Wednesday, January 19, 2000

Tristate health little improved


Survey finds a few areas of progress

BY TIM BONFIELD
The Cincinnati Enquirer

        Despite an improving economy and despite increased media messages about how to live a healthy life, a survey released Tuesday indicates the overall health picture in Greater Cincinnati has largely failed to improve since 1996.

        While health trends in Cincinnati look OK when compared to national averages, the goal since 1996 has been to bring more local health organizations together to find ways to improve community health.

HIGHLIGHTS
  Highlights of the Greater Cincinnati Community Health Status Survey:
  • 18 percent of adults said they did not have health coverage for some part of the previous year.
  • 16 percent of adults said they had no regular doctor, not even through a public clinic.
  • 5 percent of adults said they had health problems but did not seek care because they needed the money for food or rent.
  • 36 percent of Tristate adults are overweight and 22 percent are clinically obese.
  • 35 percent of local adults smoke, compared to the national average of 23 percent.
  • 52 percent of men over 39 do not get annual prostate exams and 14 percent of men over 39 have never had one.
  • 39 percent of women have never had a baseline or screening mammogram.
        The Community Health Status Survey, conducted in 1996 and 1999, was designed to take a wide-angle snapshot of Tristate health issues. Survey questions touch on obesity, smoking rates, cancer screening tests, mental health and substance abuse, seat-belt use, access to health care, lack of health insurance, even whether people feel safe in their communities.

        So far, progress appears slow.

        “I think (the survey) tells us we have a lot of work to do,” said Nancy Strassel, a spokeswoman for the Health Improvement Collaborative of Greater Cincinnati.

        “When we looked at Cincinnati we found we fell in line with U.S. averages,” Ms. Strassel said. “But the question for our community is: Is that good enough?”

        A few things have improved, such as more people getting flu shots, more women getting pap smears and fewer people saying they feel depressed.

        Some things are getting worse, such as higher obesity rates, more women saying they've never had a mammogram, fewer people getting proper dental care and more people worried about the overall quality of health care.

        But many large health concerns simply haven't changed much: Large segments of the population still don't have health insurance or a regular doctor, smoking rates still exceed national averages, teen pregnancy rates remain high and men won't get prostate exams.

        The survey was co-sponsored by the collaborative and the Health Foundation of Greater Cincinnati with consultation from the recently formed African-American Health Network. The data reflect responses from more than 2,000 residents in a 20-county area spanning parts of Ohio, Kentucky and Indiana.

        Dave Scharfenberger, administrator of the Working in Neighborhoods Senior Action Coalition, said many parts of the survey confirmed what his group has been seeing for years — that the lowest-income groups have the biggest health problems.

        The survey found that about one-fifth of survey respondents said they have fair or poor health. Those with the poorest health status tended to be poor and less educated. Like poverty itself, poor health was most common among African-American and Appalachian groups.

        None of these findings are surprising or new, Mr. Scharfenberger said. What the survey illustrates is how hard these issues can be to address.

        “I don't think access to health care has gotten easier. It all seems more complicated and more difficult,” he said. “In terms of healthy lifestyles, obviously, the message is not taking hold.”

        The survey indicated several problems with access to health-care services, many of which appeared to be linked to poverty:

        • About 18 percent of adults said they did not have health coverage for some part of the previous year.

        • About 16 percent of adults said they had no regular doctor, not even through a public clinic.

        • About 5 percent of adults said they had health problems but did not seek care because they needed the money for food or rent.

        • About 7 percent of adults said they needed prescription drugs but did not buy them because they didn't have the money.

        • About 56 percent of Tristate adults visited a dentist in the past year, notably lower than the national average of 67 percent.

        The survey also looked at mental health and substance-abuse issues.

        About 4 percent of survey respondents said they had a household member with a drug or alcohol “problem.” Of those, 57 percent said that household member had been arrested at least once because of substance abuse. Meanwhile, 42 percent of those identifying a problem with a substance abuser said the abuser has never sought treatment.

        The survey found 36 percent of Tristate adults are overweight and 22 percent are clinically obese, figures that worsened since 1996.

        Nearly 35 percent of local adults smoke, compared with the national average of 23 percent.

        About 37 percent do not exercise at least three times a week, another figure that has not improved since 1996.

        On the health-screening front, Tristate residents listed cancer as the most serious health concern in the community.

        However, 52 percent of men over 39 do not get annual prostate exams and 14 percent of men over 39 have never had one. Meanwhile, about 39 percent of Tristate adult women have never had a baseline or screening mammogram, up from 31 percent in 1996.

        Some good news: Nearly 60 percent of women got a pap smear in the past year, an improvement from 1996.

       



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