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And the survey says …

United Health Foundation ranks Wyoming as the 26th least healthy state

By TRACIE MITCHELL

Staff Writer

WORLAND – In the United Health Foundation’s 2017 annual report Wyoming was found to be the 26th least healthy state in the nation, down from 25 in the 2016 annual report. Massachusetts was ranked first as the healthiest state and Mississippi was ranked 50 as the least healthiest state.

Banner Health Washakie Medical Center CEO Jay Stallings feels that the report is a good tool to use to evaluate what needs to be worked on. “I want to use it as a basis for our community health needs assessment because it gives us a broad look; it doesn’t really drive into what we are dealing with specifically in Worland but gives us broader data for the state of Wyoming compared with others. I think that the difficulty is that we only have about 500,000 people in the state and we are spread so far apart that that kind of skews the data a little bit. Because wherever there is a larger population there is going to be more provider base and then there are just so many folks that live rural. It’s going to take some time to analyze it as it relates to what it means for Worland, Wyoming and the Big Horn Basin,” Stallings said.

“I’ve been pretty impressed by how much Wyoming, with its limited resources, is investing in health care. I think that this [annual report] is very important for helping establishing policy. Now having said that, I know people are going wait a minute, policy means that you are going to try to make me do something but I don’t think that’s it. I think it’s continuing to educate our community that we want you to live long, we want you to be healthy and these are things that you can do to help ensure that you have a healthier, happier life. Because fundamentally that’s all we really want, we want to be happy and we want to be healthy and once you lose either one of those it gets tough. So I think when I say help establish policy, it’s being able to take this rough data, because it really is, it’s not, it doesn’t come right down and say in Worland so many people are drinking, so many people are…. But it is saying that in Wyoming, here are some broad-based issues that you are dealing with and then there is obviously data behind all of these dashboard score cards that we can drill in on,” Stallings added.

United Health Foundation Medical Director Denise Leonardi stated, “A lot of states will use it [annual report] to kind of look at programs that they have in place and look at their effectiveness or look at areas that they might need to improve.”

UNITED HEALTH FOUNDATION

According to the annual report, “The United Health Foundation is excited to release the 2017 America’s Health Rankings Annual Report, which is the longest-running annual assessment of the nation’s health on a state-by-state basis. For 28 years, the report has analyzed a comprehensive set of behaviors, community and environmental conditions, policies, as well as clinical care and outcomes data to provide a holistic view of the nation’s health. This year, the report evaluates 35 core measures across these categories. The longevity of the report and wealth of credible data available for analysis provide a unique opportunity to track short- and long-term successes as well as identify current and emerging challenges to our nation’s health.”

NEGATIVES

Wyoming is considered the worst state in the nation for suicide with 27.5 suicides per 100,000 people and occupational fatalities with 12.6 per 100,000 people. Leonardi had no explanation for the suicide rate but stated her opinion on the occupational fatalities as, “Work place safety seems to be an issue, things like more public announcements, public education regarding ways to decrease injuries and work place fatalities.”

Stallings on the other hand stated that he felt that the type of work done by most of the people in Wyoming, which comes with its dangers, is responsible. He stated that the small population with a large portion of that population engaged in dangerous work is the reason that Wyoming is considered the most dangerous state to work in. “In Wyoming, when you think about the rigs, to work the rigs for gas, oil, coal exploration, farming, the agriculture sector; those are high risk. It’s different than an area where if you have a million people sitting in an office or working from an office. It’s completely different than being out working with your hands and taking on the challenges of hard work. I have a lot of respect for people who get in there and get it down but with that there is and always has been risk,” Stallings said.

Wyoming also scored very low, 47-50 on immunizations for adolescents and children and vaccinations of specific types, such as the HPV (Human Papilloma Virus) and Meningococcal (meningitis) for both males and females. Stallings stated that he thinks that the reason for such poor scores is the mistrust or distrust of any federal agency. He stated that he sees the distrust even with flu vaccinations. “We require flu vaccinations here [Washakie Medical Center], we require 100 percent of all those who work here, to ensure that we protect our community. We encourage patients, but we certainly don’t cause them to have it, but we encourage patients when they are here to get the flu vaccination,” he said. He added that when it comes to the HPV vaccination, he thinks that mistrust is topped with social stigma.

Leonardi stated that she felt that preschool and childcare facilities need to ensure proof of immunization for all the basic childhood immunizations and that more focus is needed for adolescent vaccinations such as HPV and Meningococcal. She stated that she had noticed that Wyoming was considered the third worse state [48] in the nation when it came to having primary care physicians, which may contribute to the low immunization scores.

“Nationally there are fewer primary care physicians and it’s very difficult to find primary care physicians who can love and appreciate a Wyoming lifestyle, which we do find but it’s rare. Usually a new doc comes out of school and they either want to link up with a large health organization, because it’s hard to start a new business to earn enough money originally, so they may join a partnership or something like that. In Wyoming we only have 500,000 people here and so when you look at how many people per primary care physician and then you factor in the distance between communities where there is enough people to keep a thriving practice, therein lies the challenge I think,” Stallings said. “But once a primary care physician puts up a sign and starts seeing patients there is less of a tendency to move, they become part of the community; they have a family, kids start going to school in that community and generally they stay. But then opportunities come about … Primary care, that’s a tough one, the baby boomers are retiring in nursing and physicians. The new docs and nurses coming out of school, they are looking for more security, for balanced lifestyle, so that all plays into it,” he added.

Seat belt use in Wyoming was scored at 47 in the country. Stallings stated that he thinks that the independent spirit of the people in Wyoming attributes to that low ranking. He stated that Wyoming has a small population and the probability of hitting another car is less than being in a more populated state or a city like Manhattan. “So I think individuals, everybody has a tendency not to buckle up because; I’m just running down to the grocery store and I am only going to pass two or three cars. But then that becomes a habit and then you get into the car and drive to Greybull or Cody or Thermopolis and you hit a deer; you slam on your brakes and you end up in the ditch and if you don’t have your seat belt on statistically you’re going to have greater injury or potential for death. It ends up being a personal choice,” Stallings said.

POSITIVES

Wyoming has the least amount of air pollution in the country with 3.8 micrograms of fine particles per cubic meter.

Cancers deaths have decreased 5 percent in the last five years. Obesity has decreased 6 percent in the last two years and the diabetes rate in Wyoming is 8.3 percent per 100,000 people.

Stallings stated that he feels that the reason behind the decrease in cancer deaths, obesity and diabetes in Wyoming is due to fewer people using tobacco.

He said, “I think one of the big reasons is a drop in use of tobacco. As a society we have been marketed heavily, back when I was a kid I remember almost every other advertisement on television was about tobacco. Then it was menthol, then it was the filter, that it was healthy, that it made you feel better. I mean it was stunning what they were able to get away with. Fortunately in the last 30-40 years with the anti-tobacco campaigns, which was truly here’s the truth, we have been able to bring that down and tobacco is a huge component in one’s health.”

Wyoming ranked fourth in the country for income inequity. Income inequity is the gap between the rich and the poor. According to the annual report, “There has been a steady widening in the gap of income distribution in the United States. As of 2015, the top 10 percent of earners were receiving half of all U.S. income. Countries with greater income disparity have higher rates of obesity, imprisonment, violence and chronic stress, as well as lower levels of social cohesion and trust. Most developed European nations and Canada have Gini indices between 0.22 and 0.38, while the United States Gini index has stayed between approximately 0.45 and 0.48 since the mid-1990s.”

Wyoming’s Gini index is 0.436. “Anything less than 0.440 on this Gini scale means that your income inequity is minimal,” Leonardi said.

All in all Wyoming is one state lower than being right in the middle for health and while some areas may need work there is room for improvement in every state in the nation.

“You have low air pollution, a generally healthy population based on what the rankings show. You have some great things going for you and part of it is your environment. Wyoming seems like a pretty healthy place to live,” Leonardi said.

According to the annual report, a variety of sources were used to complete this study including, the Centers for Disease Control, the U.S. Department of Education, the U.S. Environmental Protection Agency, the U.S. Census Bureau, the U.S. Bureau of Labor and the Federal Bureau of Investigation.

Visit http://www.americashealthrankings.org to view the complete study.