Vermont has long ranked at the top of the list when it comes to being healthy, one of the key reasons being that those who do the ranking give us high marks for the number of health-related programs we fund, our low crime rate, our low pollution, and high school graduation rates. Together these factors are usually present in states that are considered healthy, even though they might not reflect how long, or well, people actually live.
New England, as a region, has always been regarded as a “healthy” place to live, with Massachusetts, New Hampshire, Connecticut and Vermont normally counted among the top 10 to 15 healthiest states.
This week, however, a new analysis was released by the Journal of American Medical Association [JAMA] that, for the nation, showed a different picture. It focused on death rates. It made the news because it showed that life expectancy had dropped for the last three years, despite the fact that we spend more on health care than any other nation. Most concerning is that the mortality increase is happening among all racial and ethnic groups, and in rural areas, suburbs and cities. It’s not happening among the young, or the old, the increases are coming about within the 25 to 64 age group; people in the prime of life.
Poor health outcomes is old news and typically we’re pointed to high poverty states, particularly in the south and the mid-Atlantic region, as being the places where the challenge is most acute.
What was stunning with the JAMA report is that the five states with the “greatest relative increase” in death rates were in New England [New Hampshire, 23.3 percent; Maine, 20.7 percent and Vermont, 19.9 percent] and the Ohio Valley [West Virginia, 23 percent; Ohio, 21.76 percent; Indiana, 14.8 percent and Kentucky, 14.7 percent.]
So Vermont ranked fifth nationally in the “all-cause mortality rate”, among 25-64 year olds. That’s a stunner.
Part of this is being attributed to drug overdoses, alcoholism, and suicide, the so-called deaths of despair. But also included now are heart disease, strokes and chronic illnesses in general, in other words, diseases related to obesity.
Remember, too, that this increase is not taking place among those older than 64; it’s happening in the prime years of people’s lives. The study’s lead author, Dr. Steven Woolf of Virginia Commonwealth University, was quoted as saying, “The whole country is at a health disadvantage compared to other wealthy nations… We are losing people in the most productive period of their lives. Children are losing parents. Employers have a sicker work force.”
What’s both puzzling and concerning is how the increase in mortality is focused regionally. On both coasts and the west, health outcomes continue to rise. California and Wyoming continue to see an increase in life expectancy and South Carolina, Georgia, Florida, Texas, Oklahoma, Utah, Nevada, Oregon and Washington are holding steady. The rest of us are showing a decline in life expectancy, with New England [and Ohio and West Virginia] doing the poorest.
There are no conclusive answers. The organization is funding a more in-depth study to be run by the Committee on Population and the Committee on National Statistics. The purpose will be to produce a report that will “identify modifiable risk factors that might alleviate poor health in mid-life…”
Vermont will have a stake in whatever is ultimately recognized as key challenges to our life expectancy patterns. Most of New England will. And while a study of the problem is about to be launched — on a national scale — it also seems appropriate for Vermont and our New England brethren to form our own collaboration so that we can identify our own challenges and our own ways to respond. Such a collaboration could involve the three of us — Vermont, New Hampshire and Maine — since it’s in our three states that the problem is most acute. What we would find could be significantly different than what might be found in West Virginia or Ohio.
If it could be arranged, it would be worth the extra cash to have the JAMA organization order a special carve out for our region so that the experts could determine what makes the increase in our mortality rate so challenging.
It’s a discussion Vermont must recognize. It’s one of those issues that left unaddressed could worsen. If obesity turns out to be a factor that is reducing our life expectancy in the 25-64 age cohort, then it’s guaranteed the problem will get worse.
We can no longer assume that being named one of the nation’s healthiest states also means we live longer. It’s time we stop pretending and do something about it.
by Emerson Lynn