A state-by-state ranking of the nations overall well-being revealed some disturbing paradoxes last week as experts said hospitals can improve public health by reaching out to their communities.
Longer life, less healthy
Community outreach needed: experts
Results from Americas Health Rankings, an annual survey compiled by the United Health Foundation, American Public Health Association and Partnership for Preventiona group of businesses, government agencies and not-for-profit organizationsshowed that although the nations overall health has improved since the survey was first issued in 1990, it has remained stagnant for the past six. Vermont surpassed Minnesota to the top spot this year, while Louisiana moved up a spot to 49th, leaving Mississippi in last place. (See chart.)
Increases in obesity, poverty, tobacco use, violent crime and the uninsured have offset the modest gains in reducing the rates of cancer and cardiac mortality, the study said. And while America currently has its highest life-expectancy rate of 77.9 years, there are 43 other countries that surpass the U.S. in that category.
Researchers culled data from a variety of sources, including the Centers for Disease Control and Prevention, Education and Labor departments, National Center for Health Statistics and American Medical Association. The survey looked at factors that can determine the future health of the population, as well as historical outcomes, such as deaths or days missed because of illness. Since last year, Americas overall health has declined 0.3%, the survey showed.
The findings, in terms of rankings, underscore what many people have been talking aboutthat is, that we really are a sicker America, said Carmela Coyle, senior vice president for policy at the American Hospital Association. The health status is on a decline. The next generation may actually be less healthy than the current generation, she added.
Similarly, this generation has cut back on the physical activity that was a mainstay of previous generations, according to LuAnn White, a toxicologist and director of the Center for Applied Environmental Public Health at Tulane University. Since the end of World War II, Americans have focused on ways to save work and have more leisure time, White said, which has taken a toll on their fitness levels.
We found that basic lifestyles have a much greater effect on peoples health than environmental pollutants, White said of her research at the center, which was established in 1998. That includes nutrition as well as fitness. Packaged foods has increased exponentially, so for younger people, thats all theyve ever known, White added. The food we eat is not as good, although its much more plentiful.
Georges Benjamin, executive director of the American Public Health Association, said states that fare better usually tend to address social woes, such as poverty and the uninsured.
And they can also usually afford to invest in childrens health and education. Meanwhile, Benjamin cited three things hospitals and health systems should do to improve public health: Connect with their local health departments and meet regularly; offer smoking-cessation, fitness programs and healthcare coverage for their own employees; and make an effort to attend legislative meetingsboth locally and nationallythat concern public health.
They show up for hearings on reimbursement. Those hearings are packed, Benjamin said of the hospital community. Hearings on blood-pressure programs, seat-belt use, motorcycle helmets, infection-control fundingthere werent a lot of people in the hearing room.
But Coyle said its important not to confuse the work at the legislative level with what is being accomplished at the community level.
Thats true in Wisconsin, where Wheaton Franciscan Healthcare worked with local barbers in 2003 to establish the Barbershop Mens Health Initiative, a program that educates local citizens about the need for prostate-cancer screenings.
In the African-American community, the barbershops are establishments where a lot of people gather. Looking at the community and where males gather, the barbershop came up as a perfect target area, said Rosha Landry, the cancer prevention and detection coordinator at Wheaton Franciscan. The buy-in (came) from a meeting with barbers in the community, some media professionals and Wheaton Franciscan to brainstorm how could Wheaton partner with the barbers in the community.
Wheaton has provided more than $16,000 annually to the initiative, which includes a portion of the salary for the project leader, the cost of an annual screening event in September, and educational materials and events.
And in Anderson, S.C., AnMed Health provided more than $1 million more than 10 years ago to support a community-needs assessment and provide the seed money for Partners for a Healthy Community, an organization that addresses specific health issues in the counties that surround the hospital. AnMed Health has committed $750,000 per year for the past two years for Partners, and also provides administrative support on a contract basis with the group. In the past year, Partners has worked to place 12 nurses within Anderson Countys five school districts and develop health improvement teams in each of the 47 schools, according to Quenton Tompkins, president and chief executive officer since 2001.
Dan Corrigan, senior director of communications at AnMed Health, said local businesses, government and hospitals each have a stake in working to build a healthier community.
A lot of these folks that come in with problems are directly related to poor lifestyles, Corrigan said. So there is certainly some incentive to keep people healthy and making sure they get the care they need.
The full Americas Health Rankings report can be found at the Web site, unitedhealthfoundation.org/ahr2007/index.html.
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