News From Terre Haute, Indiana

Mark Bennett Opinion

January 6, 2013

MARK BENNETT: Heart ailments, avoidable health issues affect high numbers of Vigo residents

TERRE HAUTE — Many folks in Vigo County will analyze digits on their bathroom scales this month. After all, January and fitness resolutions are traditional partners.

Weight numbers, though, don’t tell the whole story of this community’s overall health.

Take a look at the new website, IndianaIN

dicators.org. The resource was compiled and assembled by the Indiana Business Research Center at Indiana University’s Kelley School of Business, the Indiana State Department of Health, and the Indiana Hospital Association. The site contains statistics on every Hoosier community and county, showing the impact of health care, economic factors, education levels, environmental issues, public safety, transportation and government on the cumulative health of people living in those places.

“People are getting a clear, painted picture,” said Kristin Adams, a former Terre Haute resident and director of the Office of Health Performance Management at the Indiana State Department of Health in Indianapolis.

Vigo County’s picture isn’t exactly a Monet.

The county has, by far, the highest rate of heart-disease hospitalizations among the state’s 92 counties. In 2011, the most recent figures available through the Hospital Association’s hospital discharge database, 132 out of every 10,000 residents were hospitalized for heart issues. (The exact percentage is 132.8 per 10,000.) That’s not good. The state rate is 89.4 of every 10,000 Hoosiers. The next-highest rate was 125.4 in Clay County, Vigo’s next-door neighbor.

“That’s a challenge for your community,” said Adams, an Indiana State University graduate who lived and worked here for 10 years.

Heart disease is a big problem statewide. It’s the No. 1 cause of death in Indiana. Here, it’s even more serious.

That’s not all. Vigo also has Indiana’s highest rate of preventable hospitalizations, involving 340.4 residents for every 10,000 in 2011. The state rate is 229, and only five Hoosier counties topped the 300 plateau — Vigo, Scott and Blackford in more rural areas, and Wayne and Lake in more urban areas. The category is a “measure of access to appropriate primary health care,” according to the statewide website. It reflects hospital admissions for conditions that are preventable through appropriate primary care. Such care would “control an acute episodic illness or condition, or manage a chronic disease or condition.”

As Adams explained of Vigo County’s high heart-hospitalization rate, the issue to consider is “not just admissions to the hospital. What are the root causes of this?”

The list includes the prevalence of high blood pressure, diabetes and obesity, as well as the rates of residents who have health insurance, Adams said. In Vigo County, 20.9 percent of adults ages 18 to 64 have no health insurance, Indiana’s 27th highest rate among 92 counties. Statewide, 20.3 percent of adults lack health coverage.

Our dietary culture matters, too. The county contains 7.9 fast-food restaurants per 10,000 residents, the eighth-highest rate in Indiana.

A loaded burger hits the spot now and then, but three meals a day from the drive-thru might eventually reroute that motorist to an emergency room.

The remedies for a community and individuals are well-documented: eat a low-fat diet with plenty of fruits and vegetables, maintain safe cholesterol levels, monitor blood pressure, and keep body weight within steady, normal ranges. Be smart about fast-food, Adams suggested. For those who have health insurance, get annual checkups. Those without such coverage should seek out health-care fairs in the community, Adams said, which often offer free screenings for high blood pressure, diabetes and cholesterol.

Health reminders, oft repeated, can cause eyes to glaze over and translate the words into blah, blah, blah, yadda, yadda, yadda. They’re real, though. They’re also doable. Fitness, for example, may simply amount to “being able to get up and be active,” Adams said, “even if it’s doing something like going to the park — Terre Haute has a great parks system — and pursuing things that are free.”

Adams then added, “and don’t smoke.”

Almost 1 in 4 Vigo County adults are smokers, or 23.8 percent, just below the state rate (24.4), but well above the national rate (21.2). The period during which those numbers were compiled, from 2004 to 2010, precedes the implementation of a comprehensive clean indoor-air ordinance in Vigo County, which took effect last July and prohibits smoking in most public workplaces. The county’s heart-hospitalization rate may eventually drop because of the ordinance, said Sydney Elliott, health educator for the Vigo County Health Department.

“In the next couple of years, we could possibly see us not so far up on the [hospitalizations] list,” Elliott said.

Those currently enjoying decent personal health and fitness may, understandably, see heart-related and preventable hospitalizations as somebody else’s worry. The impact transcends individual households, though. Of the 13 metropolitan areas in Indiana, Terre Haute had the highest unemployment rate in December at 9.8 percent. So, clearly, the hunt to bring new businesses and industries to the community is crucial. Those prospective companies study the local workforce before locating a plant, store or warehouse, and their criteria isn’t limited to skills and education levels. The local rates of joblessness, and heart-disease and preventable hospitalizations are probably not pure coincidence.

“A business that has to buy health insurance does not want to pay for all these heart-disease hospitalizations,” Adams pointed out.

“If you are a healthy community,” she said, “you are apt to get more business.”

Sustained progress to amend most entrenched, long-term problems requires baby steps at the outset. “And the question is,” Adams said, “which baby step is the community willing to make first?”

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

 

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