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2016 in review: Teeth, tobacco, training top health issues

Joe McIntyre/staff photographer

Josh Pennock, 8, right, and his brother Brady, 11, practice their daily dental routine at their home in Cortland in this file photo.

Keeping healthy in Cortland wasn’t just a matter of eating right, exercising and getting one’s shots in 2016. It involved public education, laws, coming mergers and even the U.S. military

Cortland lacks fluoride

News flash: The City of Cortland doesn’t fluoridate its water.

After most of a year of trying to persuade the city to fluoridate, county health officials have learned that most residents aren’t even aware the city’s water lacks fluoride.

Three-quarters of the nation’s 16,000 municipalities use fluoride to reduce cavities up to 50 percent, with benefits in school and workplace productivity and even improved heart health. But outside of Marathon, not in Cortland County. City officials declined to pursue a feasibility grant early this year to see what fluoridating would require, but agreed to continue considering the issue.

More pediatricians apply fluoride in the office, something pediatric dentists used to do exclusively, said county Health Director Catherine Feuerherm. “But community water fluoridation continues to be the ultimate goal.”

Data show half of all third-graders in the county have cavities, and a third of adults over 65 have no teeth. It’s a particular concern for the portion of the city’s population — 52 percent — who live below the poverty level. The priority was outlined at a countywide health assessment in January, with public education culminating in a September debate between top proponents and opponents of public fluoridation.

“You can’t withhold a health measure from someone when you know it works,” said Johnny Johnson, pediatric dentist and president and founder of the American Fluoridation Society.

Fluoride reduces cavities at least 25 percent in both children and adults, he said, by bonding with the calcium in teeth, making them harder and less susceptible to cavity-causing bacteria; and by saturating the system so a person’s saliva acts as a perpetual fluoride rinse.

In fact, he added, each $1 spent to fluoridate public water delivers $38 in benefits from reduced medical care and increased productivity.

“Every credible scientific group in the world recognizes fluoride as safe and effective,” Johnson said, noting more than 3,000 supporting studies.

Paul Connett, a toxicologist and founder of the Fluoride Action Network, said fluoride toothpaste should be available only by prescription. He raised questions about potential connections between fluoride and arthritis, between fluoride and thyroid problems, a rare form of bone cancer and decreased intelligence. Many of the studies were shot down for poor methodology, and some were rewritten to prevent comments from being taken out of context.

“You can criticize the studies, but to say there’s no evidence is bizarre,” Connett said. “The absence of study is not the same as absence of harm.”

The public education effort will continue, Feuerherm said, but there’s a complication. “There’s no funding for public education.”

Law restricts tobacco

Cortland County’s law banning tobacco and e-cigarette sales to people under age 21 went into effect Oct. 1, meaning the under-21 crowd need to schlep 10 miles to Dryden in Tompkins County or 11 miles Groton to feed their addiction.

When county legislators adopted the law in June on a 9-7 vote, 146 communities in 10 states limited tobacco sales to people younger than 21. By November, that number was 200, according to the advocacy website Tobacco 21, including New York, Boston, Chicago, St. Louis, Cleveland and Washington, D.C.

“The goal of this law is to get the cigarettes out of the hands of 16-, 17-, 18-year-olds. They’re not likely to drive to Groton,” she said. And their over-21 friends are less likely to share with teens.

The numbers are clear, says the American Heart Association: If people delay trying nicotine until they’re 21, only 2 percent ever will. As it is, 95 percent of smokers start before they’re 21, reports the American Cancer Society.

The average age of first use in Cortland County is 12.9 years, according to the Cortland Area Communities that Care.

Further, 19 percent of deaths in Cortland County have some connection to tobacco use, Feuerherm said earlier this month. “The big question is why the state hasn’t adopted it yet.”

The law doesn’t target buyers — they can still consume nicotine products. It targets sellers: Violators will be subject to the same fines and penalties as the state’s existing 18 smoking age, up to $2,500.

Military provides care

Cortland County paid $860 to bring the military to Homer in July to provide free medical services. The value of those services? $851,426, a return on investment of 990-to-1.

The Innovative Readiness Training exercise, which helps military medical providers develop their logistics and planning skills while helping communities with their health-care needs, saw 1,807 patients and performed 7,613 procedures, said county Planning Director Dan Dineen. Among them:

– 1,854 dental procedures.

– 725 eyeglasses prescribed and distributed.

– 427 pets vaccinated for rabies.

– 125 pets spayed or neutered.

The event cost the community $19,569, but Cortland County got $15,000 from the Southern Tier East Regional Planning and Development Board, $3,709 in donations, 3,335 volunteer hours, leaving just $860 in county outlay.

The county has filed a fast-tracked application to host the event again in 2017, Dineen said. If that falls through, it has a similar application for 2018 in partnership with Tioga County.

Hospital adds services, seeks affiliation Cortland Regional Medical Center announced in October it would seek to affiliate with a larger health-care network, even as it marked its 125th year of operation.

“We’re just entirely too small to take on the rising costs associated with population-based health management,” said hospital President Mark Webster. “We’d actually be able to benefit from the purchasing power … and the resources a large organization can bring to the table.”

When Webster took over as the hospital’s president in January 2014, he was tasked with reining in a $7 million deficit. The hospital’s fiscal standing has improved, he said. The board’s decision to seek a partner had more to do with preparing for the future.

“We have improved the finances pretty substantially but we’re not where we need to be,” he said. “We’re not doing this because we’re running out of cash or there’s a capital need. Our decision is … based more on where we see the future of the organization.”

The hospital hired Philadelphia-based health care consultants Veralon to help draft a request for proposals that would go out to at least 10 area health care networks. The plan is to identify prospective partners by April 2017 with an affiliation established by January 2018.

That effort came as the hospital announced a $13 million plan in February to build a cancer treatment center and medical office space on Homer Avenue. It will include a $6 million linear accelerator to let the hospital offer radiation therapy. Construction begins next spring and includes a pedestrian walkway over West Main Street.

It also installed a $2.2 million magnetic resonance image machine in November, replacing one it ran on West Road. The new machine is faster and less stressful with better scans, the hospital said.

However, the hospital closed a walk-in care center in August for lack of patients, among other reasons. Cortland-area residents have one other walk-in clinic: the Cortland Convenient Care on Commons Avenue in Cortlandville.

A new system was installed to speed admissions and treatment at the hospital’s emergency room, nearly halving treatment times. But emergency room care is more expensive, with insurance co-pays between $100 and $1,150 instead of a clinic’s $50 or $60, hospital officials said.