Framework

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Nurse Sally Patterson goes over medical information at the trailer home of David Smith of Carmel, Maine. Patterson makes such visits across a wide swath of the northern section of the state, part of a collaborative effort among businesses and health workers to help patients live healthier lives and stay out of the hospital.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

David Smith looks over his daily medications. He gets help with organizing his medicines when nurse Sally Patterson visits.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

Medication instructions help a patient keep track of things.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

Nurse Sally Patterson pays another visit to a patient.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

"I feel so lucky to live here," says Gertrud Champe, a retired college professor in Surrey, Maine. Champe, who suffers from chronic obstructive pulmonary disease, has been getting intensive community-based care for years.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

Gertrud Champe says she's still able to travel and garden thanks to the community-based healthcare she receives.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

Nurse Sally Patterson visits with a patient.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

Christine McDonald, right, of Carmel, Maine, was initially skeptical of receiving help from nurse Sally Patterson, but after their visits began she was able to bring her blood sugar under control.

PHOTOGRAPH BY: Carolyn Cole / Los Angeles Times

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Sally Patterson grew up learning to shoot a gun and to value community service. Her grandfather had a potato farm. Her great-grandfather drove Bangor’s first firetruck. She trained to work in surgical operating rooms.

Now, as a nurse, she crisscrosses huge stretches of Maine’s North Woods region, leaving her house as early as 5 a.m. to visit some of the area’s sickest residents. She is part of a team of doctors, social workers and other nurses who work together to help patients manage their illnesses, live healthier lives and stay out of the hospital.

Many of the nation’s healthiest communities are wealthy and have large numbers of college-educated residents. But northern Maine is among a handful of telling exceptions, making it an important guidepost as the country searches for ways to improve health.

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