Martha's Vineyard Rural Health Scholars, 2009 - 2021

Each year students from UMass Chan Medical School visit the island of Martha's Vineyard as a part of the Rural Health Scholars Program. In partnership with community stakeholders, the scholars visit the Island and over a two-week period study a key population health issue.

This is a systematic review to document the key themes, commonalities, and recommendations from the 2009 - 2021 Rural Health Scholars Presentations.

For the community this is a tool to see how we are progressing toward our goals for a healthy community.

For local researchers, its a compilation of the students' work and a resource for comparing Martha's Vineyard's most pressing health needs.

In this review 17 thematic areas were identified and are listed along the bottom X Axis of Figure 1. The thematic areas represent quite a range of health needs, so they were further grouped into four categories: SDOH, Special Populations, Specific Health Needs, and Systemic Challenge

All Rural Health Scholar Presentations to date by year, focus area, and title

Year, Focus Area Presentation Title

2009 High School Transition  Transition to the High School Years 

2010 Falls Prevention [Presentation not available] 

2011 Elderly MH SUD  Elderly Mental Health & Substance Abuse  Services

2012 Healthy Food Access   Accessibility and Affordability of Healthy  Foods

2013 Healthy Aging Initiative  Coordination, Communication, & Servic e

2014 Elder Mistreatment  Examining Elder Mistreatment on MV 

2015 Homelessness  Homelessness on MV 

2016 Substance Use  Addiction and the MV Community 

2017 Sexual & Reproductive Health  Assessing SRH on MV 

2018 Advanced Care Planning  Laying the Foundation for Advanced Care Planning  

2019 Inclusive Rec. & Leisure  Inclusive Recreation and Leisure 

2020 Food Insecurity  Addressing Food Insecurity on MV 

2021 Youth Ed. & Training  Identifying Education & Training Needs of Youth 

The Martha's Vineyard Community is in the midst of a housing crisis which has several reprecusions on the health of the community.

The Island has a robust bus system, bike routes, and the towns and neighborhoods are connected by paved and dirt/gravel roads, but transportation is not equitable among the elderly population and communitites of color.

The seasonal nature of Martha's Vineyard community leads to many population health concerns regarding consistant insurance coverage and worker safety.

Diet is central to person health. Ensuring access to a healthy diet requires adequate transportation, economic access to food, availability to fresh and local food, and access to specific foods for diet-related chronic diseases and other health needs.

Meeting elder care needs on the Island has been especially difficult in recent years. Lack of affordable worker housing and the significant growth of the older population on Martha's Vineyard adds to this challenge.

Martha's Vineyard is a beautiful community to grow up in, but few options for group social connection, provider shortages, and social pressures makes this group especially vulnerable to mental health and substance misuse.

The Vineyard is home to many different ethnicities with various language needs. Most notably, the Brazilian population has a great need for reducing language barriers in health care.

With many immigrant families calling the Island home, a rapidly aging population, and a vibrant community of people living with disabilities, Martha's Vineyard residents experience varied levels of access to health care resources and services.

Mental Health needs have long been a major health focus on Martha's Vineyard. Most notably mental health needs are wraped up with concerns of substance use disorder, affordable housing, and the growth of the Island's elderly population.

Substance Misuse or Substance Use Disorder (SUD) has been a major health concern among Islanders for generations. High alochol consumption and the opioid epidemic have significantly affected the Martha's Vineayrd community.

Like most communities across America, Martha's Vineyard has its fair share of chronic diseases like diabets, hypertension, and some cancers.

Closely related to mental health and substance misuse needs is the lack of on-Island detox and recovery facilities/services. Local services are overburdened and without a local treatment center or recovery housing, most patients must go to the mainland for treatment. A process that cuts individuals off from their community and sources of support.

Across the Island's sub-populations, stigma is a major barrier to accessing services, especially services for mental health, elder support, food assistance, and any service that could draw attention to a person's undocumented status. Even when resources are abundant, islanders can be hesitant to access services, a dynamic that will need to be addressed to fully meet the community's health needs.

Fostering robust and open communication around health is important for realizing the Island's health goals. Almost every cohort of Rural Health Scholars cited intra/inter organizational communication as a care access barrier for patients navigating services across departments and across organizations. There is also need for improved 1:1 communication between providers and patients and general outreach to the community.

Given its geography, Martha's Vineyard has always had a smaller selection of health services available compared to mainland communities. A fast growing population with unique health needs compounded with an affordable housing crisis has made provider shortages a reality for virtually every health care organization on the Island.

A need for wraparound care has been cited by many patients interviewed by the RHS over the years. Many patients have a complex set of health conditions requiring them to see providers at the various health care organizations on the Island. Practicing warm hand offs and utilizing human connection like I2's Community Health Workers and Peer Recovery Coaches are among some of the solutions being piloted in the community.

A lack of consistent and current data makes research on community health a daunting task. Past Rural Health Scholars have recommended organizations work together to standardize data and identify a centralized entity to collect, store, & analyze population health metrics.