WILTON — Fen Fowler can’t talk about health care without talking about the cycle of poverty. And weatherization. And wood pellet stoves.

“Weatherization is about health, though,” he said. “You wouldn’t think of weatherization as being about health, but it is. It’s important to live in a healthy environment.”

Fowler, who received the annual Community Health Leadership Award recently from the Franklin Community Health Network, said he is honored to be recognized in the field in which he has worked under the philosophy that access to health care can’t be separated from other social factors, particularly among those who live on the edge of financial stability.

When Franklin Community Health Network leadership was considering who should receive the award, Fowler’s name came up immediately because of his long history as a community advocate who looked to meet the needs of the community, according to CEO Rebecca Arsenault.

Fowler, 63, is the executive director of Western Maine Community Action, a group founded to fight poverty by attacking its roots. The Aroostook County native’s work with the organization started 39 years ago as a summer job while he was at the University of Maine at Farmington. He grew into leadership not only with the group, but also in a role on the boards of groups such as Western Maine Alliance, Maine Jobs Council and the Rural Institute on Poverty.

Community action groups were created as part of the Economic Opportunity Act of 1964. It was a part of President Lyndon Johnson’s War on Poverty, which included creation of an assortment of government programs to take care of social issues and create what Johnson termed the Great Society.

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The Office of Economic Opportunity at first was an independent agency, but it was absorbed into the Department of Health and Human Services during the Reagan administration. Decades later, Fowler is still using its approach to fight poverty in rural areas of Maine.

Most recently, Fowler led the effort to sign residents up for the Affordable Care Act, which caught the Franklin Community Health Network’s attention, Arsenault said.

“Under his leadership, Western Maine Community Action helped people manage through that process when it was a very challenging thing to do,” she said. “Even if just a handful of people had been signed up, that would have been important.”

Many of Johnson’s Great Society programs have gone by the wayside in the past 50 years, but Fowler said he believes the principles behind them are as true today as when Johnson was president.

“Our job is to help people be as self-sufficient as possible,” Fowler said. “And it’s a lot easier to be self-sufficient when you are healthy and have access to health care.”

Western Maine Community Action’s efforts recognize that the relationship between poverty and health is “complex and bi-directional,” said Erika Ziller, deputy director of the Maine Rural Health Research Center at the University of Southern Maine’s Muskie School of Public Service.

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On the one hand, she said, poverty can lead to bad health because of lack of access to care; but it also affects health because of lack of educational opportunities, which lead to things such as poor nutrition and higher rates of smoking.

One of the latest findings in her research, she said, is how the prolonged stress of poverty and a lack of access to health care can increase a person’s stress to the point that it harms their health.

“When you’re scrambling to get more resources for your family, that stress has an impact on you at a biological level,” Ziller said.

At the same time, bad health can lead to poverty through consequences such as lost days at work, loss of employment and high medical bills.

She said Fowler’s belief that health care is tightly interwoven with economic standing reflects the reality of how the two aspects of life interact.

“I would say that this is an accurate assessment, and that efforts to tackle either poverty or poor health need to recognize this interconnectedness,” she said.

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Fowler and Western Maine Community Action are a funnel for 57 funding sources to try to reach that goal.

Programs have come and gone. Rural Health Associates, an incentive program for doctors treating the rural poor, existed for around a decade before dissolving in the mid-1980s. The business model was designed to promote health outcomes instead of paying for treatment received. The program came up with creative solutions such as temporary health clinics to reach into the corners of the rural county.

Fowler said the program’s proactive approach attempted to tackle problems of poor people only able to get reactive treatment for a prolonged health problem.

“It helped promote being healthy, instead of just treating sick people,” he said. “After it went away, it really had made us aware of the state of the community’s health.”

The state’s first family planning resource center was formed under the community action group, but last year it was moved to the umbrella of Maine Family Planning, with the hopes of saving by consolidating family planning services.

Arsenault noted, when presenting Fowler the award, that Fowler had helped establish the Rural Institute on Poverty in a partnership with the University of Maine at Farmington to study poverty and use that information to identify best practices.

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Still, Western Maine Community Action hosts several programs that specifically promote health. It hosts a branch of Women Infants and Children nutrition program for low-income mothers with children under the age of 4.

For the past year, the community action group has also been working on a program of volunteer insurance navigators who help residents understand the Affordable Care Act and make sure they are getting the best deal they should be.

Fowler is not ready to quit yet.

In the future, he’d like to work more to help seniors age in their homes. He’d like to increase funding for the programs they have now. And overall he’d like to increase communication among the community action group’s different programs and get closer to the group’s original mission of fighting the different facets of poverty in a unified effort.

“I want to do good work fighting poverty, where we deal with all aspects of the big issue,” he said.

Kaitlin Schroeder — 861-9252

kschroeder@centralmaine.com


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