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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Greene: Health Factors

According to the 2013 America’s Health Rankings Report, Vermont is the second healthiest state in the country, after Hawaii. And since we’re also one of the oldest states, with a median age of 41.5, I was curious to look further into these statistics.

Well, for starters, we have the highest high school graduation rate in the country – and worldwide, education is a well documented indicator of improved health outcomes. We also have among the highest rates of people with health insurance, at 92%.

Then too, in the last ten years, our smoking rate fell by almost 3% in adults and fully 10% among youth, and our cardiac death rate dropped by a whopping 34%.

Tracy Dolan, Deputy Commissioner for Public Health, cites two additional facts - we exercise and eat 4-5 servings of vegetables per day. In fact, in a recent Gallup poll, Vermonters reported doing at least 30 minutes of exercise 4-5 times a week. The exercise, by the way, doesn’t have to be recreational: snow shoveling and roof raking count. So it seems that good habits outweigh age, and Dolan says we aren’t that much older than other states, anyway.

On the downside though, Vermont has among the highest asthma rates in the country, due in part to our old housing stock. And we rank #1 in pet ownership - fully 73% of households contain at least one fur-bearing pet, the dander of which contributes to asthma. Our pertussis rate has climbed significantly, due, Dolan says, to a reluctance to get vaccinated. Binge drinking is up 1% from last year - and the percentage of children living in poverty has nearly doubled in the last five years. Poverty, especially in childhood, is a huge determiner of health.

Historically, American healthcare has been geared to the catastrophic: diagnose, medicate and cure. This model worked brilliantly in the era of widespread infectious disease and the discovery of antibiotics. But for heart disease, diabetes and strokes, health habits - like eating right, exercising, and not smoking - seem to have more bearing.

Environment determines 20% of our health outcomes. Doctors, community and heredity each account for another 10%. That means our habits account for 40% or more – even though 88 cents on every healthcare dollar still goes to high tech medicine – like ER visits, expensive tests, and operations.

Fortunately, it’s not just about where money is spent. Attention and efforts like the legislative action that increased Vermont’s cigarette tax count too. Every time an increase was enacted, smoking, especially among youth, decreased – a great health benefit for little cash outlay.

Nationally, health initiatives like the Blue Zone Project in Iowa seek to involve whole communities. Employers encourage workers to walk instead of sit at meetings. Cities are putting in more sidewalks. Schools are improving nutrition and making sure kids get daily exercise.

And here at home, we can’t simply rest on our laurels – especially if we want to beat Hawaii.

Stephanie Greene is a free-lance writer now living with her husband and sons on the family farm in Windham County.
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