this nature, it would seem, could sustain a practice in Elberton at least. But on the contrary, the hospital in Elberton just recently ceased its obstetric services and now women must go to hospitals in either Athens or South Carolina to delivery their babies. The question then becomes what happens to Elbert County residents who do not have the financial means to seek quality healthcare outside the county?

Those left behind now face a limited, or perhaps non-existent, pool of medical professionals from which to choose. I would imagine that this trend encourages those residents to not get the care they need. Driving all the way to Athens for a prenatal checkup may not be feasible for some women and in turn, both mother and baby suffer. I don’t know the answer, but it does seem that when decisions - like doing away with an entire wing of a hospital - are made, certain populations are overlooked and are left to suffer consequences by which the decision-makers are unaffected.

Bringing ACSM to Elbert County

2009-03-31T12:58:00.000-04:00

After attending the American Conference of Sports Medicine in Atlanta recently, I started wondering whether or not information discussed at meetings such as these ever really trickles down into less metropolitan areas of the country.

Thinking back to the attendees at all of the meetings I sat in during our day at the conference, most were well attired, very fit, and well-versed on the subject of all things exercise. One particular presentation was related to the newly-released physical fitness guidelines for Americans. The information, although dense, was indeed informative but I couldn't help wonder how many of the meeting's attendees would return home to rural parts of the country - I assume not too many. The fitness-obsessed lifestyles of the often affluent, educated class tend to concentrate themselves within city-life where 24 hour gyms and personal trainers abound. And this is all based on observational data but it does seem that small town America misses out on both the good and the bad when it comes to the quest to be fit.

My suspicions were confirmed after some discussion with Christa, Elbert County's extension agent. Christa suggested that trying to incorporate the new guidelines into youth or even adult programming was confusing to people. They already had to contend with the new nutritional pyramid (which also has an element of physical fitness built in). She indicated that most people know what's good for them - that it's really a matter of common sense - but a lot of people do not have physical fitness as a priority.

So the question then becomes: is it a matter of education or just a certain level of free time - often an accompaniment of affluence - that drives individuals to engage in health-promoting activities? And when professionals hold fancy conferences to discuss the latest and greatest in medical advances, how relevant is that to low-income earners in Elbert County?

REACH

2009-03-14T14:46:00.005-04:00

Quick lesson on stroke:
There are two types of stroke – ischemic and hemorrhagic. Ischemic strokes, simplified, are caused by some sort of blockage in the vessels of the brain – a brain attack (as compared to a heart attack). A hemorrhagic stroke, as the name suggests, is caused by a leakage in the vessels – a rupture or a burst.

In 1995, the FDA approved tPA, a clot buster drug, for people in the midst of an ischemic stroke – a breakthrough because it was the first drug ever that showed a beneficial effect for stroke patients – 30% more likely to emerge from the stroke without any impairment. However, there are two major problems associated with tPA for stroke: it must be administered within three hours of the first symptoms of stroke and it can only be given to ischemic stroke sufferers – tPA can cause hemorrhages in the brain and would therefore be detrimental to a patient already suffering from some sort of leak or bleeding.

Stroke in Georgia:
Stoke is of particular concern for the southeast (excluding Florida) – the region has been coined the stroke belt for its unusually high rate of strokes. Georgia is the 5th worst state in the country for stroke occurrence and mortality per capita. And a sizable portion of the state’s population still live in rural counties, most of which do not have locally available someone highly skilled in neurological evaluation – the most likely result being that rural stroke sufferers will not be evaluated within that three hour timeframe and thus will not eligible for tPA.

But in 2003, Dr. David Hess, Chief of Neurology at the Medical College of Georgia, developed a program that could help patients in rural counties, like Elbert, be evaluated by a neurologist from their local hospital. The REACH program is a telemedicine program that allows neurologists in Augusta to view real-time video of patients at rural hospitals, review a digital version of a CT scan taken at the rural hospital, and evaluate the patient for proper treatment options.

Access to care in Elbert County is a big issue. Specialists are not in abundance and residents of the county tend to rely on health care professionals in Athens or Anderson, SC for their medical care. But with acute illnesses, like stroke, every second counts and having to drive to an hour for an evaluation dramatically reduces an individual’s likelihood to benefit from drugs like tPA. The goal of the REACH program is to get everybody in Georgia within 30 minutes of evaluation.

Getting Creative

2009-03-03T14:52:00.020-05:00

Like most counties in Georgia, Elbert has a high rate of teen pregnancy and a correlating problem of high school dropouts. In an attempt to address these problems, Mary Champion, the nurse manager at the Elbert County Public Health Department, is getting creative.
In the past, holding programs at the Health Department has not proved particularly successful – mainly because high school kids aren’t interested in showing up at the Health Department after school - "it's just not very cool", to use Mary's words. So Mary has received some grant money that will help her design and fund educational programs in disguise.

The first of these events was held last Monday at the Boys and Girls Club in Elberton. The idea was simple. The local radio station and paper advertised an after school gathering for teens - just to come and hang out and maybe learn a thing or two (but nothing was mentioned specifically about pregnancy prevention).

A lady from the labor department

had a booth as well as Christa Campbell, the UGA extension agent in Elbert County - her booth was all about nutrition and physical fitness. The health department also set up a booth. The kids got to fill out a raffle ticket every time they participated in a learning activity at each of the booths.

Mary was really hoping just to get kids in the door. And keep them coming back – with raffle tickets. Although the topic of birth control was not even discussed Monday, Mary plans to – as the kids get more comfortable – work the education into future events of the program.

The event was ultimately a mild success, though, for the first hour and a half, the gym was almost empty. I overheard one of the nurses say that Elbert County was “probably the worst county in the state in terms of trying to get people to participate in things.” And it’s hard to judge how much of an impact it had on the kids. I couldn’t tell how engaged they actually were in the activities but I suppose, from a broader perspective, that wasn’t necessarily the major objective.

Mary is not facing an isolated challenge in Elbert County. But it does seem that the implied lethargy toward civic involvement might make her task more difficult then some counties with stronger social capital ties. It will be interesting to see how the idea progresses and whether she is able to reach those who might really benefit from such a program

Radon in Elbert County

2009-02-12T20:26:00.001-05:00

My first meeting with the extension agent for Elbert County went really well. Christa has only been on the job in Elbert County for a little over a year but she’s been working as an extension agent in Georgia for at least a decade – the exact number of years escapes me presently.

As part of her job, Christa is in charge of radon education in Elbert County. Before talking to her I had heard of radon and vaguely knew of it as a health risk associated with poor indoor air quality but I wasn’t necessarily aware of its impacts on public health.

According to a 2003 Environmental Protection Agency study, radon causes 21,000 lung cancer deaths in the US each year – second only to smoking. Although the threat of radon is not unique to Elbert County, exposure to the gas is of heightened concern for residents given the county’s particular geologic composition.

Radon is a naturally occurring chemical that results from the breakdown of uranium. Soils containing higher amounts of uranium, like granite, will naturally have higher amounts of radon. So counties like Elbert, which rest upon granite outcroppings, will consequently have a higher likelihood of exposure to the gas.

Christa was very helpful in providing me with a lot of information about radon – from detection and prevention to, more interestingly, regulation (or, more appropriately, the lack thereof). Unlike dangerous environmental chemicals like lead, for example, people are free to buy and sell houses without providing or inquiring about radon levels. Christa indicated that legislation is on the horizon but for now, radon is essentially a silent killer.

So the granite industry cannot really be held directly responsible for radon gas in homes because it is a naturally occurring phenomenon. However, would it be unreasonable to call upon the industry to help increase awareness and education – given that they are profiting from the same geology that is making people sick?

Information Overload

2009-02-03T19:05:00.002-05:00

So this week I, along with all of my fellow Deep South Health bureaus, have been working to localize a scientific, peer-reviewed journal article and apply it within each of our respective counties.

For me, the most overwhelming aspect of this assignment has been the endless amount of information available from the various government agencies that seem to have a hand in regulation of some kind - for the mining industry, specifically the granite mining industry of Elbert County – and beyond. I am in acronym overload…

The CDC, NIOSH, OSHA and MSHA just to name a few – all of which had something to say about the mining industry and how it was to be regulated.

To try to begin a discussion of the merits of various bureaucratic agencies would require knowledge of government inner-workings that I simply don’t have but it does seem to me, despite my crude understanding of the regulatory process and government oversight, that so many acronymic entities could potentially muddy the water.

I worked briefly as a PBS reporter covering the Nevada state legislature, and if that experience taught me anything, it was that government agencies (in this case BLM, USDA Forest Service, US Fish and Wildlife Service, and the National Park Service) don’t always communicate so well and given divergent goals and mandates, the standards set by each are not always consistent across agencies and many times they are conflicting.

This only makes for a confused citizen or in the case of Elbert County and granite mining, confused employers and employees. I don’t know that the same case holds true with matters of public health and occupational safety but considering how many directions I was pulled upon my initial investigations into mining regulations, I can only imagine how a granite miner might feel, should he or she dare to search for industry specific, health-related information.

Elbert County: The Granite Capital...

2009-01-26T18:48:00.000-05:00

This past Sunday was my first foray into uncharted territories, otherwise known as Elbert County. Despite having spent the majority of my life (minus a couple years on the West Coast) here in Athens, I must admit that, prior to Sunday, I had not yet had the occasion to visit Elbert County - population 20,511.

The majority of the county’s residents live in or around Elberton, which serves as the county seat. Elberton does have a hospital – Elbert Memorial Hospital – but it is small and has just recently, as Dr. Claude Burnett mentioned, closed obstetric services.

Granite is king in the Elbert County. According the county website, “the area's granite monument production accounts for one-third of total production nationwide”. The importance of the granite industry to county identity is instantly apparent upon arrival. Everything that can be fashioned out of granite is indeed done so. The natural resource is obviously deeply ingrained in the heritage and livelihood of Elbert County residents.

In addition to mining, the county is also home to two state parks – Bobby Brown State Park and Richard B. Russell State Park – both of which are nestled against bodies of water.

So natural resources serve as vital components to the local economy and will likely provide me with vast amounts of interesting material on public health and the environment.

It takes a journalist...

2009-01-21T18:44:00.001-05:00

As an introductory assignment in my environmental practicum class last week, we were asked to compose a 2-4 page “political biography”. It was quickly explained to us that the task had nothing to do with politics but rather it was an introspective exercise to identify particular life events that had shaped our relationship with the natural world and motivated us to pursue advanced degrees in ecology or related fields – why it’s called a political biography, I have no idea.

The lead professor for the course then compiled these biographies and extracted from them key statements regarding various motivations, relationships and opinions that were either common or unique amongst the students in my class.

Relationships with the natural world and the motivations behind our academic pursuits were variable but followed along a consistent theme of “I was outside a lot as a kid doing ______, instead of inside watching television”. I did have the particularly awkward experience of being forced to acknowledge publicly that Jim Henson is both my personal and professional hero. Not that I am embarrassed about this, in fact it’s quite the opposite. It was, however, a bit uncomfortable when a classroom of scientists – looking to natural science giants like John Muir, Rachel Carson, and UGA’s own Eugene Odum for inspiration – discovered that I had instead been influenced by a man and his puppets.

Apart from the minor incident of public humiliation, for me, the most interesting result of the exercise came later when the discussion turned to what my classmates felt were the most pressing issues for ecology- and science in general. The unequivocal response was communication.

Scientists, at least as much as I’ve seen amongst my classmates and my professors, recognize the need for better methods of information dissemination – in a comprehensible form, consumable by an average citizen – as a vital component of their charge as a productive member of the scientific community. As I see it, most people involved in matters of health (biological, environmental, etc) are drawn to the field by a desire to improve the world around them. And most also recognize that effective communication is something with which the scientific community struggles.

Helping in this pursuit, by bridging the gap in communication, the journalist becomes a critical member of the conversation and one that, I believe, is welcomed and valued – most of the time….