4/10/2011
By ERIN MATHEWS Salina Journal
Thirty-two percent of Saline County's adult population is obese, according a recently released information that ranks counties according to factors affecting the health of their residents.

In fact, only Seward County with 33 percent and Wyandotte County with 36 percent had a greater portion of obese adults.

However, the percentage of obese adults in Saline County isn't that much higher than a number of other nearby counties, including Cloud, Ottawa and Clay at 30 percent, Ellsworth and McPherson at 29 percent, and Dickinson at 29 percent.

But the bad news for Saline County doesn't end with its obesity ranking.

Sixty-seven Kansas counties are healthier places to call home than Saline County, according to the 2011 County Health Rankings, compiled by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. In northwest and north-central Kansas, only Phillips, Logan, Washington and Sherman counties had a lower ranking.

What brings Saline County's overall score down is poor outcomes in social and economic factors, health-related behaviors and physical environment. Some of the county's worst rankings were for sexually transmitted diseases, the teen birth rate, access to healthy food, air pollution caused by particulate matter, poor mental health days and the high school graduation rate. The lowest ranking of all was for obesity.

The rankings include social and economic factors such as unemployment and high school graduation rates that aren't usually thought of as health-related but in reality have a great effect on people's overall well-being, said Dr. Robert Kraft, associate director of the Smoky Hill Family Medical Residency Program at Salina Family Health Care Center, 651 E. Prescott.

"Those are certainly health risk factors," he said. "There's no direct correlation for any particular patient, but as a population, it will tell you whether it will, in general, be a healthy population or not."

Saline County does rank well in the clinical care area, including numbers of uninsured adults, availability of primary care providers and preventable hospital stays.

Could be a wake-up call

Kraft said the county health rankings could be a good tool for those who make public policy.

"What I would say is our public policy makers really should look at these numbers and pick the things that are most troubling and see if there are things we can do to help in those areas," Kraft said.

Del Myers, health education supervisor for the Salina-Saline County Health Department, said that a few years ago there wasn't much county-level data available, so the rankings are helpful.

Some of the results are more accurate than others, she said, pointing out that statistics like number of cases of sexually transmitted infections would be based on hard data.

Other categories, such as the number of poor mental health days, are based on survey results of people with land-line phones.

In some categories, multiple years worth of data are averaged to come up with a county's score. "They're good to look at and get a wake-up call for your community," she said. "It's one piece of the puzzle. There are many different ways to measure health, and if you look at outcomes from different sources, you get different numbers."

She said the health department and Salina Regional Health Center soon will be collaborating on a community health assessment that she expects to provide more specific information. A community health plan will be developed based on the results of the assessment, she said.

Behavior changes take time

Myers said the County Health Rankings first became available nationwide in 2010, when Saline County was ranked 61 overall in Kansas. Myers said she saw nothing in the most recent information that surprised her. Efforts have been under way for some time to address many of the problems the rankings reveal, she said, but improvement requires behavior changes, and those take time.

"Health behaviors are really hard to change," Myers said. "A lot of the time it takes one or two generations to change."

It was an eye-opener

Ellen Hogeland, health and wellness director for the YMCA, said Saline County's ranking in obesity is "definitely an eye opener."

"At the same time, maybe it can be fuel for the fire," she said. "We need to start focusing on preventative health care, which is exercise and nutrition. It's sad definitely, but there's also still hope."

Hogeland has coordinated a communitywide effort to lose weight called the Pound Plunge, since it started three years ago. So far, participants have lost a combined total of 20,000 to 22,000 pounds.

Pound Plunge participants are encouraged to change their lifestyles and make better choices.

"It's not a complete diet and all-out exercise," she said. "That's not what it's about. It's about changing your eating habits and making wiser choices and incorporating more activity into your life. The two go hand in hand."

Hogeland said organizers decided to start Pound Plunge in Salina because obesity is a national problem with severe health implications, including diabetes, heart disease and a host of other illnesses.

"It's because we have such an easy society," she said. "We just drive a block to the convenience store to pick up a Super Gulp."

Obese parents, obese kids

Obese parents teach their children habits and model an unhealthy relationship with food for them, Hogeland said, and that becomes a cycle that is hard to break.

Hogeland and Myers serve together on an obesity-focused coalition formed about a year ago. Hogeland said anyone with "a passion to see Saline County become one of the healthiest and change that obesity marker" is welcome to join the Nutrition and Physical Activity Coalition.

The coalition brings together community leaders to advocate for policy changes that would encourage healthy choices.

"Policy decisions really have the most impact on health behaviors because a policy doesn't really give people that bad choice," she said. "Policies are really a big focus in trying to get that behavior change."

Example: New smoking law

Take, for example, the state's new law banning smoking in public buildings, which Myers said is having a huge effect in improving people's health, or the mandatory seat belt law, which has saved lives and lessened the severity of injuries of people involved in car crashes.

Law-making efforts to control obesity in other states have included requirements that ingredients of restaurant food are disclosed and implementation of special taxes on junk foods loaded with sugar.

Myers said school nurses and physical education teachers are doing a good job encouraging physical activity for school-aged children. She said the district is implementing a plan to improve lunch nutrition in accordance with national guidelines for excellence. Menu changes increasing fresh fruits and vegetables and decreasing fried foods are being implemented, she said.

n Reporter Erin Mathews can be reached at 822-1415 or by e-mail at emathews@salina.com.

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