Living on the Vineyard is healthy and idyllic but it also comes with headaches - quite literally, as it turns out.

Migraine headaches were among the top five ailments found among Vineyard residents during a recent health survey. The other four health problems that make the list are depression, allergies, arthritis and hypertension.

Depression is especially high among year-round residents of the Vineyard, and so is alcoholism, but that may come as little surprise to anyone who is familiar with People and Predicaments, a clinical study of the Vineyard done in the 1970s by Dr. Milton Mazer, a well-known Island psychiatrist.

Today the Vineyard's sole psychiatrist is again at the center of a health report, but this time the report includes more than mental health.

On Sunday night Dr. Charles Silberstein, who is also chairman of the Foundation for Island Health, presented the bulk of the results of the Health Report of Martha's Vineyard. Launched eight months ago, the report is a comprehensive health survey that was sponsored by nearly every health care organization on the Vineyard.

There are a lot of them - and many were in evidence at a public forum held Sunday to announce the results of the survey.

Held in the Martha's Vineyard Regional High School Performing Arts Center, the forum was billed as a town meeting, but the turnout of about 160 was anemic, especially given the size of the hall. A decision by the foundation to ask for $15 at the door may have contributed to the low turnout; also just down the road at the same hour the Harlem Gospel Choir was rocking the Tabernacle in front of a sellout crowd.

The forum was moderated by CNN journalist and Oak Bluffs seasonal resident Charlayne Hunter-Gault, who was called in at the last minute to pinch hit for 60 Minutes anchor and seasonal resident Mike Wallace, injured in a fall over the weekend.

Even Ms. Hunter-Gault commented on the thin ranks.

"My one disappointment is that there are not enough of you here, and not enough of you that resemble the rainbow that I know this Island to be," she said at the conclusion of the forum.

But there was plenty of discussion.

Hospital board chairman John Ferguson, one of four panelists at the forum, said he was shocked to see the report state that nearly two-thirds of hospital physicians were considering leaving the Island.

"I was surprised by that," Mr. Ferguson said, turning the statistic into a light moment with fellow panelist and Vineyard physician Dr. Ilene Klein. "Are you leaving?" he said.

But the moment of humor turned quickly serious against the statistic in the survey: 58 per cent of all Vineyard physicians said they would consider leaving the Vineyard in the next five years to practice medicine someplace else.

Dr. Klein echoed what the survey found: that Island doctors have a high quality of life and happy relationships with their patients, but peer support is lacking on the Vineyard.

The survey was directed by Diane Becker, a professor of medicine and director of the Center for Health Promotion at Johns Hopkins University. The work included a population-based mailed survey and a separate survey of Vineyard physicians and other health care workers.

The population survey went out to 5,700 randomly selected adults on the Vineyard, including part-time and year-round residents. The response rate was high: 49 per cent of full-time and 29 per cent of part-time residents answered. Nearly 100 per cent of practitioners responded, a remarkable number, according to Dan Munoz, a fourth-year medical student who ran the clinician portion of the survey and reported on it Sunday night.

Here is a snapshot of the results:

* About a quarter of the people who answered the survey said they have migraine headaches often. The number was the same among full- and part-time residents.

* About a fifth of the people who answered the survey said they have allergies and asthma.

* About 17 per cent of year-round residents and seven per cent of part-time residents reported having some kind of depression.

* About 22 per cent of all residents reported having squamous and basal cell skin cancer, and nearly four per cent of all residents reported having the more serious melanoma skin cancer. In both types of skin cancer, the rates were higher among year-round residents.

* More than 18 per cent of all residents reported having had Lyme disease within the last two years.

* Over 70 per cent of full-time residents and 84 per cent of part-time residents said they saw a doctor for regular health care last year.

* Almost 80 per cent of both groups said they currently need dental care.

* More than 34 per cent of full-time residents and 11 per cent of part-time residents said they regularly use a practitioner who does some kind of alternative therapy.

* Vineyard physicians spend an average of 23 minutes with each patient they see.

Some said they thought there were significant gaps in the study.

"We know very little about families and children and about the Brazilian population, the non-English speakers," said Dr. Silberstein.

Dr. Klein questioned the statistic on the number of people who use alternative and complementary care, calling it low.

"We know it's more like 50 per cent of the people," she said.

Other panelists were Tad Crawford, a member of the Dukes County Health Council, and Pat Rutherford, vice president of the Institute for Health Care Improvement in Boston.

Discussion ranged across all the topics of the day, from the emerging plan to build a new hospital to the labor dispute between mental health workers and managers at Martha's Vineyard Community Services.

There were even moments of what is sometimes known in youthspeak as completely random.

Ann Margetson, an Oak Bluffs resident, recalled last year's controversy over the departure of Dr. Richard Koehler, saying that it had undermined the many Islanders' faith in the hospital.

"I have very little confidence, and I'm sorry we need a new hospital," she said.

The moderator pressed Ms. Margetson to conclude her comments on a positive note, asking her to tell the hospital board chairman what she wants from a new hospital.

"I want it to be more than one floor," Ms. Margetson said. "Vertical communication is much faster than horizontal."

The complete results of the survey are posted on the Foundation for Island Health web site at