Getting healthier takes time and effort

Active: Jim Owen exercises on a rowing machine in a gym located on the fifth floor of Union Hospital’s Professional Office Building on Friday. Owen’s personal story is illustrative: It takes time and effort to be well.

Tribune-Star/Austen Leake

Jim Owen, 62, eats healthy and follows a vegan, plant-based diet.

He exercises at a fitness center three times per week and walks daily in Fairbanks Park.

Owen also works closely with the Wabash Valley Crew rowing club.

After having a heart attack at age 45, he began eating a healthier diet in an effort to avoid medications  — but he didn’t entirely give up beef and chicken. A few years ago, after seeing the documentary PlantPure Nation, he went to the Maple Center for Integrative Health and took the next step — a vegan diet containing no animal products.

He said his energy levels and all-around health have improved even more.

Becoming healthy is not about a short-term diet plan, but a long-term lifestyle change, he said.

A vegan diet may not be for everyone, but a national study of health outcomes — by county — suggests more Vigo County residents need to make lifestyle changes to improve their health and live longer lives.

Again, Vigo County ranks poorly

In 2014, Vigo County ranked 66 out of 92 counties in the state for health outcomes, according to the annual County Health Rankings released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

But for this past year, the ranking had fallen to 83rd.

What’s gone wrong, and what’s necessary to move in the opposite direction?

Socio-economic factors and high poverty rates play in, as well as high rates of smoking, obesity and lack of exercise, experts say.

Vigo County also ranks 70th when considering data for premature deaths of people younger than age 75. The county data from 2015 to 2017 showed 436 deaths from cancer, 391 deaths due to heart disease, 111 accidents [which could include drug overdoses] and 75 suicides. [The data looks at years of potential life lost per 100,000 people].

While a number of initiatives have been introduced in Vigo County in recent years, a lot of times, health changes take a few years, or even a generation or more, to see results, said Joe Hinton, a Chicago-based researcher with the University of Wisconsin Population Health Institute.

New programs may need more time to work, he said.

He believes it’s also important to look at social/economic factors that impact health. Those who have a good education, higher incomes, access to better housing, food and health care, will often be healthier, he said.

Those who live in poverty, with more limited access to quality housing, food and health care, often will not be as healthy, he said.

In Vigo, one in four kids live in poverty, higher than the state average; 40 percent of children live in single-parent households; and the unemployment rate has been somewhat higher than the state average.

Some positives include the ratio of population to primary care physicians [1,140 to 1] and access to exercise opportunities.

A detailed 2018 Community Health Needs Assessment by Union Hospital, Inc. identified the following six health priorities for the hospital’s service area, which includes Vigo: tobacco use, obesity, food environment [resulting from lack of transportation and other issues], infant mortality, mental health/substance abuse and cancer.

Public health funding 

The Vigo County Health Department says there is a need for greater investment in public health at the local, state and federal levels. In total Centers for Disease Control [CDC] funding for Indiana, per capita, in fiscal year 2016, Indiana ranked near the bottom at $17.11 per capita, according to Trust for America’s Health. The highest per capita was Alaska, at $49.67.

Per person state public health funding is $13 in Indiana, again, near the bottom of all states, also according to Trust for America’s Health 2017 data. New York was $87; Iowa $70; Idaho, $90; and Alaska, $114.

 The Vigo County Health Department took a significant hit about 10 years ago when property tax caps took effect. “We lost so much staff and so much money, we’ve never recovered,” said Joni Wise, administrator.

With more funding, the department could do more programming, she said. 

When it had more funds and more staffing, the department used to do STD [sexually transmitted disease] testing. Along with that, when clients would come in, the department could take other risk reduction measures and address other issues, such as drug use; the health department could refer those clients to other programs, she said.

The department is involved in collaborative efforts with other agencies, including the United Way of the Wabash Valley mobile market initiative, which takes fresh fruits and vegetables to areas that may not have easy access with the goal of reducing obesity and improving health.

Greater investment in public health, both locally and statewide, would help attract business and industry, Wise believes.

Twenty years ago, state officials talked about some of the state’s major health problems, including infant mortality, high smoking rates and high obesity rates. Today, those remain among the top health issues.

“I think one of the questions that needs to be asked is — why are we not investing in our people? Why are we not investing in their health,” Wise asked.

Union Health initiative

Union Health is taking steps that should help address community health issues through its “population health” initiative, said Adam Naumann, system director of population health who began his job about three months ago.

Overall goals are to decrease health care costs, both for the hospital system and patients; improve quality of care; and improve patient outcomes.

This year, the emphasis will be on improving care coordination; providing comprehensive wellness care for patients, to include smoking cessation, nutrition and weight management; increasing access to primary care and chronic disease management; and outreach to other community partners, which will expand in 2020.

The initiative involves Union system-wide, both inpatient and outpatient, across all departments.

Officials hope that one of the results is a reduction in hospital re-admissions.

This summer, efforts are underway to possibly have a pilot project offering an exercise program for elementary-age children at a school that demonstrates challenges in health outcomes, Naumann said. He’s been in discussion with a community partner.

The goal in 2020 is to expand those community partnerships. “If we can start to develop healthy habits in children early on, then there is a lot of preventative care that happens,” he said.

Union Hospital’s most recent health needs assessment can be found at: https://www.myunionhealth.org/assets/documents/community-benefit/012019-file.pdf

It includes much data as well as a listing of many programs aimed at improving community health in nine Wabash Valley counties.

Sue Loughlin can be reached at 812-231-4235 or at sue.loughlin@tribstar.com Follow Sue on Twitter @TribStarSue.

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