Healthcare

Overview

Healthcare is an ongoing concern in the North Country due to the small population of residents spread across a wide geographical area with few hospitals or clinics. With movement of young people out of the region and a rising median age, there is concern about maintaining a robust workforce, including healthcare workers. Elder care, loneliness, and mental health were mentioned by ACORN participants as issues they see in their communities. The spread of vector-borne diseases adds to the existing burden on the healthcare system as species like ticks migrate further north.

Check out the full report to read more about the efforts specific organizations in the North Country are undertaking to tackle these issues and the solutions proposed by listening session participants.

Cover photo courtesy of Adirondack Health.

Healthcare Resources

In rural areas like the North Country, access to healthcare resources is often a struggle. There are many communities without hospitals or urgent care clinics, meaning that residents have to travel to receive routine and life-saving care. Residents frequently have to travel even greater distances to find hospitals or care centers with professionals in a particular specialty.

Emergency medical services cover large geographical areas while lacking capacity to recruit and compensate first responders, leading to agencies relying on volunteers to serve their communities.

"Adirondack Medical Center in Saranac Lake is the largest hospital in the Adirondacks." NCPR, Jun 16, 2025 (News photo: Emily Russell)

There is a need to attract specialists for work in rural hospitals, for agencies to work with insurance companies for standby capacity payments and fair and timely reimbursement for EMS to help first responder recruitment, and to increase funding for county public health to effectively address evolving local needs and elder care.

Infectious & Vector-borne Diseases

Dr. William Reiley, President, Director, and CEO of the Trudeau Institute spoke about infectious and vector-borne disease at the Adirondack Climate Conference. He said that the relationship between climate change and human health is increasingly evident in the global rise of infectious diseases. As climate patterns shift and human activity continues to encroach on natural ecosystems through global travel, urbanization, and population growth, disease transmission methods are being altered, resulting in more frequent and widespread outbreaks. The Trudeau Institute is at the forefront of researching these emerging outbreaks and public health threats.

Numerous infectious diseases are aggravated by climate change. Vector-borne diseases, in particular, are a major area of concern. Mosquitos are the number one killer throughout the world because they transmit so many deadly diseases such as malaria, dengue, and yellow fever. The warming climate is affecting where mosquitoes can live and are now transmitting diseases into different regions of the world that they first were not found. The Southern United States, for instance, is now reporting cases of dengue virus, a disease once largely confined to Asia and parts of Africa. This geographic shift is expected to intensify as climate conditions continue to favor vector survival and reproduction. Similarly, ticks have migrated northward into Northern NY as temperatures rise, bringing associated diseases like Lyme disease to previously unaffected areas.

Elder Care

Mercy Care for the Adirondacks is a nonprofit organization established in 2007 to support older adults and address social isolation and loneliness, which are recognized as significant social determinants of health particularly in rural environments. Operating in the “Tri-Lakes Plus” region (Keene Valley to Tupper Lake, Wilmington, Bloomingdale, and Vermontville), Mercy Care also helped start similar programs in Ticonderoga, Elizabethtown, Plattsburgh, Malone, and Massena.

Katherine Rhodes, Director of Elder Care & Volunteer Services for Mercy Care, shared the following data for Essex County:

Elders connecting through Mercy Care for the Adirondacks' mission (Photo by: Mercy Care for the Adirondacks)

The only segment of the population projected to grow are people aged 65 and older.
14% of households lack internet access, 10.5% don’t have a computer, smartphone, or tablet.
25% of families are being led by grandparents taking care of grandchildren.
22.6% of the population is socially vulnerable.
Many are reluctant to ask for or accept help, and many older adults have one or multiple chronic conditions that make it harder to respond to a disaster.

Mercy Care is actively integrating climate preparedness into its programming, recognizing the vulnerability of older adults to hazards such as flooding, icing, basement water intrusion, and wildfire smoke. The organization is distributing Disaster Preparedness Household Emergency Binders for both elders and volunteers, many of whom are older adults themselves. These binders provide safety information and checklists to enhance household-level preparedness and serve as a grab-and-go repository of essential personal information and critical documents such as power of attorney, medical and insurance information, and emergency contacts. Additionally, Mercy Care is assembling a “Guide for Successful Aging” to help people plan to age the way they choose. It will prompt consideration and conversations with loved ones about a wide range of topics including how they intend to stay socially engaged as they age, what they will do if they can no longer safely live alone, and who they consider to be their support system. It will also include community resources and one-pagers from local organizations.

A number of elders who participated in ACORN listening sessions identified a lack of safe housing for older adults in the region. This was a topic of concern both for elders who prefer to age in place in their homes, as well as for elders looking for a cohousing-type model of housing. Many elders also lack access to a car or transportation, growing their isolation from their surrounding community.

Mental Health

In Essex County, the Building Resilience in Essex Families (BRIEF) coalition brings together local organizations to strengthen how the community supports families, particularly related to stress and emotional challenges.

Former BRIEF Coalition Coordinator, Stefanie Valovic Miller, presented on the topic of climate change and community mental health support at the Adirondack Climate Conference. More extreme weather, uncertainty about the future, and changes in daily life can increase anxiety, stress, and even trauma. Building emotional and climate resilience in tandem is important.

Ms. Miller explained people build resilience in two main ways: through inner strengths like life skills, perseverance, even a sense of humor; and through outside supports like strong families, caring communities, and safe, supportive schools and workplaces. These supports, which include libraries, fire departments, and community groups, form a network that helps people feel connected and cared for, especially during tough times.

The BRIEF coalition uses a tool called the Resiliency Wheel to understand and grow these supports. It focuses on different areas of life, including family, school, work, and the wider community. Key parts of the wheel include feeling cared for, having clear expectations, learning important life skills, and having chances to help and connect with others. These things not only help people cope with stress, but they also help people prepare for challenges like natural disasters or climate-related changes.

The BRIEF Coalition Resiliency Wheel tool based on the work of Dr. Nan Henderson at Resiliency in Action.

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