County health officials paint mixed picture for Town Board

Putnam County residents are, by many measures, healthier and more secure than their neighbors across the region. But beneath that overall stability, health officials say, a series of troubling trends are emerging – from rising mental distress to increasing economic strain – which could negatively shape the county’s future if left unaddressed.

That was the message delivered April 15 to the Carmel Town Board by Vicki DiLonardo, a senior public health program assistant with the Putnam County Department of Health, as she outlined the findings of the county’s 2025 Community Health Assessment and the early steps toward a new health improvement plan.

DiLonardo’s presentation was part of a countywide outreach effort, with health officials visiting municipalities and community groups to gather input before finalizing priorities. Residents are being asked not only to react to the data, but to help determine which issues matter most and what resources might be brought to bear.

“We identified eight focus areas by looking at where we’re performing worse over time, worse than the state or region, or where there are disparities,” DiLonardo said. “And then we’re going to use community feedback to help guide what we do next.”

While Putnam remains relatively affluent with low unemployment, the assessment found signs that financial pressures are mounting for many households. Poverty rates remain low but are creeping upward, and a growing number of renters are considered “cost-burdened,” meaning a significant share of their income goes toward housing. Nearly one in five survey respondents reported difficulty finding work that pays a livable wage.

Those pressures ripple outward, DiLonardo said, affecting everything from access to health care to the ability to maintain a healthy diet.

Food insecurity, while still less prevalent than in other parts of the state, is also on the rise. At the same time, fewer adults report eating fruits and vegetables, and rates of overweight and obesity are increasing. Those trends are closely tied to chronic illnesses such as heart disease and cancer, which remain the leading causes of death locally and nationwide.

Health care access presents another mixed picture. Insurance coverage rates in Putnam are comparatively strong, but that statistic masks deeper challenges. Cost remains a barrier for about 10 percent of residents – higher than in surrounding counties – and some struggle to find available providers.

“There are disparities by race and ethnicity, and insurance doesn’t tell the whole story,” DiLonardo said. “Availability and affordability both matter.”

Among the most concerning findings is the state of mental health in the county. Survey respondents identified it as their top concern, and data shows higher levels of mental distress compared to neighboring counties. While Putnam’s suicide rate remains below the state average, officials noted a recent uptick that warrants attention.

“We want to look upstream,” DiLonardo said. “What can we do before people reach that point of crisis?”

Substance use trends add another layer of concern. The county is seeing higher and increasing rates of both binge drinking and smoking compared to the state. Particularly troubling, officials said, are survey results from local students showing elevated rates of binge drinking and a significant number reporting riding in a car with a driver who has been drinking.

“These behaviors are risk factors for chronic disease, and they’re starting early,” DiLonardo noted.

Other areas of concern include disparities in prenatal and postnatal care, particularly among communities of color, and declining rates of exclusive breastfeeding in hospitals – a reversal from previous years when the county outperformed state benchmarks.

Among children, preventive care indicators are also trending in the wrong direction, she said. HPV vaccination rates – important for preventing certain cancers – are the lowest in the region and fall below state targets. Meanwhile, blood lead testing among young children has declined steadily in recent years, raising concerns about missed opportunities to detect exposure early.

Still, the presentation was not without encouraging news.

DiLonardo pointed to past success in improving early childhood vaccination rates, an area that had been flagged in a previous assessment. Through coordinated efforts between Health Department staff and pediatric providers, those rates have since increased—a sign, she said, that targeted interventions can make a measurable difference.

“It shows that when we identify a problem and work together, we can improve outcomes,” she said.

More broadly, many of the county’s strengths remain intact. Putnam continues to benefit from relatively low unemployment, high insurance coverage, and generally favorable comparisons to state and regional averages in several categories. Even in areas of concern, officials emphasized that the county often starts from a stronger baseline than others.

The challenge now is to prevent negative trends from gaining momentum.

Following the presentation, Town Board members and attendees were invited to weigh in on the data, discuss how these issues affect their communities, and identify resources that could help address them. Participants were also asked to rank their top priorities, feedback that will be combined with input gathered across the county.

That information will ultimately feed into the county’s Community Health Improvement Plan, a state-required document that outlines strategies and interventions for the coming years.

For DiLonardo and her colleagues, the process is as important as the data itself.

“We can look at numbers all day, but hearing from the community helps us understand what’s really going on,” she said. “That’s what guides meaningful action.”

As Putnam embarks on its next planning cycle, the message from health officials is clear: the county is doing many things right, but staying ahead of emerging challenges will require attention, coordination, and sustained community engagement.

For more information, visit putnamcountyny.gov/health/community-health