Avoyelles slips in community health rankings

By RAYMOND L. DAYE

    Avoyelles Parish lost ground in a national parish-to-parish ranking on community health.
    The 2015 County Health Rankings, prepared by the non-profit Robert Wood Johnson Foundation (RWJF) and University of Wisconsin Population Health Institute, was recently released. The report shows that while many of the parish’s individual factors stayed about the same -- some worse, some better -- its ranking among the state’s 64 parishes slipped to 54th in both Health Outcomes and Health Factors comparisons.
    Avoyelles was 45th in Outcomes and 52nd in Factors last year. The Outcomes category compares such things as life span and overall health of community residents. Health Factors looks at statistics on smoking, obesity and excessive drinking; physical inactivity and access to exercise opportunities; access to physicians, dentists and mental health providers; teen births and sexually transmitted diseases; high school graduation rate, children in poverty and percent of children in single-parent households; violent crime and other factors.
“For too long being healthy has been defined as simply not needing to seek medical care,” an RWJF spokesperson said. “But it is time to look at the bigger picture of health, and how it extends to work, family, and community life. Factors such as education, obesity, smoking, unemployment, air quality, poverty, and teen birth rates all influence health.”
    The County Health Rankings report measures these and other factors in an effort to give  communities a glimpse of possible health problems they face and encourage them to create local solutions to those problems.
    The parish’s best showing  this year and last was in “Physical Environment,” which looks at air and water quality, commute times and housing issues. Avoyelles was No. 6 out of 64 in that category, but was No. 4 last year.
    The parish’s physical environment was 47th in 2013 and 46th in 2012, which means we must be doing something right -- environmentally speaking.
 
Weak area
    Avoyelleans’ weak area in the health survey continues to be in “Health Behaviors.” The  parish, as a whole, smokes more, is less physically active and more obese than the state average. In bad behaviors, we rank 61 out of 64.
    We are slightly under the state average for excessive drinking -- 14% compared to the state’s 16%. However, our percentage of automobile accident fatalities involving alcohol is 49 percent compared to 33 percent for the state. The parish report showed 43 percent last year.
    The report does not provide an average life expectancy comparison, but measured “length of life” by the “number of years of potential life lost before age 75” per 100,000 population. Avoyelles had 11,041 “lost years” per 100,000 residents while the state had 9,131.
    Approximately 27 percent of Avoyelles adults smoke -- the same as last year. That compares to 22 percent statewide.
    Avoyelles has an obesity rate of about 38 percent, slightly better than last year’s 39 percent. About 34 percent of Louisianians are obese, according to the County Health Rankings study.
    An unsettling statistic indicates Avoyelles parishwide violent crime rate is higher than the state average, with 573 violent crimes per 100,000 population compared to the state’s 536 per 100,000.  The report also shows a three-year trend of increased violent crime -- 474/100,000 in 2013 and 527/100,000 in 2014.
    There was also an increase in the rate of injury-related deaths from last year. The parish had a rate of 83 per 100,000 in this year’s report and 71/100,000 last year. The state average is 75/100,000.
    The rate of teen births declined slightly, but is considerably above the state rate, according to the report. The rate indicates that 73 out of 1,000 births in Avoyelles is to a woman aged 15-19.
    There was a significant jump in the incidence of sexually transmitted diseases, from 399/100,000 to 536. The state rate is 594/100,000.
 
Complicated problem
     Dr. David Holcomb, Office of Public Health Region VI administrator and medical director, said his office analyzes the County Health Rankings every year for the central Louisiana parishes. Of particular concern each year are the results in Catahoula, Concordia and Avoyelles parishes. Concordia was 58th in Health Outcomes and 55th in Health Factors out of the 64 parishes. Catahoula was 59th and 58th, respectively.
     “It is a more complicated problem than just saying ‘We need to do this to be healthier,’” Holcomb said. “It is also affected by educational level and income. Unfortunately, Avoyelles has a fair amount of poverty and the education attainment of residents is not as good it could be.”
     Holcomb said a lack of interest and effort is not the problem in Avoyelles.
     “There is a very active parish initiative that meets regularly to try to work out strategies to address these kind of needs in the parish,” he said. “The best results for Avoyelles will require a collaborative effort involving health care providers, the education community and those driving the economic development of the parish. It must have all three involved to be successful.”
     The three priorities addressed in a recent evaluation of the parish was to increase access to health care, increase access to behavioral/ mental health services and economic development.
      Holcomb said the need for mental health care services shows up in statistics which consistently place Avoyelles Parish with one of the highest suicide rates in the state and one of the highest incidence of domestic abuse.
     The statistic for this year shows there is one mental health provider for every 4,589 residents. That compares to an 859 to 1 ratio statewide. The “top 10%” goal nationwide is 386 to 1.
     As distressing as that figure is, it is actually one of the “bright spots” in the report. Last year there was only 1 mental health provider for every 6,939 Avoyelles Parish residents. The 2013 report did not include  the ratio for mental health providers.

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