Mike Maples, MD
“I could not agree more.”
It’s not all that often that I can say that about an editorial in our local paper. But in the April 10 edition of the Yakima Herald-Republic, they got it right. The headline reads “Education is best tool for county health improvement”.
They are referring to the County Health Rankings that were released in March. This is the fourth year that the Robert Wood Johnson Foundation, in collaboration with University of Wisconsin, has issued the report that ranks health fa
ctors for every state and every county in the nation. And for the fourth year in a row, Yakima County anchors the list of Washington counties, finishing 35th out of 39 counties. The editors go on to note that the picture is set to improve and credit their optimism to increases in health insurance resulting from the Affordable Care Act (aka: Obamacare), and particularly to the CWFM Residency (noting its expansion from 6 to 10 residents per year recently), and to the College of Osteopathic Medicine at PNWU.
The editors note (correctly) that it’s not just education of providers that will make a difference. We have to educate people, too. When we examine the reasons for Yakima County’s low ranking, the causes are fairly clear. On one hand, there are structural issues in the economy of the county that result in high rates of poverty and lack of health insurance, which are both nearly twice the average rate for the state. The other drivers of the poor score are the result of decisions that people make….especially young people in our communities. These include: a very high rate of premature death, resulting mostly from car accidents and violent crime; high rates of obesity and inactivity; and very high rates of sexually transmitted infections, teen births, and single parent homes.
Yes, we are poised to be able to provide access to primary care providers. But if we are going to really address all of these health outcomes, we’ll also need to do more to educate people….especially our young people.
There’s another story in the health rankings that is not mentioned in the editorial: the #1 county in Washington for 2013 – Kittitas! This illustrates the diversity of social, demographic and economic factors in our own small service area. Kittitas County’s great numbers are largely driven by the fact that a quarter of the 40,000 people in the county are associated with CWU. That drive’s down the average age dramatically. It drives up educational attainment, incomes, and insurance status. These things are all associated with better health status and better health decisions.