News From Terre Haute, Indiana

Mark Bennett Opinion

December 14, 2013

Raising the bar

Hoosiers need to change perceptions about health

TERRE HAUTE — Around coffeeshops, kitchen tables and office watercoolers, Hoosiers have cussed and discussed the federal health care law.

In those chats, we typically enumerate our various ailments and share horror stories of getting those ills treated.

Some folks might watch cable TV commentators take turns ranting for hours about the latest twists in the Affordable Care Act’s implementation.

By contrast, Indiana residents aren’t spending much time preventing the need for health care. Too many of us smoke. Too few of us exercise. We weigh too much. We breathe too much polluted air. Too few of us are bothered by those tendencies. In a state that prides itself in independent thinking — common-sense Hoosier values — we struggle with maintaining our own physical well-being. Snubbing good-health practices may seem like an act of independence, but too often that defiance puts an I’ll-do-it-my-way type in a medical clinic waiting room with, ironically, dozens of other people. We’ve all been there.

The previous paragraph is hard to accept, but it’s Indiana — just like mushroom hunting, basketball and the Indy 500. The numbers, from multiple sources, consistently affirm and reaffirm our profile.

“We smoke a lot. We sit a lot,” said Kristin Adams, director of the Indiana Office of Public Health and Performance Management in Indianapolis.

The United Health Foundation’s 24th annual report, released last week, verifies her assessment. The foundation ranked Indiana among the worst states in overall health. Again. Indiana was No. 41 in 2012 and stayed 41st this year. The rest of the bottom 10 states are in the South — Tennessee was 42nd, followed by South Carolina, Oklahoma, Kentucky, West Virginia, Alabama, Louisiana, Arkansas and, the most unhealthy, Mississippi.

Indiana stands out in some categories, and not in positive ways. Only six states have higher smoking rates, with 1.1 million Hoosiers lighting up regularly. More than 1.5 million adults — almost a third of the grownup population — are obese, a huge jump from 15 percent in 1990. The state ranks 49th, almost the worst, in its levels of air pollution. We have the 41st worst case of physical inactivity. Diabetes is prevalent in Indiana, 11th from the bottom. Not surprisingly, the infant mortality rate tops all but five other states. Just eight states have higher rates of cancer deaths.

A larger percentage of Hoosiers report “poor mental health days” than residents in 42 other states.

While we vent about the cost of changes in health care, let’s remember this lifestyle pushes the pricetag up even more. It hurts the economy, too.

“A well population goes to work, and they miss fewer days of work,” Adams said, “and they’re more productive.”

The Indiana Department of Health — under Health Commissioner Dr. William VanNess, who took office a year ago — has targeted three primary behavior changes to break the unhealthy cycle, Adams explained. The goal is to decrease the rates of adult obesity, smoking and infant mortality. That doesn’t happen magically. The governor, legislators and the state health department can lead, guide and fund initiatives, but they can only do so much. Businesses, schools, churches and, especially, families must consider Indiana’s generally poor health behaviors a big problem, too. There has to be a willingness to address the touchiest issues, such as chronic air pollution and its impact on the numbers of asthma and chronic breathing problem cases.

“Everybody has a piece of this,” Adams said.

Hoosiers have to change their perception of “health care.”

“Taking on a prevention model, rather than a ‘sick’ model [of health care], is really one of our pushes across the state,” Adams said. Prevention of diseases, such as diabetes and heart ailments, would have a tremendous effect on Hoosier well-being and standards of living.

“It is much cheaper to do the prevention side than the ‘sick’ health care,” she said.

Coordinated efforts work. Despite Indiana’s myriad health issues, some progress has occurred. In the past year, the prevalence of physical inactivity has dropped to 25.9 percent of adults from 29.2 percent.

Being near the bottom in so many categories has one upside. There’s only one way to go.

“Sometimes those [health rankings] are a good thing because you have to stop the downslide before going up,” Adams said.

That makes sense — Hoosier common sense.

Mark Bennett can be reached at 812-231-4377 or mark.bennett@tribstar.com.

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