Nevada again rates near last in health

Wednesday, Nov. 15, 2000 | 11:15 a.m.

A national health advocacy group has once again put Nevada near the bottom of the list of states for overall health, only marginally improved from where it was a decade ago.

But the study funded by UnitedHealth Group, a Minneapolis-based health maintenance organization, placed Nevada 45th out of all states for the health of its residents. It is the 11th year that the company has published the annual study, and the 11th year that Nevada has placed near or at the bottom of the list.

The nadir for Nevada came in 1996, when the state placed dead last. The best showing came in 1992, when the state was 43rd. In 1990, the first year of the ranking, Nevada came in at 46th.

The study cited the following factors as contributing to the relative ill health of its residents: high prevalence of smoking, lack of health insurance, incidence of infectious diseases and premature death.

Among all factors the study gives the incidence of smoking the highest weight, said Dr. Mary Guinan, state health officer for the Nevada Health Division.

"We're not going to move out of the bottom until we reduce our smoking rate," said the state's chief health administrator.

The federal Centers for Disease Control reported Nov. 2 that Nevada has the highest rate in the country, with 31.5 percent of the population smoking. In contrast, Utah had the lowest rate in the country, with 13.9 percent smoking, and came in third overall in the health rankings this year.

Guinan said the state needs a comprehensive state program to help people beat tobacco addiction and to discourage people from taking up the habit in the first place.

The state does not spend money to battle tobacco use, she said, and state law does not allow local governments to pass tougher laws to discourage its use.

Kentucky, tied for tobacco use with Nevada in 1999, improved at least in part thanks to state investment in an anti-tobacco program, Guinan said. Kentucky spent $5.5 million, its share of the national tobacco settlement, in a statewide anti-smoking effort this year.

Guinan urged smokers to join the American Cancer Society's Great American Smoke Out, a yearly event that the organization holds to ask people to quit for one day -- and hopefully, forever. Guinan said public health agencies throughout Nevada are supporting the event.

Dr. Donald Kwalick, chief health officer for the Clark County Health District, echoed Guinan.

"The single most preventable cause of all diseases is tobacco use," Kwalick said. Diseases tied to smoking include heart and lung problems, asthma in children linked to second-hand smoke, premature births for infants and an overall decline in the quality of life, he said.

Guinan said the prevalence of smoking can be tied to other substance abuse problems, and the combination contributes to a poor showing in other areas of the health ranking.

The state ranked 47th worst in the nation for prenatal care, defined in the study by visits by expectant mothers to doctors. Guinan said pregnant women who smoke or abuse drugs or alcohol are less likely to visit a doctor, even though government and private-sector programs exist to help those women.

She said the state ranks 15th for infant mortality, indicating that children who are born are more likely to survive than in two-thirds of the rest of the country.

The state health division is studying why pregnant women avoid trips to the doctor and how to encourage them to make those visits, Guinan said.

She said the state also is working to increase access to health care and health insurance for everyone, but particularly for children.

A big part of the problem is that parents usually don't think about the need for insurance for children except when they are sick, Guinan said.

One improvement for the state's young people and infants: the teen pregnancy rate, highest in the nation in 1997, has dropped to fourth in the nation by last year, Guinan said.

A large service-sector economy and short-term construction projects, both big employers in the state, often don't offer health insurance. Kwalick said many workers are young and move in and out of the state quickly.

Authors of the study said it can be a tool to compare services and make improvements where necessary, targeting resources where they will do the most good.

"Health care professionals, public officials, community leaders and individuals can use this information to assist them in spotting health trends, analyzing the effectiveness of state health initiatives, and targeting or refocusing new initiatives designed to improve community and individual health," said Dr. Reed Tuckson, UnitedHealth Group vice president for consumer health.