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Monday, October 12, 2015

Poor Health and Well-Being in Scioto -- "Physician, Heal Yourself"

It is well-publicized that Scioto County is one of most unhealthy counties, if not the most unhealthy county in the State of Ohio. According to County Health Rankings and Roadmaps -- a well-accredited source that uses data compiled by the Centers for Disease Control and Prevention, the National Center for Health Statistics, and the Division of Behavioral Surveillance Dartmouth Institute for Health Policy & Clinical Practice -- Scioto County has held this dubious distinction of being extremely "unhealthy" for many years.

The County Health Rankings measure the health of nearly every county in the nation. Published online at, the "Rankings" help counties understand what influences how healthy residents are and how long they will live.

The "Rankings" look at a variety of measures that affect health, such as high school graduation rates, access to healthy foods, rates of smoking, obesity, and teen births.

Based on data available for each county, the "Rankings" are unique in their ability to measure the overall health of each county in all 50 states. They have been used to garner support for local health improvement initiatives among government agencies, healthcare providers, community organizations, business leaders, policy makers, and the public.

Counties receive two ranks: "Health Outcomes" and "Health Factors." Each of these ranks represents a weighted summary of a number of measures.

* Health outcomes -- including evaluations of tobacco use, diet and exercise, alcohol and drug use, sexual activity, access to care, quality of care --represent how healthy a county is.

* Health factors -- including assessments of education, employment, income, family and social support, community safety, air and water quality, housing and transit -- represent what influences the health of the county.

In Health Outcome Ranks, Scioto ranks 88 (last in Ohio) based on an equal weighting of length and quality of life.

In Health Factors Ranks, Scioto ranks 86 (third from last before Meigs and Pike) based on weighted scores for health behaviors, clinical care, social and economic factors, and the physical environment.

(Bridget Catlin, PhD, MHSA. Amanda Jovaag, MS. Julie Willems Van Dijk, PhD, RN. Patrick Remington, MD, MPH. "County Health Rankings and Roadmaps: Ohio." Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. 2014.)

How About Well-Being In General?

Of course, health is likely the most important factor in a person's well-being. Well-being matters because it effectively reflects not only health, but also employment, education and the local environment.

A recent Gallup study (2013) found that the well-being of Americans hasn't improved in many years, and, in fact, it has even shown slight decline. While national figures remained flat overall, the ranks of the states with the highest well-being scores changed considerably.

The Gallup-Healthways Well-Being Index, which interviewed more than 176,000 people from all 50 states last year, measures the physical and emotional health of Americans across the country. 24/7 Wall St. reviewed the more than 50 metrics comprising the six broad categories Gallup used to identify well-being.

Gallup-Healthways calculated a national well-being score as well as one for each state, assigning scores from 0 to 100, with 100 representing ideal well-being.

In generating the rank, Gallup combined six separate indices, measuring access to basic needs, healthy behavior, work environment, physical health, life evaluation and optimism, and emotional health.

In addition to the index, 24/7 Wall St. considered data from the U.S. Census Bureau's 2012 American Community Survey, including median income, poverty levels, and the percentage of adults with a high school diploma or higher.

From the Bureau of Labor Statistics, 24/7 reviewed state unemployment rates as of December 2013. They also reviewed 2010 statistics for life expectancy at birth and deaths from heart disease, as well as 2011 data on prescription drugs, published by The Henry J. Kaiser Family Foundation. We also considered state violent crime rates in 2012 from the FBI's Uniform Crime Report Program.

Dan Witters, research director of the Gallup-Healthways Well-Being Index, said a strong economy and a healthy, educated workforce can improve well-being, just as high well-being may also influence further development. Because these relationships appear to exist, "there's a lot of things that employers or communities can do structurally, culturally, legislatively, that can positively affect change around well-being," Witters added.

The Gallup-Healthways survey found in states with high well-being scores ...

* Residents were less likely to smoke and more likely to exercise regularly and learn new things every day.

* These states also enjoyed the positive outcomes of such behaviors, including lower obesity rates and other common health problems.

The opposite was generally true for states with low well-being ...

* Residents were more likely to have unhealthy lifestyles or limited access to basic necessities.

* Residents tended to feel physically and emotionally unhealthy.

* Residents were among the most likely in the nation to suffer from health problems such as high cholesterol and blood pressure, as well as obesity.

* Broadly, residents in these states did not feel they were thriving.
* The states with the lowest well-being typically had very low median household incomes. Having a stable income is important because it enables people to access basic needs such as healthy food, clean water, medicine and health care.

In a nation of 50 states and in a state of 88 counties, residents of Scioto County, Ohio, are among the very lowest in matters that influence well-being. This can be interpreted to mean that residents of Scioto County are some of the most miserable people in America.

The Gallup-Healthways survey found that Ohio ranked as the 5th lowest state for well-being, trailing only Alabama (4), Mississippi (3), and our Appalachian neighbors Kentucky (2), and West Virginia (1).

Ohio's "Well-being index score" was 64.2 on a scale of 0-100. (West Virginia ranking last had an index of 61.4.) Life expectancy was 77.8 years (13th lowest), percent obese was 30.9% (8th highest), median household income was $46,829 (17th lowest), and percent with high school diploma was 88.8% (25th highest).

So, according to the research, despite its low well-being score, Ohio stands out from other low ranking states because it doesn't exhibit many of the elements often present in those states. For one, Ohio's median household income of $46,829 in 2012 was higher than most states with low well-being scores. Similarly, its residents had better access to basic needs than residents of other low well-being states.

So, why is the Buckeye state so poor in well-being?

Gallup-Healthways found Ohio residents generally had low evaluations of their lives, trailing only West Virginia and Kentucky by that measure. Just 49.3% of respondents stated they were thriving in their lives last year, one of the lowest proportions in the nation. Relatively few respondents indicated they had a learning experience within the previous 24 hours, and residents were among the most likely in the U.S. to have felt angry that day. This contributed to Ohio's low ranking for emotional health.

(Ashley C. Allen, Thomas C. Frohlich, and Alexander E.M. Hess. "Report: The most miserable states in the USA." 24/7 Wall St. February 27, 2015.)

The poor condition of health and well-being in Scioto County is currently being addressed by a group of dedicated, hard-working executives and individuals of the Scioto County Health Coalition. Their tireless work must be bolstered by the support and action of the citizens of our county to effect higher rankings. What could be more important to the future safety of our county than raising our rankings of health and well-being?

When we consider the low esteem that so many of us hold for our county, we see indifference and inaction ruling the day. Nothing will significantly change in a population content to accept "below par" for the norm. It is not enough for us to accept the beautiful natural environment in which we live as the only positive factor for a healthy life. We need an immediate reality check accompanied by a healthy attitude adjustment.

I believe first we must change our own individual attitudes from a state of depressed acceptance into a belief that building new and positive visions -- no matter how small the improvement -- will raise the well-being of all. Instead of deploring negative conditions and simply "treading water" in a current flood of despair, we must use our energy to swim against the current one stroke at a time.    

Our county is home to high cancer rates, enormous addiction rates, staggering poverty, and low employment opportunities. But, we must consider these things as recognizable symptoms of what is likely our biggest malady -- our own rigid insistence that some outside force is going to enter our county and instantaneously transform our well-being. We think we are going to wake up one morning and win the Cure-all Economic and Social Lottery to become benefactors after simply riding out the storm.

In reality, our "dependent" malady lingers and becomes chronic because we, ourselves, have allowed it to breed an unsubstantiated confidence that faith and mere hope will solve what is terribly wrong with our well-being. 77,258 people who actively fix themselves can be the cure that makes our county healthy, confident, and strong. We must look within each of our selves to find changes that benefit our individual well being.

I will apologize before I say this -- I'm sorry that this evaluation will ruffle feathers. But, here goes. This is how I see it:

* Too many people here are comfortable with their ignorance. They must read, think, and learn more to better educate themselves and their loved ones. Old-fashioned, cerebral activities need to be valued and carried out by all. The citizens need to expose themselves to a wide range of educational opportunities and realize that their increasing their mentality is the equal opportunity to betterment. They must dedicate themselves to lifetime learning and always be open to change.

* People must stop addictive vices, begin to act as role models, and encourage others to live sober, industrious lives within healthy moderation. Drinking, taking drugs, smoking, being dependent upon any artificial means of happiness lead to poverty, joblessness, criminal activity, health problems, social problems, addiction, and many other negative outcomes.  

* Just because citizens have the right to do things doesn't release them from their moral obligations to their communities and their manners for friends and neighbors. Too many want to do everything they view as their freedoms at anytime and at anywhere. When personal rights come into conflict with social graces, more people should choose compassion and caring for others.  

* Far too many people refuse to listen these days, preferring to anger instead when confronted with an opposing opinion. The lack of cooperation between the rich, the middle class, and the poor is appalling. In days past, so many potential problems were solved when caring people simply pushed up their sleeves and worked together. This is impossible in a social system that relies on political cronyism and Good Old Boy power and control.

* Before folks are bestowed with the good job, the beautiful house, the loving spouse and family, and the security of their precious freedoms and liberties, they must realize that schemes and scams and criminal accumulation of coveted resources build hollow American Dreams. No human owes someone else absolute comfort or assurance. These things are earned through the hard work and the love proffered by each individual. Even when riches are not attained, each person has strict obligations to better his or her community for as long as they live.  

* The "I think I can mentality" has to become a strong, personal belief. Of course, everyone must rely upon others for essential assistance; however, the old cliché of "Nothing worth having comes easy" is a daily reality to successful, happy people. And, the beauty of this reality is that people most respect those who overcome tremendous odds to thrive. How many people in Scioto County must do just that -- overcome the odds through perseverance to achieve well-being? My guess is numbered in thousands. This accomplishment creates the greatest God-given intangible known: Integrity at the core of the human will.    

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