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February 18, 2010

Valley gets dismal health review

Study looks at wide aspect of health factors

By Brian M. Boyce

TERRE HAUTE — If a recent ranking of health in American counties was turned upside-down, the Wabash Valley would have reason to cheer.

As it is, local health officials are already at work combating a complex array of problems they know all too well.

The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation released Wednesday a comprehensive ranking of overall health in the counties of America’s 50 states, more than 3,000 total, using standardized formulas to measure how healthy people are and how long they live.

Vigo and its surrounding counties ranked near the bottom of the state, while Hamilton, Hendricks, Boone and others closer to Indianapolis came out on top.

Megan Bland, health educator for the Vigo County Health Department, said Wednesday afternoon that there are a number of factors to consider when looking at the numbers, including population size and socioeconomic conditions. But overall, the rankings give officials good targets at which to shoot in their on-going battle for public health.

In the ranking of “Health Factors,” which includes measures of alcohol use and availability, tobacco consumption, sexually transmitted diseases, teen pregnancies and income, Vigo ranked 78 out of Indiana’s 92 counties. Vermillion ranked 85, Owen was 82, Clay was 81, Sullivan ranked 72, while Parke came in 66, according to the report.

In the ranking of “Health Outcomes,” which includes measures of mortality and morbidity, such as birth weight and premature deaths, Vigo ranked 69, Sullivan ranked 87, while Parke came in at 73, Clay at 68, Vermillion at 63, and Owen at 58.

Joni Foulkes, administrator of the county health department, said there were a wide variety of indicators used in the study, most of them fairly common in their usage as benchmarks.

“It looks like there’s a wide composite of problems, from education to health to behavior,” she said, adding that in many segments, the term “quality of life” could be used interchangeably with “health.”

It’s also important to consider, she said, that Vigo County’s two hospitals deliver the majority of babies for the surrounding counties, such as Clay, whose hospitals no longer offer that service. Data such as teen pregnancies and low birth weight would be skewed in that direction, she explained.

Vigo County’s teen birth rate was pegged at 41 per 1,000 compared to top-ranking Hamilton County’s 16.

Other indexes were straightforward. Vigo County’s chlamydia rate was 284 per 100,000 population, compared to Hamilton County’s 98. In the measure of children in poverty, Vigo County scored 23 percent. About 31 percent of Vigo County’s adults were termed “obese” and 26 percent smoke. Fifty-three percent of Hamilton County’s adult population boasted a college degree compared to only 23 percent in Vigo County.

Foulkes said the intertwined relationship among poverty, health and lifestyle is a tough one to fix.

“How do you come up with a solution until you understand the problem?” she asked rhetorically, adding that one has to question the source of responsibility for these behaviors. Should the government, the individual or the community control issues such as smoking and obesity, and to what extent, she asked.

Meanwhile, Bland said smoking and obesity are obvious targets as she works in the role of public education.

Thursday afternoon, Bland was inside Room 216 at Meadows Elementary School, participating in a national anti-tobacco program titled “Tar Wars.”

About 15 fourth-graders jumped up and down while trying to breathe through a small straw after completing worksheets containing tobacco statistics.

“This is how people get when they become tobacco users,” she said as the kids breathed heavily through the small straws. “Things that used to be very easy to do suddenly become hard to do.”

Ten children could not participate in the exercise as they identified themselves as asthmatic before the drill. In an earlier exercise, Bland asked the fourth-graders to estimate the percentage of adults who smoke. More than a dozen guessed out loud that between 80 and 100 percent of adults smoke. When Bland asked why they guessed that high, several said aloud that every adult they knew and lived with smoked. Many of those same children visibly identified themselves as asthmatic just minutes later.

Bland explained that smoking not only strains the lungs, but can cause wrinkles and browning of the teeth in addition to being very expensive.

On the north side of town, though, the waiting room was full Thursday afternoon at St. Ann Medical Clinic on Locust Street.

Founded in 1997, the clinic serves patients without insurance, Medicaid or Medicare, or those below 125 percent of the federal poverty level. And according to information provided by Sister Lawrence Ann Liston, administrator of the clinic, those people number in the thousands.

“We really and truly have sick, sick people,” she said inside her offices there.

During the fiscal year 2009, the clinic reported 8,638 visits, 764 from new clients.

The clinic has already seen more than 4,000 visits since Sept. 1, Liston said, estimating they’ll hit 10,000 this year.

Patients lacking health insurance tend to ignore the preventive measures that can stop an illness early, she said. Just last week, a woman who had survived cancer at an earlier stage in life came to their door already in the fourth stage of breast cancer. A young man in the latter stages of testicular cancer also came in recently, she said, adding that surgery was required due to the advanced stage of the illness.

“They’re often in a crisis or emergency state when they get to us,” she said.

In addition to treatment, the clinic offers a wide variety of programs ranging from counseling to prescriptions, diabetes education and smoking cessation. The goal, Liston said, is to work with the “whole person” in combating illness.

Still, the numbers seem to be growing in the wrong direction.

“Well, I think unemployment is one thing,” she said when asked for a reason. Liston said she’s seen former Pfizer employees in the clinic’s line. Lacking health insurance and a job, people who once thought themselves secure have nowhere else to turn. “We have a lot of poor in this area, and they’re working poor,” she said of those people with jobs that don’t provide insurance and often pay low wages.

Bland said the health department will continue its efforts to educate the public on the importance of preventive care. “I think with health, there’s always room for improvement.”



Vigo vs. Hamilton

How Vigo County stacks up. A side-by-side comparison with Hamilton County, which ranked No. 1 in both Health Outcomes and Health Factors.

• Chlamydia (per 100,000 population)

Hamilton County – 98

Vigo County – 284

• Children in poverty

Hamilton County – 5 percent

Vigo County – 23 percent

• Adult obesity

Hamilton County – 25 percent

Vigo County – 31 percent

• Adult smokers

Hamilton County – 15 percent

Vigo County – 26 percent

• Uninsured adults

Hamilton County – 10 percent

Vigo County – 14 percent

• Teen birth rate (per 1,000 females age 15-19)

Hamilton County – 16

Vigo County – 41

• College degrees

Hamilton County – 53 percent

Vigo County – 23 percent

• High school graduation

Hamilton County – 87 percent

Vigo County – 71 percent

Source: www.countyhealthrankings.org



Health outcomes

Ranking of health outcomes among Indiana’s 92 counties:

1. Hamilton County

11. Putnam County

58. Owen County

63. Vermillion County

68. Clay County

69. Vigo County

73. Parke County

87. Sullivan County

Health outcomes included the study of mortality and morbidity. Mortality was examined in terms of death data, primarily “premature deaths,” or those before age 75. Morbidity was studied in terms of quality of life, including overall health, birth weight and mental health.

Source: www.countyhealthrankings.org



Health factors

Rankings of health factors among Indiana’s 92 counties:

1. Hamilton County

29. Putnam County

66. Parke County

72. Sullivan County

78. Vigo County

81. Clay County

82. Owen County

85. Vermillion County

Health factors include tobacco use, diet, unsafe sex, alcohol, access and quality of health care, education, employment, income, community safety, family and social support and environmental air quality.

Source: www.countyhealthrankings.org



Brian Boyce can be reached at 812-231-4253 or brian.boyce@tribstar.com.

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