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Mary Selecky
Soda ads get a makeover for the recession 1/31/09
John Wolcott, Editor
Dave Clark, Assistant Editor
Published: Friday, January 30, 2009

Report ranks Washington 10th healthiest in nation

An annual report measuring national health benchmarks has identified Washington as the 10th healthiest state in the country. According to America’s Health Rankings Report (AHRR), 2008 marks the fourth consecutive year in which the U.S. as a whole had failed to improve its overall health care. Washington has gained 13 ranks since the report was first issued in 1990, earning one of the highest overall improvement scores recorded.

The AHRR is the longest running report of its kind, evaluating health, environmental and socio-economic data on a state-by-state basis. It is a joint venture between the United Health Foundation, the American Public Health Association and the Partnership for Prevention.

Topping the report’s newest list of healthiest states are Vermont, Hawaii, New Hampshire, Minnesota and Utah. Louisiana, Mississippi, South Carolina, Texas and Florida have been listed as having the poorest health care in the county.

Secretary of Health Mary Selecky said one of the most significant areas of improvement in Washington State has been in the reduction of tobacco use, which has fallen from 28.6 to 16.8 percent since the report was first published. The state has the sixth lowest prevalence rate of smoking in the U.S., a big improvement over its initial ranking at 16th place. In 2005, it became the fifth state to introduce a comprehensive law prohibiting smoking in public indoor places and in workplaces including bowling alleys, skating rinks, taverns, bars, restaurants, and casinos on non-tribal land.

“This has helped our health considerably,” said Selecky about the state ban.

Washington recently celebrated the 10th anniversary of the Tobacco Master Settlement Agreement, which places restrictions on tobacco companies and requires them to make payments to states as compensation for the cost of providing care to people with tobacco-related illnesses. The state uses settlement funds to improve healthcare and tobacco prevention programs such as Nostankyou.com, a new Web site designed to educate young people about the dangers of tobacco use and second hand smoke.

“We do some very exciting stuff with kids,” said Selecky. “We’ve cut down on kids smoking by half, but there is still work to do. A lot of these kids think they can quit whenever they want, but if they’re hooked they can become lifelong smokers.”

Another highlight of this year’s AHRR was Washington’s 1st place ranking in low infant mortality, which has improved by 51 percent since 1990, down from 9.7 to 4.8 deaths per 1,000 live births. This is a stark contrast to the nation’s 29th world ranking recorded by the Centers for Disease Control and Prevention.

Washington holds the fourth lowest rate of preventable hospitalizations (51.9 discharges per 1,000 Medicare enrollees), and has the fifth lowest percentage of persons under the age of 18 living in poverty (up from 10.5 to 11.6 percent).

Despite its successes, Washington continues to face a number of health care challenges, including measurable disparities in the state’s population based on race and geographic location. Low birth weight babies are seen in 10.6 percent of non-Hispanic blacks compared to 5 percent in Hispanics. The cardiovascular death rate for blacks, 329.7 deaths per 100,000, is higher than other races in Washington who experience 263.7 related deaths per 100,000.

More than a fourth of all 9th graders are failing to succeed, the report states, earning Washington a 33rd ranking for its low high school graduation rate. Obesity in Washington State has grown over the last eight years from 9.4 percent to nearly a third of the population at 25.9 percent. Since last year’s report was issued, the percentage of children between the ages of 19 to 35 who receive complete immunization coverage dropped from 78.6 percent to 73.9 percent, costing Washington its 37th rank position to settle at 48th place.

“It’s very sobering,” said Selecky about the report. “Our state’s low high school rates are a call to action for communities, quite frankly. On the immunization rates, providers and government must work to make sure parents get accurate vaccine information to make the right decisions and protect children against diseases.”

Efforts to improve health care in Washington are being made more challenging by deepening economic hardships, she said. The current recession is squeezing consumers who are making tough decisions about their health expenses. Like them, state and local health care providers are reassessing their priorities and reshaping the way they operate as fewer retail taxes make their way into the state’s coffers. Selecky said the number of uninsured is expected to rise, and many people will delay seeking treatment. Stressful conditions may tempt past smokers to pick up a cigarette again or return to other additions.

In an attempt to help close a projected $6-7 billion budget shortfall, Gov. Christine Gregoire released a proposed 2009-2011 budget in December that would cut $3.5 billion in funding for education, public safety and other areas. If approved, the biennial budget would reduce overall state spending for health and human services by 12.2 percent. Her budget calls for the elimination of Washington’s Adult Day Health program, which serves 1,900 adults and elderly with developmental disabilities. The governor’s budget would end child welfare pilots that provide training for foster parents caring for high-needs children. High-cost placements at secure crisis residential centers would be cut, as well as a 5 percent reduction in funds operating nursing homes for Medicaid patients.

The proposed budget would also stop grants from being issued to an affected 21,000 people who are unable to work because of a mental or physical disability, and to 6,500 people receiving grants for people struggling with drug and alcohol addition. Funding for the state’s Basic Health Plan, which offers low-cost health care coverage to low-income residents who are ineligible for Medicare, would be cut by 42 percent.

Funding for subsidized health care coverage to children of low-income families would also be suspended, and the state would no longer purchase vaccines for children who are not covered by Medicaid. Managed care companies would be reduced by $86.9 million, and funds paid to non-psychiatric hospitals would drop by 4 percent for outpatient and inpatient services. The use of generic drugs in state health programs would increase by 20 percent, while coverage for some drugs would decrease.

Public hearings on the governor’s budget proposals were held in January. The House of Representatives and the Senate are expected to draft and adopt separate versions of each budget before working to reach a consensus on and finalizing a single state budget. The session began Jan. 12 and is slated to last 105 days.

For more information about America’s Health Rankings Report, visit www.americashealthrankings.org.

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