Oxford County, Maine

Located in the western region of Maine, Oxford County boasts a sprawling natural landscape that has fragmented the population, creating a density of 26 people per square mile.

Historically, the manufacturing of wood products, paper, shoes, leather, and metalworking formed the base of Oxford County’s economy, along with tourism. For many years, these industries, especially manufacturing, sustained the Oxford County economy. Over the last three decades, with the expansion of free international trade, some of these manufacturing companies have closed their Maine factories, including some in Oxford County. These closures resulted in a loss of 22,400 jobs statewide. Although manufacturing remains a mainstay of the county’s economy, the economic base has shifted from manufacturing to other industries, such as tourism, health care and education. This shift has led to an increase in unemployment and underemployment, and a decline in economic opportunities because of lower wages and seasonal employment.

As economic opportunities in Oxford County have declined, poverty has become an increasing concern for residents. In addition to poverty, the county is facing rising rates of mental health issues; a lack of public transportation; high rates of obesity; and increasing substance use. In the last 15 years, health coalitions and state legislators have worked to connect Oxford County residents and address these challenges through strategic partnerships and community engagement. Despite these improvements, Oxford County still faces several challenges, including potential legislative changes that could threaten public health funding.

Overview

Population and Demographics

Population: 57,517

SOURCES:
U.S. Census Bureau

Context and Actions

Community Context and Challenges

Although nearly 90% of Oxford County residents have a high school diploma, only 19% have a bachelor’s degree or higher, compared with more than 28% in the state and 29% in the nation.
The percentage of children living in poverty increased from nearly 18% in 2010 to almost 21% in 2014, compared with 19% in the state and 22% in the country.
The percentage of adults at risk for heavy drinking rose from 6% in 2006 to 9% in 2011, compared with less than 8% in the state and 7% in the nation.
Nearly 12% of high school students have taken a prescription drug not prescribed to them, and 3% have used heroin at least once.
Oxford County residents diagnosed with depression increased from approximately 19% in 2006 to 23% in 2011, compared with 24% in Maine and 18% nationally.

SOURCES:
U.S. Census Bureau. (2014). 2010–2014 American Community Survey 5-Year Estimates.

U.S. Census Bureau. (2010). 2006–2010 American Community Survey 5-year Estimates.

Taking Action

In 2011, representatives from sectors including health, media, government, education, and nonprofits formed the Oxford County Wellness Collaborative (OCWC).

The collaborative was formed in response to the 2010 County Health Rankings, which ranked Oxford County the lowest of all Maine counties on health outcomes and health factors. Today residents are resolute in their commitment to tackle community health issues.

NOTE:
These baseline reports, created in 2016, reflect our initial observations on select community programs and initiatives to gauge ongoing, as well as newer, efforts to improve community health. Future reports will provide more in-depth insights and analysis into this community's activities.

Asset-Based Community Engagement

Through its collaborative efforts, Oxford County Wellness Collaborative applied for and received funding from the Maine Health Access Foundation to create an asset-based community engagement model that focused on collective impact, included community members from all backgrounds, and fostered more collaboration from diverse sectors and populations.

Tobacco Prevention and Disease Prevention

Two of the state’s 27 community health coalitions, called Healthy Maine Partnerships (HMPs) serve Oxford County: Healthy Oxford Hills and River Valley Healthy Communities Coalition. At their inception, these two HMPs focused on tobacco prevention, but throughout the years, state funding has required that their efforts extend to other health problem areas. This has led to expanded policy, advocacy, community capacity building and programmatic activities to address substance abuse, obesity and chronic disease prevention and management. The HMPs have collaborated with school districts, local businesses, mental health and social service agencies, and local farms and farmers markets in these efforts.

Oxford County Moves

OCWC was awarded funding to develop a marketing plan called Oxford County Moves to highlight the potential for active transportation in Oxford County, and mapping accessible and safe bike routes in the County. They worked with active bikers and walkers to develop educational materials, maps and other resources to promote walking and biking around Oxford County. The current efforts of the OCWC Active Living work group are focused on contributing to the Department of Transportation's work plans so that when roads are rebuilt, shoulders are part of that plan to ensure safer routes for walking and biking.

Community Health

Stephens Memorial is a member of MaineHealth and has supported the Oxford County Wellness Collaborative since its inception through its community health division. The close, collaborative relationship between OCWC and these health care partners, which provide technical assistance, data analysis, in-kind and direct financial support, augments the overall capacity and stability of the OCWC, as well as improving alignment of community and health care system population health efforts.

Going Forward

Oxford County’s residents, policymakers, and businesses have identified physical isolation and disconnection as key challenges to residents’ health and well-being. Yet despite these geographical challenges, multiple stakeholders across myriad sectors have been actively collaborating over the last 15 years to prevent substance abuse; address issues of mental health; foster safe and active lifestyles; and support job development. Additional surveillance; data and information gathering; analysis; and reporting will examine the progress and impact of these initiatives on the health and [incomplete text?]

As the state funding discussions continue and new strategies are developed to build a Culture of Health, the following key questions remain:

What are the interrelationships among economic, educational, and other social drivers of health in Oxford County, and how are leaders addressing them in a coordinated way?
How will Oxford County respond to pending funding cuts that affect their public health efforts?
How will the expansion of Oxford Casino affect the economic, social, and health status of Oxford County residents?
How have local coalitions and partnerships overcome physical and social isolation to engage residents in efforts to improve their health and well-being?
To what extent are substance abuse, mental health, and economic hardships interconnected in Oxford County? How are stakeholders addressing poverty, depression, and heroin use in the county?
How is Oxford County continuing to ensure that all residents, especially low-income residents, are involved in the county’s decision-making process to build a Culture of Health?