Monday, November 05, 2001

Health ratings for Tristate improve little

High rates of smoking still problem

By Tim Bonfield
The Cincinnati Enquirer

        Continued high rates of smoking and heart disease have prevented Ohio and Kentucky from keeping up with public health improvements reported by most other states.

        Ohio was ranked the nation's 24th healthiest state in 2001, down from 23rd a year ago. according to a study by the UnitedHealth Foundation and the American Public Health Association.

  A recent study ranks states according to 17 public health measures, from smoking rates to motor vehicle deaths. Here's how the Tristate stacked up:
  1. Minnesota
  2. New Hamphsire
  3. Utah
  4. Connecticut
  5. Massachusetts
  23. Indiana
  24. Ohio
  39. Kentucky

  46. Florida
  47. West Virginia
  48. South Carolina
  49. Mississippi
  50. Louisiana
  Source: UnitedHealth Foundation
        Kentucky's ranking remained unchanged at 39th while Indiana climbed to the 23rd spot, up from 26th a year ago.

        Part of the reason Ohio and Kentucky have not improved as fast as other states is that both states have so many residents like Mount Airy resident Bob Parsons.

        After smoking for more than 40 years, Mr. Parsons has chronic obstructive pul monary disease (COPD) and heart disease. He has stents propping open two of his coronary arteries. He uses an inhaler four times a day and he drives to a medical office building at Christ Hospital twice a week for pulmonary rehabilitation.

        Mr. Parsons, 80, wheezes whenever he walks too fast or climbs too many steps. And he winces every time he

        sees a young person light a cigarette.

        “What I can't understand is why so many young people are starting to smoke. I see it all the time and it makes me want to go up to them and tell them my experience,” he said.

        The UnitedHealth Foundation, based in Minnetonka, Minn., is a charity that provides several million dollars a year in grants to community health organizations. It has tracked state public health issues for 12 years.

        Since 1990, the nation's overall health has improved in several ways, the report states, including a 36 percent decrease in motor vehicle deaths, a 30 percent reduction in infant mortality, and a 6.3 percent decrease in smoking rates.

        But states have not benefited equally from these improvements.

        “This report represents a call to action for individuals and decision-makers alike ... to identify health trends, analyze the effectiveness of government programs and identify potential health problems,” said Dr. Reed Tuckson, senior vice president of UnitedHealth Foundation.

Healthiest states
               The UnitedHealth study ranks states according to 17 measures developed by a panel of public health experts. Factors include smoking, motor vehicle deaths, infant mortality, heart disease, cancer rates, obesity, violent crime, unemployment and access to prenatal care.

        The states with the best overall health scores were Minnesota, New Hampshire, Utah, Connecticut and Massachusetts.

        Minnesota stands out for several reasons. Statewide, smoking rates have dropped from 28.7 percent of the adult population in 1990 to 19.8 percent in 2001, giving Minnesota the nation's fifth lowest smoking rate. It also reports high government spending on public health services, low rates of violent crime, and the nation's lowest rate of premature death, according to the report.

        By contrast, Ohio has the nation's fifth highest smoking rate at 26.2 percent. Heart disease deaths and cancer rates run above national averages. Support for public health services has declined from being above national averages in 1990 to below average in 2001.

        These problems have masked a sharp reduction since 1990 in motor vehicle deaths in Ohio according to the report.

        In Kentucky, a leading tobacco-producing state, smoking rates topped the nation at 30.5 percent in 2001 and have fallen less quickly than most other states. High rates of heart disease, cancer and lost activity days due to illness or injury also hurt the state's ranking.

        Indiana ranked among five states with the strongest improvements in public health during the past year.

        It still has the nation's fourth highest smoking rate at 26.9 percent, but Indiana cut its uninsured population from 14.4 percent to 10.8 percent in a single year. Since 1990, the state also has reduced heart disease rates and has cut motor vehicle death rates in half, the report states.

Tobacco fund spending

        The UnitedHealth findings come as no surprise to Dave Myers, executive director of the American Cancer Society's Hamilton County chapter.

        In addition to high smoking rates directly affecting Ohio and Kentucky's public health scores, the consequences of smoking also show up in the states' high cancer and heart disease rates, he said.

        “We continue to have challenges in the tobacco arena,” Mr. Myers said. “We're just not moving very fast on that.”

        Like several states, lawmakers have dedicated a small portion of Ohio's $10.1 billion tobacco set tlement to tobacco control programs, opting instead to spend much of the money on school construction.

        In addition, Ohio's state Senate has passed a bill that would prevent city and county health departments from adopting smoking regulations, a bill that has been hotly opposed by public health advocates and faces a veto threat from Gov. Bob Taft.

        Mr. Parsons said he quit smoking 19 years ago, when his doctor warned him that his habit could take 10 years off his life.

        “A lot of people of my generation smoked in their early years. As a person gets older and more conscious of their health, that's a good incentive to quit,” he said.

        Mr. Parsons said he has lived to age 80 primarily because he has worked hard to maintain what lung capacity he has left.

        “I'm sure it has prolonged my life,” he said.

        Smoking may be the biggest single unhealthy factor, but it isn't the only public health problem facing the Tristate, said Lynn Olman, president of the Greater Cincinnati Health Council.

        Many of the differences in state public health scores, especially for heart disease, obesity, violent crime and lack of health insurance, reflect problems that often come with poverty.

        According to the report, the five least-healthy states in America are Louisiana, Mississippi, South Carolina, West Virginia and Florida. In addition to medical problems like heart disease, most of those states also have high rates of unemployment, high school drop outs, motor vehicle deaths or violent crime.

        “When you don't have any money, you don't do as much in preventive health,” Mrs. Olman said. “A lot of these issues are very, very difficult to change.”

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