Friday, December 27, 2013

Health report says county can do better

St. Luke’s releases Community Health Needs Assessment

Express Staff Writer

Though Blaine County was ranked the healthiest county in Idaho last year, more work is needed to improve programs related to substance abuse, weight management and mental health. That’s one of the primary messages contained in a Community Health Needs Assessment recently completed by St. Luke’s Wood River hospital.
    The 159-page report provides trend, magnitude and preventive information related to 18 top causes of death, 13 health behavior factors, 11 clinical care factors and five social and economic factors. The federal Affordable Care Act requires such an assessment, along with an implementation plan for improving community health, to be filed every three years by nonprofit hospitals such as St. Luke’s.
    The report states that the hospital views addressing substance abuse as a high priority because the Wood River Valley has an above-average level of binge drinking. Twenty-three percent of Blaine County residents surveyed reported excessive or binge drinking at least once during the past month, far above the U.S. average of 15 percent. Excessive drinking was defined as women consuming at least four alcoholic drinks in one day and men consuming at least five.
    Erin Pfaeffle, St. Luke’s manager of community and mental health services, told the Blaine County commissioners during a presentation of the report Tuesday that anecdotal evidence shows a much higher incidence of heavy drinking among county youth than the national average.
    “Excessive drinking is a risk factor for a number of adverse health outcomes,” the report states. “These include alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence and motor vehicle crashes.”
    The report notes that motor-vehicle crashes in the county cause about 19 deaths per 100,000 population annually, well above the U.S. average of about 12 deaths. Pfaeffle said vehicle crashes are correlated with alcohol and drug use, but she pointed out that statistics on local accident numbers don’t differentiate between those involving local residents and those involving visitors, who tend to be out drinking more than residents are.
    According to the report, illicit drug use in Blaine County dropped from 9 percent of those surveyed in 2006 to 4 percent in 2010, bringing it in line with the rest of the state. Illegal drug use is highest among males less than 34 years old, the unemployed and those without a high school degree.
    The hospital considers weight management a high priority because even though Blaine County ranks in the top 10 percentile in the nation for low obesity, with a level of 18 percent, the condition is trending higher in the community and is a contributing factor to a number of other health conditions. Low-income people and those without high school diplomas have significantly higher rates of obesity.
    Mental illness ranks high as a priority because Idaho has one of the highest percentages of mental illness in the nation and one of the lowest per-capita numbers of psychiatrists. The report notes that Idaho, along with other Western and rural states, provided a disproportionate number of soldiers to the wars in Iraq and Afghanistan. It states that up to half of soldiers returning from active duty report psychological problems.
    “Returning veterans and our slow economy are likely to put pressure on levels of mental illness in Idaho in the coming years,” the report states.
    High-priority clinical care needs in Blaine County include affordable care and availability of behavioral health services. Affordable care ranks as a high priority due to its interest by community leaders and because more people in the community, especially children, are living in poverty. The poverty rate in Blaine County remains well below the national average of about 22 percent, but rose substantially between 2003 and 2010 from about 7.5 percent to about 15 percent.
    Pfaeffle noted at the County Commission meeting that the hospital provides care to anyone, regardless of insurance status or ability to pay.
    Blaine County scored well in many areas of health measurement, including:
- Diabetes, with a rate of 0.4 percent, compared to about 8 percent in the U.S. and Idaho. The report attributes the low rate to a high rate of physical activity in Blaine County and a low rate of obesity.
- A cancer rate that is 40 percent below the national average. The trend for cancer deaths is down nationally and has been flat in Blaine County for the past 10 years. Lung cancer is the leading cause of cancer death in Idaho, and more than 80 percent of lung cancers are caused by tobacco smoking. Skin cancer deaths in Blaine County are 0.8 per 100,000 population, well below the U.S. average of about 3 per 100,000.
- An asthma rate of 2 percent, compared to 9 percent nationally.
- Heart disease deaths are about 75 per 100,000, compared to about 195 nationally.
- About 17 percent of adults surveyed had not visited a dentist in the past year, compared to about 30 percent nationally.
    The report states that St. Luke’s will continue to collaborate with the people, leaders and organizations in the community to carry out an implementation plan designed to address the most pressing community health needs identified in the assessment.
    County Commissioner Larry Schoen called the report “a tremendous opportunity to raise visibility” about health-care needs in the community. He suggested the creation of a health-care forum to build more collaboration among community groups. He said the county should at least put up an Internet bulletin board to provide information on available services.
    Schoen said improved community health will reduce the need for government services at many levels, including law enforcement.
    The entire assessment can be viewed on
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