We’re the best at being the worst,” jokes Dr. Dino Beckett, CEO and medical director of Williamson Health and Wellness Center. He’s acknowledging the area’s daunting health statistics: Mingo County ranks near the top of the state in chronic diseases like obesity, hypertension, and diabetes. Addictions and challenges grew as the town shrank, a victim of downturns in coal mining and manufacturing. When Beckett, now 48, returned to his hometown after earning his medical degree, he added a free clinic to his practice. But he soon saw that the town needed a new model for both health care and economic development. He knew that residents shared a desire for healthier lives. He also believed that the town’s huge health needs could inspire its business opportunities. What if clinic revenues could be reinvested for other health-related projects? With childhood friends and government allies, he began to explore how the town could help itself.
“Health care is an economic driver,” explains Beckett, not only for big cities but also for towns like his. Ten years into the experiment, Williamson Health and Wellness Center, now a federally qualified health center, has expanded its staff from seven to 50 people and will add another 20 this year. The clinic’s philosophy of preventive care, promoting wellness through healthy food and activity, has also encouraged a raft of new ideas. One innovative project in development would convert a notorious “pill mill” into a one-stop facility to treat substance abuse and help people in recovery to prepare to join the workforce. With a goal of “10,000 healthier lives,” wellness is becoming the asset that unites the local community.
Strong partnerships developed through the Mingo County Diabetes Coalition underpin much of Williamson’s progress. Becoming trusted visitors to patients’ homes, community health workers comprehensively screen, monitor, and clinically treat high-risk diabetes patients. They also help address other family needs: healthy food, physical activity, housing, transportation, and more. “It takes a few visits to gain trust,” says Melissa Justice, who directs the current staff of three workers. “Then they’ll say, ‘I was hoping you’d show up. How do I take these medicines?’ ”
“It’s an odd dynamic—the patients want to please us,” says Beckett. Comprehensive data proves that patients who stuck with the program experienced a drop in a key blood sugar measure, hemoglobin A1c, by 2.2 percent. “That’s huge,” says Beckett. “If you were a drug manufacturer and you were able to drop [A1c levels] by just 0.6 percent, you would have a billion-dollar drug.”
The positive results of Williamson projects funded by the Centers for Medicare and Medicaid Services have prompted insurers like Aetna Better Health of West Virginia to prepare to share claims data with clinics. Discussions are underway.
“Treating diabetes is one of our highest expenses,” says Kimi King, director of clinical services for Aetna. Diabetes and prediabetes cost West Virginia an estimated $2.5 billion each year. If insurers reimburse clinics like Williamson for effective community health outreach, providing preventive care will become a proven business model for clinics around the country.
Local fresh food has been hard to find. Now, volunteers tend the Ramella Park Garden of Eatin’, with three high tunnels and raised beds near a public housing complex. A seasonal farmers market will soon take over a former American Legion hall downtown, adding a full-time commercial kitchen and local grocery. Other greenhouses at the high school and local farmers deliver enough produce that the market can deliver fresh fruit and vegetables weekly throughout Mingo County on the My Mobile Market truck. The project accepts SNAP, WIC, debit cards, cash, and other vouchers, including the Health and Wellness Center’s Prescription Veggies. Other sustainable projects include innovations in solar energy, green building job training, and creative reuse for old downtown buildings; in addition to the renovated “pill mill,” other storefronts are being targeted for tourism development, meeting spaces, and a hostel.
Williamson is developing high-tech tools for health and new health entrepreneurs. Passport, a new software application to debut this year, creates incentives for users to self-report their daily physical activity and healthy eating. Developed by University of Virginia students, the program also accepts written entries. Users will earn points that can be used for related online purchases, like race registration or running shoes. The app promises to be a valuable tool for preventive health researchers as well.
Williamson has also worked for the past year with students from Stanford University Graduate School of Business. With Impact Experience, a global program, the team identifies entrepreneurial opportunities in Williamson and connects the community to potential venture capital to build new businesses.
“In rural counties, people know each other. What works in Williamson is the community partnerships, not one agency doing it on their own,” says Richard Crespo, aprofessor of community health at Marshall University whohas led diabetes prevention efforts throughout Appalachia.“Early on, they brought a lot of people together. Everyoneis voicing dreams for their area, figuring it out.”
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