East Texas Ranks Low In Health Report
By KELLY GOOCH
East Texas health officials are scurrying to respond to a report that paints a bleak county-by-county picture of health in the region.
Anderson and Cherokee counties ranked 207 and 174, respectively, out of 221 Texas counties for health outcomes such as mortality and morbidity, according to a report released jointly by the University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation. The foundation is a philanthropic group devoted to health issues nationwide.
Henderson County ranked 172, Rusk County ranked 145, Van Zandt County ranked 146 and Wood County ranked 157. Smith County had one of the better rankings of 65.
For the most part, the counties' rankings for health factors such as adult smoking, adult obesity and physical inactivity were not much better, with Anderson County at 193, Cherokee County at 197, Rusk County at 116, Van Zandt County at 106 and Wood County at 141. Henderson County and Smith County came in at 89 and 35, respectively.
"If you look at higher rates of obesity in combination with higher rates of smoking, lower rates of education, which is directly linked to health status, and fewer positions, fewer health care providers and widespread geography, meaning it takes a while to get anywhere, you add all of that up and they're worse in East Texas," said Dr. Paul McGaha, regional director for the Texas Department of State Health Services. "And that I think is reflective on why our disease rates are higher and our life expectancy is relatively lower in some counties."
Now that those rankings are in, health officials said they are concerned and taking action.
In Cherokee County, the biggest struggles are the same as nationally -- the obesity rate, smoking and lack of physical exercise. The obesity rate was at 33 percent while physical inactivity was at 30 percent -- 5 percentage points higher than the state average.
So Cherokee County Health Department Executive Director Chris Taylor is working to create a strategic plan with input from elected officials, schools and staff.
He said workout facilities are available in some areas, but the county has a unique challenge because it's primarily rural.
The county also is considered a poor county, Taylor said, so the tax base is much smaller, and the public health dollars it receives are not comparable with Smith County.
He said he knew about those struggles coming into his position, and he hoped he'd be able to bring community resources together to create the necessary change or at least the opportunity for change.
"My initial thought was a lot of concern because it wasn't long ago that Smith County was kind of in the same boat," Taylor said. "We didn't have smoking ordinances, and you saw a lot of prevalence of disease and things, and it really hasn't been until the recent years where you've had a lot of the medical growth. You've (also) had a lot of the preventative medicine growth and you've had (the) Fit City (Tyler initiative), and all of those are things that brought awareness to healthy lifestyles, and that is sort of still limited in Cherokee County."
Therefore, he's working on understanding behavioral patterns behind the epidemic. That includes developing the strategic plan with a road map to target areas most in need of improvement.
Taylor said he believes the root of problems in those areas comes down to behavioral patterns that people grow up doing and partake in until there is a motivator for change.
"If we've smoked since we're 8 years old, we're going to smoke until we see something drastic happen...," he said.
But "if you don't recognize that behavior and implement steps to change it, all the education in the world is going to do nothing."
"We all suffer from what we suffer from because we're used to that behavioral pattern, and it's very difficult to change it," he said.
Taylor hopes to have the strategic plan finished and ready by the beginning of July so he can present it to the Cherokee County Commissioners Cou
In addition to the strategic plan, Taylor said he sees a need to build relationships with entities and nonprofit groups nationwide who are trying to do something about public health.
He said the city of Alto has started doing a health fair almost each month, and the department wants to help build that and showcase it to the rest of the county.
It would also love to bring a Tyler Fit City initiative to Jacksonville, Taylor said, and although he sees being rural as a problem because there isn't as much direct access to resources, he also sees it as a greater opportunity for local farmers to provide fresh fruits and vegetables to county residents.
"I think more than anything I want there to be a sense of urgency and for people to understand what public health is," Taylor said.
"They see it as a clinic, but people need to understand we are concerned with the health of the public regardless of (factors such as) gender (and) wealth. ... Public health should effect local policy and should expect change to improve the health of our residents."
In Anderson County, the mortality rate can partly be explained by the county's multiple prison units, said Marie Reed, regional nurse manager for the Department of State Health Services.
"In that prison complex in Anderson County, not only are all inmates in a high risk setting, but we also have the state's hospice unit there and geriatric unit, so you will have higher incidents of death in that county," she said.
As far as health efforts, there is an obesity coalition, whose activities center around diabetes, healthy living, healthy activities and hypertension.
And, in Palestine, there is a new walking trail in Reagan Park, which is "very user friendly and open," Ms. Reed said.
Additionally, Palestine Mayor Bob Herrington is looking at getting more activities going, and the city has a no smoking ordinance for public buildings unless it is a restaurant with a designated smoking section, she said. Athens in Henderson County recently adopted a smoking ban ordinance.
But those counties aren't the only ones making efforts. In Rusk County, there is a coalition called Leadership Encouraging Activity and Nutrition, a group of people interested in the county's health.
Among other things, the coalition tries to use resources to address health issues such as smoking, exercise and breast feeding.
For example, coalition Chairwoman Toinette Ladage said the group wants to work with the city of Henderson on its parks and trails.
"Henderson has an interesting plan. With its master plan, its plan is to connect all parks together with trails and connect all the city with trails," Ms. Ladage said.
On the nutrition side, she said, the coalition worked to help the city get a grant for a farmer's market, which was scheduled for dedication Saturday.
Additionally, the group, in conjunction with the Texas Department of State Health Services and the Texas AgriLife Extension Service, is in the midst of Step Up & Scale Down, a 12-week educational program based on U.S. Department of Agriculture 2010 dietary guidelines. Step Up & Scale Down includes 12 weekly lessons, and participants view demonstrations of healthy recipes. They also can weigh in and keep track of how many miles they've walked. At one point, more than 110 residents had signed to participate, Ms. Ladage said.
"I do think those (health ranking) statistics are alarming. I do think we have a problem, but we're trying to address that. The group has lost quite a bit of weight," she said.
Now, she said she's trying to get ideas on how to continue a healthy initiative throughout the year.
"The city (of Henderson) is going to have more things in the park. They're constantly adding to it, constantly adding to trails. ... Right now, things are moving well. The city manager and city council are very much involved with it," Ms. Ladage said.
Although many East Texas counties did not fare well in the rankings, Smith County stayed close to the better end of the spectrum. with a ranking of 65 for health outcomes and 35 for health factors, an improvement from its 2011 ranking of 66.
Adult smoking, excessive drinking, motor vehicle crash rate, sexually transmitted disease rate and teen birth rate all decreased, according to data from the Northeast Texas Public Health District. The county also saw a decrease in the number of uninsured and preventable hospital stays.
Stephanie Taylor, public information officer with the health district, attributed the success several areas, including establishment of the Tyler Fit City Challenge, Tyler's strong smoking ordinance, a breast health screening initiative, Pay Attention East Texas Coalition campaigns against reckless driving, and Tyler's expansion of walking trails.
In order to continue a good trend, Smith County will continue to do those things because they've been successful, she said.
But there will be new things as well. Mrs. Taylor said the health district recently received a grant opportunity from the Department of State Health Services called Transforming Texas, which will focus on exposure to secondhand smoke, tobacco control, healthy living, physical activity, good nutrition, and the built-in environment, such as parks and trails, in Smith, Van Zandt and Wood counties. There is also a component for chronic disease prevention to focus on blood pressure, cholesterol and blood sugar control at the individual level, she said.
"We'll do a lot of screenings as part of it," Mrs. Taylor said. "We're putting community health workers into our community who can serve as health coaches and to help people. ... Take prescriptions as prescribed (and) understand what healthy weight is. ... Just having someone to coach them along I think will be really beneficial."
In the end, Mrs. Taylor said she believes a lot of good programs and change will come from Transforming Texas.
Since the Tyler Fit City Challenge is successful, the health district hopes to take components of the program and build a healthy living coalition in Van Zandt and Wood counties based on their specific data and rankings.
"We really like the county health rankings because it gives a basis on what areas we can really put some ... strategies in place and hope to improve," Mrs. Taylor said.