US Health Care Plunges, Texas Drops 9 Points
Ranking: Texas is 46th this year; it was 37th in 2007.
- Strengths: Strengths include a low prevalence of smoking at 19.3 percent of the population, a low prevalence of binge drinking at 15.0 percent of the population, a low rate of cancer deaths at 186.3 deaths per 100,000 population and a moderate infant mortality rate at 6.5 deaths per 1,000 live births.
- Challenges: Challenges include a high rate of uninsured population at 24.9 percent, a high percentage of children in poverty at 25.0 percent of persons under age 18, a high incidence of infectious disease at 23.8 cases per 100,000 population and limited access to primary care with 95.0 primary care physicians per 100,000 population. Texas ranks lower for health determinants than for health outcomes, indicating that overall healthiness may remain low in future years.
- Significant Changes: In the past year, the percentage of children in poverty increased from 22.0 percent to 25.0 percent of persons under age 18. In the past year, the prevalence of smoking increased from 17.9 percent to 19.3 percent of the population. Since 1990, the infant mortality rate decreased from 9.3 to 6.5 deaths per 1,000 live births. Since 1990, the prevalence of obesity increased from 12.3 percent to 28.6 percent of the population.
- Health Disparities: In Texas, low birth weight babies are more common among non-Hispanic blacks at 13.9 percent than Hispanics at 7.2 percent. Access to health care varies significantly by race and ethnicity in the state; 29.3 percent of non-Hispanic blacks and 55.7 percent of Hispanics lack health insurance compared to 16.8 percent of non-Hispanic
U.S. health gains stall, could reverse
… look at nearly two decades of progress in access to medical care, immunizations, prenatal care, infant mortality, heart disease deaths, smoking cessation, deaths by infectious disease, violent crime and occupational fatalities.
America’s Health Rankings™, provides an annual analysis of national health on a state-by-state basis and ranking of the healthiest and least healthy states. The 2008 Rankings reveal the overall health of the U.S. population has not improved for the fourth year in a row.
The health status of Americans has stagnated. America’s Health Rankings™ shows that after steady improvement from 1990-2000 the health of the American people has leveled off, despite an increase in health care spending and major advances in medical technology.
… our health care system is heavily tilted toward sick care at the expense of well care or keeping people healthy. About 95 cents of every dollar spent in the U.S. on health goes to diagnose or treat disease after it occurs, leaving less than 5 cents on the dollar to prevent disease.
It’s not enough to just increase access to medical care. America’s Health Rankings™ points out, health outcomes are the result of multiple factors that are intertwined, including personal behaviors, public and health policy, community and environment, and clinical care. Real reform will address all of those factors.
Other findings from the report:
- From 2007 to 2008, 36 states had positive changes in their overall health scores and 14 had negative changes.
- Utah had the lowest prevalence of smoking (11.7%)
- Massachusetts had the lowest rate of uninsured citizens (7.9%)
- Colorado had the lowest obesity rate (19.3%)
- The percentage of uninsured Hispanics is 34.2%, compared with 17.7% of non-Hispanic blacks and 12.2% of non-Hispanic whites
- Non-Hispanic blacks had the highest rate of low birth weight infants (13.8%), followed by non-Hispanic whites (7.2%) and Hispanics (6.8%)
- Blacks have a more than double the rate of cardiovascular death than other races (395.7 versus 181.8 per 100,000 population)
This report can be downloaded from America’s Health Rankings 2008.
What’s Wrong with America’s Health Care
Doctors ditch drug samples to avoid influencing treatment
5 misconceptions about health care
The United States is No. 1 in only one sense: the amount we shell out for health care. We have the most expensive system in the world per capita, but we lag behind many developed countries on virtually every health statistic you can name.
We rank near the bottom of countries in the Organization for Economic Cooperation and Development, just ahead of Cuba and way behind Japan, France, Italy, Sweden and Canada, countries whose governments (gasp!) pay for the lion’s share of health care. Infant mortality in the United States is 6.8 per 1,000 births, more than twice as high as in Japan, Norway and Sweden and worse than in Poland and Hungary.
US Compared to other nations is SAD
US Map of Health Rankings - Southern US has poorest Health
… interactive map provides a quick snapshot of 2008 findings nationwide, as well as state-by-state results. Select the appropriate tab or roll over your state to learn more.
Texas has lost ground in the past decade, this is sad because it has declined under the watchful eye of the Republican Party who idolized George W Bush. Many Texas Republican politicians and a few Texas Democrats have been caught in the hypocritical pocket of Corporate Lobbyists . The Republican Party, in general, has favored BIG Business, including Medical Corporations who see the sick as dollar signs. Texas looks like it leads the pack in putting dollars above life quality. Texas needs to reinstate the Hippocratic oath and throw out the Hypocritical oath it has been following.
Texas Health Care Association
Texas Health and Human Services Commission (HHSC)
Texas Health Resources
By excluding the insurance challenged among us, the American Health industry is no longer responsible to the patient. Doctors and practitioners are forced to genuflect to big business for their daily bread. They are forced to limit or expand treatment as dictated by the payer and the chain of medical testing providers they must support, according to the insurance networks they are bound to. Those fortunate Americans, who can afford to travel to foreign medical facilities, often have a more success receiving treatment without the burdens of industry dictated treatment programs.
December 7th, 2008 at 10:13 am
I recently discovered a blog about a family physician in a rural practice. he posted about job losses and emergency medical services service cuts in his community. I started musing in response, and I believe that the comment would be appropriate here, as well in terms of investigating what local, immediate, low cost options are available:
How about entertaining the idea of community potluck/health screenings at local schools and fire houses? School nurses are becoming scarcer than hen’s teeth, too, and so are likely overwhelmed and missing children’s screenings (my guess - your mileage based on your own practice stats will surely tell a much clearer story).
The rationale for community-based potlucks is that you can get all ages together for meals (a lot of hidden hunger in rural communities), can get eyes on those who appear malnourished or otherwise appear distressed, can do the usual non-invasive BP, vision, hearing, dental, depression, etc. screenings and can work in some effective education and advocacy.
And for all, you can create family based documentation tools - adopt a simple EHR screening tool, and burn CDs with the screening data on the spot. If you’re creative you can put add ons such as medication histories, vaccination hx, allergies, etc. (Would be a great marketing tool for local practices to go in together with hospital/lab/dx imaging, etc). The school nurse (if there is one) could input directly into her student health database from the event, as could any public health providers.
You could do fire prevention demos, low cost/high nutrition cooking demos and eat the experiments, have smoke/CO detector battery exchanges, distribute toothbrushes and toothpaste, help with Medicare and Medicaid claims, have an office on aging rep speak to home safety for people with low visual acuity and fall risks, have a rep from the jobs/unemployment center, a local community college recruiter give resume pointers, have breastfeeding literature, etc. Sort of a combo health and safety fair, jobs and social service support event.
If you staff potlucks with a public health nurse and/or school nurse, you can get some bonus advantages with PH data collection, disease surveillance (TB, Substance abuse, flu, etc).
Pretty darn low cost, lots of opportunity to ID vulnerable and connect with services/support.
I think that we’ll have to resort to old-fashioned low tech events such as these in order to get any sort of public health surveillance and care - and not just in rural areas.
I would also keep these deliberately OUT of churches so that there isn’t any ideology and guilt repression and suppression of information (especially if you are going to do any reproductive health screening/education/prevention).
Ohio used to have out of Ohio Wesleyan Univ, if I recall, a rural health program which addressed the ag. community specifically (safety around PTOs, inhalation and airborne pulmonary protection, farm safety, etc.) I wonder if this would be of interest to you.
Investigate joining the local public health advisory board on the community, county and state levels.
People who are highly vulnerable often literally disappear, and these fairs are one way to encourage them to get some good food, some social interaction without stigma, some support, and it many be a way for them to be able to volunteer and become networked and engaged in their communities.
December 7th, 2008 at 1:34 pm
Annie, that is a great idea. There are heroic stories like yours in almost every state. I call them PODS of caring and common sense. Our communities are only as healthy as the sickest of us. Community events are easier to organize and help that specific community. My analogy is that a community is like a motor boat, but the nation is like a giant container ship. It takes a lot to move it and turn it around.
If the Federal Government could come to a consensus about the value of life in this country, they might be able to restructure how health care is administered. Doctors may take the Hippocratic Oath, but they are administered by politicians and corporations who work with the Hypocritical Oath …
Volunteers may be more available now that more people are jobless. At least the ones who have given up finding a job. Then again, the jobless may be pre-occupied with their own survival. I can’t wait to see what a Democratic Administration can do to replace this broken system.
You have great ideas. Please share more.
December 7th, 2008 at 4:55 pm
America’s Free Clinics provide quality health care to those working Americas who have no medical home. Free Clinics receive little to no state or federal funds meaning tax payers do not pay for the services provided at these clinics. Free Clinics are funded through grants, donations and fund raising events. Free Clinics provide health care for Americas that do not have insurance and who are not on Medicare or Medicaid. There are over 1200 free clinics in the United States of America and they provide care to 2-4 million Americans.
December 8th, 2008 at 12:15 pm
Fine reporting, BossKitty. And the low number of uninsured in MA is a principal reason I moved here 8 wks ago. So far, the drawbacks have been no job, a temporary living situation that has sharply curtailed my net access, an ongoing wait to qualify for that healthcare and the possibility of being compelled to move to a much worse healthcare state (FL) just to keep a roof overhead.
From the tables in that report, we’re seeing a lot of indicators of faux affluence: paying too much for healthcare while obesity skyrockets (the latter may also indicate the side effects of depression (overeating) and too much time in a higher-tech environment, where computer usage and video games increase sitdown time at the expense of regular exercise and more physical games.
It’s also great to hear Annie’s proposals where innovative solutions were suggested instead of comments describing what’s wrong.
Kudos to you both.
December 8th, 2008 at 7:45 pm
Nicole Lamoureux, “Free Clinics receive little to no state or federal funds meaning tax payers do not pay for the services provided at these clinics.”
This is what my concern is. Because these Free Clinics depend mostly on donations to supplement their grants, they are very vulnerable to the economic downturn. Donors are evaluating the size and frequency of their donations, usually at the instruction of their accountants. They have to rearrange their assets because, donors are taxpayers too. Many grants are funded by taxpayers through various institutions like colleges and trusts. Colleges and trusts are being squeezed because their taxpaying benefactors are being squeezed.
The economic situation may not break everyone down, but there will be less expendable income for donations. So, maybe taxpayers are not directly responsible for contributions, but they are indirectly paying for these services.
These are wonderful services. These 1200 clinics depend on the good will and humanitarianism of people. The same people that use these clinics, in some indirect way, also contribute to them. This may be the future of health care. Everyone contributes and everyone is covered.
December 8th, 2008 at 8:01 pm
Hey Kevin, thanks. I agree, instead of bitching about our sorry condition, lets hear some innovation. The playing field is being leveled, lets take advantage while we have their attention. There will always be those in denial, don’t waste your time on them. Those in denial will be happy waiting for the rapture bus.
Collect friends with ideas. Start talking among ourselves and with our local and state representatives. Everyone knows, to move forward we must start thinking for ourselves and take personal responsibility for climbing out of the mud.
Making proposals for solutions is how we start.
I hope MA works out for you. Be creative, dog sit, house sit, water house plants, but please don’t end up in FL.
I have a friend who is literally homeless, unplugged from his blog, but sends a word document to a friend blogger who posts his series about being homeless ‘from the inside’. See if you can make a journal about your adventures and sell it to the newspaper … don’t run out of ideas.