Report raises alarm on obesity; smoking and heart disease also a concern

Obesity, smoking and heart disease are ranked among the top public-health priority issues in the 2015 Community Health Assessment, completed by the Cape Girardeau County Public Health Center and collaborating community partners.

The assessment is completed every three years and includes information on county demographics, education, socioeconomic conditions, public safety, domestic violence, maternal and child health, infectious diseases, chronic diseases and morbidity and mortality.

In a brief presentation at the last Cape Girardeau County Commission meeting, Cape Girardeau County Public Health Center executive director Jane Wernsman shared some of the assessment's highlights.

"In summary, we look at a whole lot of health indicators, from causes of death, injury reports, environmental issues, and then we summarize with our community partners what our public-health priorities should be," she said.

The last community health assessment was in 2012.

The most significant health concerns reported at the time were obesity rates in adults and children; increased smoking rates, particularly during pregnancy; and childhood immunization rates lower than state rates.

The list is slightly different from the top three concerns reported in the 2015 assessment.

"This year, obesity rates were still high enough for us to warrant that as an issue," said Wernsman. "[Other issues were] smoking rates in our county, particularly smoking during pregnancy, and heart disease -- which, obesity and smoking contribute to the heart disease."

A 2011 survey conducted by the Missouri Department of Health and Senior Services Office of Epidemiology showed 19.3 percent of adults in Cape Girardeau County said "no" when asked whether they participate in any type of physical activities or exercise outside of work.

Another study from the same year found 86.4 percent of adults in the county eat an inadequate amount of fruits and vegetables.

The state health department shows the number of overweight people in Cape Girardeau County grew from 35.2 percent in 2007 to 39 percent in 2011.

Slightly more than 24 percent were considered obese in 2007, and nearly 26 percent of adults were considered obese in 2011.

This is compared to Missouri's numbers, with 34.5 percent reported overweight and 30.1 percent obese in 2011. Designation of overweight or obese is determined by body mass index.

Unlike the numbers for obesity, the percentage of cigarette smokers decreased from the last report by a few points.

At 21 percent, Cape Girardeau County reported slightly fewer active smokers than the state in 2011.

The county, however, experienced a higher percentage of people reporting the use of smokeless tobacco, compared to the state.

Cape Girardeau County also had one of the lowest percentages of active smokers compared to surrounding counties. Ripley County had the highest, at about 46 percent, followed by Iron County with 41 percent.

As Wernsman said, the county health center's concern with smoking goes beyond the number of smokers.

The prevalence of smoking during pregnancy is another issue.

More than 20 percent of mothers in Cape Girardeau County smoked during pregnancy, compared to 17.5 percent of mothers in Missouri in 2013, according to the Missouri health department.

The rate of women who smoked during pregnancy decreased in 2013 compared to 2010, but the assessment indicates the trend over the past 14 years has not dropped significantly.

As smoking rates in general are higher in the southeastern counties, so are the smoking rates during pregnancy.

Cape Girardeau County's rate of smoking during pregnancy was lower than nearly all of the other Southeast Missouri counties considered in the assessment.

Iron County had the highest rating at 35.2, followed by Mississippi County's rate of 32.7 and New Madrid County of 32.1.

The third ranking health issue identified in the report focused on heart-disease rates within the county.

The county's trend of emergency room visits related to heart disease have experienced a "statistically significant increase," according to the assessment.

It also is the leading cause of death in the county, with 346 deaths attributed to heart disease from 2012 to 2013.

Cancer accounts for 31 percent of the county's deaths, coming in second. The remaining causes are smaller in percentage. Chronic lower respiratory diseases were reported third at 8 percent.

Heart disease, cancer and lower respiratory diseases also are the three leading causes of death in Missouri.

Now the assessment is out, the Cape Girardeau County Health Center can share the data with community partners to begin searching for solutions.

A major player in the effort to improve the county's health is the Healthy Communities Coalitions. Its members consist of employees or volunteers from a number of entities, including the county health center, the city of Cape Girardeau, Southeast Missouri State University, SoutheastHEALTH and Saint Francis Medical Center.

The coalition is a result of a comprehensive Community Health Needs Assessment completed in 2013 by SoutheastHEALTH and Saint Francis Medical Center, separate from the county's assessment, although some data were contributed by the local hospitals.

Shauna Hoffman, marketing director for SoutheastHEALTH, said its team "played a very large role" in the formation of the coalition, crediting the work of senior marketing analyst Anna Galeski and corporate and community sponsorships coordinator Teri Wilson.

SoutheastHEALTH contributes to the organization of the meetings and assisted with the planning and facilitation of the health center's 2015 health assessment.

Dr. Tom Diemer, vice president of quality and safety for Saint Francis, is the hospital's physician member on the coalition.

He applauds the efforts of entities coming together for the better of the county and said he hopes to see more momentum in the future.

"Really, what we've tried to do is look at obesity and look at vascular [heart] disease and see if there are some ways to intervene," he said. "One thing is just raising public awareness of it."

Obesity is especially problematic, he said, and is "almost becoming an epidemic."

Efforts taken by the coalition to reverse this trend including supporting the community gardening efforts around Cape Girardeau that provide fresh produce to residents and free classes on how to prepare food grown in the garden.

Fast food is cheap and convenient, whereas healthy eating can require a little more effort, Diemer said.

That's where the value of the garden and the cooking classes come in.

It also is important to start speaking to children early about healthy lifestyle choices, Diemer said.

"One of the things I would like to see is getting even more involved with the schools," he said. "Because we know if you don't reach someone heading down the road to obesity by the third grade, there's a really good chance you're not going to be able to turn them around, which is sad."

Outside of the coalition, the community health center is making the most of its community partnerships to provide more programs for the public. SoutheastHEALTH will host a series of free smoking-cessation classes, for example, beginning Sept. 23.

Those interested in reading the 2015 Community Health Assessment may visit the Cape Girardeau County Health Center's website, cgcohealthdept.com.

srinehart@semissourian.com

(573) 388-3641

Pertinent address:

Cape Girardeau, Mo.