The thing I love most about the drive from Athens to Hart County? Cows. Oh, and the occasional miniature donkey or goat. They're cute but they serve a purpose, of course; the large number of farms in the area contributes to the county's position as fifth in agricultural sales for the state (2007).
After my first few visits, however, I learned that Hart County is much more than just farmland.
Hart County is a rural county with a population of around 24,000. While smaller than most counties in Georgia, it also boasts an active community and an interesting make-up.
I learned that what was once an area rich in textiles now relies heavily on income from it's man-made lake, Lake Hartwell, which attracts part-time residents, retirees, and vacationers. While there are more affluent residents around the lake, according to Ilka McConnell, UGA's Hart County Archway Partnership professional, they are more the exception than the norm. Those who live in Hartwell, the county seat, tend to have less income and work in industrial settings. The county's unemployment rate as of December, 2010 was 12 percent, with 19.7 percent of individuals living under the poverty level.
Many of the health problems in Hart County seem to stem from lifestyle and income, and are often compounded by a lack of health care services. The county is designated as a health care professional shortage area as well as having a medically underserved population. There is a single hospital in Hartwell with 82 beds, but the beds on the first floor aren't in use. There is also a MedLink clinic to provide primary care, as well as a few other family practitioners.
When it comes to acute care, the hospital is able to provide several services but more often patients are referred to physicians in places like Athens or Anderson, SC for specialized treatment in cardiovascular diseases, neurology, oncology, etc. Interestingly, there is a "wellness" center adjacent to the hospital that specializes in cosmetic procedures such as vein care, Botox injections and various laser treatments.
When speaking with Rhonda Dyar, the Nurse Manager at the local health department, I learned that many of who live in Hart County depend on the health department for all of their health needs, like child health care, women's health care and other services that are lacking in the county or unaffordable. She also said that the tiny clinic, usually equipped with only two nurses, is constantly behind on meeting the needs of its clients and is often booked solid.
As with most rural areas, major health issues in the county include cardiovascular diseases, obesity and diabetes. That obesity and diabetes are problems is evident simply by driving around town. The first restaurant I spotted when I first visited was a McDonald's right in the center of downtown, directly across from the police station. Leading causes of death for the area waiver around lung cancer, heart disease and stroke, which is representative of the US, but the rates are exaggerated for Hart County.
Lisa Graham, an RN and legal nurse consultant at the Hart County Hospital, told me that diabetes and obesity are both cyclical problems in the area that stem from lifestyle, surroundings and income. In fact, she stated that for many diabetes patients, noncompliance with medications and diet is often due to a lack of viable options.
Mary Lowery, an RN at the hospital, reiterated this by saying that people "eat what they can afford," stressing the social and economic aspects not only of diabetes and obesity, but of most health problems in the area.
"You're gonna buy your cigarettes and alcohol before you buy your food."
Both Lowery and Graham said that the state of the economy has put a damper on health care in the county, preventing some from accessing critical medications or preventative measures. Add in the few available health care services within a close distance of Hart County residents, and you have a recipe for lasting chronic diseases and an unhealthy population.
There is another side to the county's health story, however.
There is a surprisingly long list of local charities, nonprofit organizations, support groups, clubs, and churches that do or could be used to address health care issues in the county. The hospital hosts weight-loss, substance abuse and other meetings. Diabetes support groups and education are rising in popularity, and the school system takes a proactive stance on nutrition and sports.
Hart County, in a nutshell, appears to me to have several county-wide health concerns. But what I also saw when meeting residents or driving around town is a relatively close-knit community with the desire to grow.
