Health Care

Residents of 3 Counties Not a Picture of Health, Study Finds

YOUNGSTOWN, Ohio – Adult residents of Mahoning County still smoke more, drink more, weigh more and exercise less than residents of Ohio as a whole, the annual Robert Wood Johnson Foundation survey of Americans’ health finds.

The report also finds that adult residents of Mahoning County are more likely to have contracted a sexually transmitted disease than all Ohioans.

Among the 88 counties in the Buckeye State, Mahoning County ranks 18th worst. Trumbull County came out 28th worst and Columbiana County 34th worst.

The report released today, “County Health Rankings & Roadmap: Building a Culture of Health, County by County,” assessed the health gaps in all 50 states and the District of Columbia.

The data on Mahoning County are both better and worse than they look, Mahoning County Health Commissioner Patricia M. Sweeney said Tuesday. (The foundation sent her and other county health commissioners a copy in advance.)

Yes, the numbers are bad, she said, but some categories show improvement, others are static and still others are moving in the wrong direction.

Results of the Mahoning County 2014 Community Health Improvement Plan, a joint effort of 30 community partners to “improve health outcomes” by 2016 – that is, encourage residents to lead healthier lives – show that an increasing number of adults are eating at least five helpings of fruits and vegetables every day. The data also show that grade school children are spending more time per week being physically active in school.

Children in Mahoning County spend 105.2 minutes per week engaged in physical activity in their grade schools, she said, 21 minutes a day on average, when it should be closer to an hour per day.

However, adult obesity has risen because of the increased number of physically inactive adults. And fewer women are breastfeeding their infants.

Too many adults still smoke but more are quitting, the 2016 Goal Achievement Status Report says. It cited the number of participants in the Youngstown YMCA diabetes prevention programs who met the 2016 goal of the Health Improvement Plan but not tobacco cessation training throughout the county.

Mahoning County is neither alone nor unique, Sweeney said. The “need for health education remains,” especially in low-income neighborhoods.

“Place matters. Where you live matters,” Sweeney said, pointing to the discrepancies in life expectancy and overall health of residents based on their ZIP code.

As many observers of how health care delivery in the United States have reported, Sweeney too lamented that more is spent on acute health care than prevention. Spending more on prevention would result in less need for acute care, she said.

Based on the data the Robert Wood Johnson Foundation staff collected and analyzed, most of the 8,900 “excess deaths” in Ohio occurred prematurely because the adults led poor lifestyles.

“If residents of all counties in Ohio had the same opportunities for health,” the report says, there would be 366,000 fewer adult smokers, 201,000 fewer obese adults, 205,000 fewer people who lack health insurance, 174,000 more adults ages 25 to 44 with some education beyond high school and 65,000 unemployed.”

With a population of 11.64 million as estimated by the U.S. Bureau of the Census, Ohio ranks seventh among the 50 states.

Turning to Mahoning County, the foundation found that 8,500 residents die prematurely each year, 17% are in poor or fair health, and 10% of the babies born in county hospitals have a low birth weight.

Twenty-one percent of adults smoke, 16% drink to excess, 31% are obese, 28% are physically inactive and only 76% have access to exercise opportunities.

For Trumbull County, 8,300 die premature deaths, 16% are in poor or fair health, and 9% of the women who deliver in Trumbull County hospitals have babies with low birth weights.

Nineteen percent of adults smoke, 15% drink to excess, 33% are obese, 28% are physically inactive and 16% lack access to physical exercise.

For Columbiana County, 8,300 residents die before their projected life expectancy, 17% are in poor or fair health and 8% of the women who give birth in a county hospital have offspring with a low birth weight.

Twenty percent of adults smoke, 18% drink to excess, 30% are obese, 26% are physically inactive and 28% lack access to exercise opportunities.

For Ohio, 21% of adults smoke, 12% drink to excess, 24% are physically inactive and 17% lack access to exercise opportunities.

Two in nine highway deaths, 22%, in Ohio result from “alcohol impairment,” the Robert Wood Johnson Foundation report says. For Mahoning County, the figure is three in 10, 30%; in Trumbull County, it’s nearly four in 10, 39%; and Columbiana County shows 36%.

The “social determinants of health,” as Sweeney calls them, are the factors that lead to good or bad choices in a person’s health. Two are income and education. The wealthier a household, the more education its members have attained, the less likely that its members smoke, drink to excess, are overweight or sedentary and lack the opportunity to exercise. They’re more likely to eat a healthful diet that includes fresh fruit and vegetables.

“We must change the social determinants,” Sweeney said. “We have inequity in our health outcomes.

The infant mortality rate among black women is three times that of white women, she pointed out.

Those who live in low-income neighborhoods all too often live in “food deserts” where the opportunity to buy fresh food, including fresh fruits and vegetables, is absent.

Moreover, the residents are often afraid to walk outside for exercise. And all too often streets are repaved but the sidewalks are left in poor repair, she said.

While the number and miles devoted to bike lanes has grown, bike lanes and trails remain minimal.

Three overpasses in Mahoning County — U.S. Route 224 over Interstate 680 in eastern Boardman and Canfield Township and Western Reserve Road over I-680 where Western Reserve separates Boardman and Beaver townships – were replaced, Sweeney noted, without the original sidewalks or bike lanes.

Sidewalks and bike lanes encourage exercise, she said.

Likewise, new residential developments are built that comply with the requirements for green spaces but without sidewalks and bike lanes.

Published by The Business Journal, Youngstown, Ohio.