New statistics provided by Marion General Hospital and national universities portray dire news on the state of public health in Grant County.
According to Marion General Hospital, Grant County ranks 87 out of 92 Indiana counties for mortality (length of life), and 91 out of 92 in morbidity (quality of life).
As Marion General works through different channels to mitigate the county’s health crisis, a generational health problems continue on numerous levels. A variety of lifestyle issues produce high rates of diabetes, cancer, and general public health in the county.
Those factors include but are not limited to above average levels of smoking, lack of easily accessible fresh produce, a high density of fast food restaurants and other environmental variables.
Bad habits make up much of the county’s problem.
“Only 10 percent of overall health is your medical treatment you receive,” said Stephanie Hilton-Siebert, the CEO of Marion General Hospital.
The remainder of individual health is determined, 50 percent, by personal behaviors (smoking, diet, and exercise), 20 percent by environmental factors and the last 20 percent by genetics.
Though personal lifestyle holds half of the importance for individual health, there are environmental as well as socioeconomic factors that produce and affect these lifestyle choices in a broader community.
According to Marion General, Grant County ranks 69 out of 92 in social and economic health factors, and also 81 in physical environmental factors.
Those elements cannot be neglected when considering public health in the county, says Hilton-Siebert.
“Our health behaviors and our social economic factors and our physical environment are high,” she said. “Overall access to care is an element, but the rest of those pieces have to go hand-in-hand in order for us to make differences and make improvements.”
Of these multiples health crises facing the county, the issue of lung, tracheal, and bronchial cancer could be the most prevalent. The Institute for Health Metrics and Evaluation determined in 2014 that Grant County men had smoking-related cancers at a rate of 105.3 per every 100,000. For comparison, Indiana has a rate of 86.5 while the national rate is 67.6.
These figures are corroborated by Marion General’s findings on smoking rates. The hospital determined that 23 percent of adult Grant County residents smoked, the second highest rate in Indiana.
Another dimension of this health care crisis is related to diet and food availability.
Evidenced by research done by the University of Wisconsin, Grant County ranks fourth in Indiana in diabetes prevalence, behind only Martin, Lawrence, and Jay counties. As those counties are largely rural, Grant County is the most populated county on that list.
Despite these numbers, other data available through Marion General contends that diabetes in the county is down 10 percent, with those in the stages of pre-diabetes is down 11 percent.
Cancers and other diseases related to diet are also above the state average.
The Institute Health Metrics and Evaluation placed the rate of ischemic heart disease in the county at 255.4 per 100,000, with a state average of 213.3. The Indiana State Department of Health, in it’s most recent data collected between 2008 and 2012, placed cancers like colon and rectal at a rate of 53.6, nearly ten percent above the state average.
These statistics could be perpetuated by environmental and socioeconomic factors. The county’s low median household income, coupled with a high rate of fast food restaurants, help reinforce a generally unhealthy diet among Grant County’s residents.
“We know processed foods and obesity are factors in cancer,” said Rob Dawson, Associate Dean of Nursing at Indiana Wesleyan University. “But whole foods and fruits and vegetables, they’re hard to find and expensive.”
A bill currently under consideration by the Indiana General Assembly, Senate Bill 232: Access to nutritious food program, is making the initial steps to address the issue of accessibility to healthy food in the state.
One of the bill’s provisions officially defines “food desert” for the state of Indiana, determining an official definition of “a rural town or urban neighborhood” where “at least 33 percent of the population resides more than one mile from a supermarket or large grocery store.”
The legislation also directs the office of Lt. Gov. to convene annual meeting of non-profit and faith-based organizations to determine “best practices and programs....to be effective in improving the distribution of fresh and nutritious food and education in food preparation and nutrition in food deserts.”
Other states, such as Pennsylvania and Virginia, have created direct investment funds controlled by the government that provide direct subsidies to food distribution.
One of the Indiana bill’s authors, State Sen. John Ruckelshaus, R-Carmel, said such a direct investment fund was not politically possible as some officials “weren’t comfortable with government subsidizing the private sector into coming into the areas” with food deserts to build grocery stores.
“The whole point,” Ruckelshaus said, “is for people to open their minds up to other alternatives to traditional models of government subsidizing brick and motor projects in certain areas.”
While the state government deliberates, Marion General Hospital has been working to establish funding to help the county’s health crisis in the short term.
Hilton-Siebert said the hospital has “started a coalition” with local and state partners, and received a grant to fight smoking from the Indiana State Department of Health.
The hospital also conducts a “community needs assessment” every three years to determine the county’s needs in public health. The next assessment is in the fall, and the hospital needs citizens in the county to volunteer for the research.
The assessment will need “as many individuals as we can to get involved,” said Hilton-Siebert.
Though alleviating the public health crisis in the county will require work, many actors, both state and local, have recognized the problem and are working to fix it. Broadening that change, however, may require a shift in the cultural and socioeconomic factors of the county.