Las Vegas Sun

March 29, 2024

Nevada poorly ranked in health study

Eight-year-old Paulina Garcia can tell you about the University Medical Center's emergency room.

"It's really big and far away," she said Tuesday.

As happens with many children from poor families in the Las Vegas Valley when they are sick, Paulina and her brother, 5-year-old Vidal, were taken to UMC for years when allergies gave them coughing fits and trouble breathing every winter.

A new report says there are more children in poverty like the Garcias all the time in Nevada and that, with other measures of health, brought the state to 37th worst in the nation this year in overall health, down from 36th last year.

The ranking brought reactions ranging from "it could be worse" to alarm about worsening economic conditions that could make it harder in the future for many Nevadans to stay healthy.

The report, called "America's Health: State Health Rankings," says that the number of children living in poverty in Nevada was at 14.8 percent in 2004, up from 9.1 percent in 2003. Prepared by the United Health Foundation and two other groups, the ranking has been compiled for 15 years.

Though Nevada's overall ranking was low this year, the state ranked particularly low -- in the bottom fifth -- in six categories: motor vehicle deaths, violent crime, lack of health insurance, adequacy of prenatal care, cancer deaths and total mortality.

The growing number of children living in poverty dropped Nevada's ranking in that category, one of 18 the report measures, from seven to 24.

Tom Eckstein, one of the study's authors, said high childhood poverty rates "tend to be linked to poor health ... (and are) a strong social determinant in health outcomes."

As for the other categories, though the state dropped in ranking for some, the actual numbers behind those rankings didn't change much in most.

For example, the number of motor vehicle deaths -- or deaths per 100 million miles driven -- remained at two in 2004 and 2003. But the state's ranking dropped to 41 this year from 40 last year, apparently because of improvements in the numbers of other states.

Similarly, total mortality -- or deaths per 100,000 -- went down slightly in the past year, to 934.4 from 941.5, and Nevada remained ranked at 42nd both years.

The relative stability in numbers caused several local health experts to note that things could be worse.

"It would appear to me that even though our numbers aren't that good, they're not increasing at the level of our population, so we've managed to create some stopgaps," said Fran Courtney, director of clinic and nursing services for the Clark County Health District.

Merlinda Gallegos, who works at the Chung Ying Tang Foundation, a local nonprofit group concerned with public health, said, "optimism says we have to celebrate what's improving."

She pointed to another category listed in the report that has shown slight improvement since last year: the percentage of the population that smokes. The percentage of smokers dropped slightly from 26 percent to 25.2 percent. The state's ranking in the category also improved, coming in at 37, compared with 38 last year.

Gallegos said public health campaigns have helped with that issue.

Gallegos used to work with United Way and helped design the 2003 Southern Nevada Community Assessment, a comprehensive look at health and other problems in the region.

According to that report, mental illness was one of the key issues facing the valley. Gallegos said psychological health should also be considered in the United Health Foundation's state-by-state ranking.

Other experts said that the ranking showed a need to focus more on the future of the state: its children.

They said the rising percentage of children in poverty, together with the low ranking given the state for prenatal care, were causes for concern.

Nevada ranked 41st in prenatal care, with 69.7 percent of pregnant women receiving enough medical attention. Those numbers were a slight improvement over last year, when 68.2 percent of pregnant women received care before giving birth.

"We're still not a state that cares about our children," said Barbara Ludwig, a consultant for the health district who works on school-based health clinics.

Ludwig said that obtaining adequate health care will likely become more difficult in the future for many people who come to the valley and take jobs that pay little and lack benefits.

Donna Coleman, director of the Children's Advocacy Alliance, a nonprofit organization, said rising housing costs will also affect the ability of working families to obtain health care.

"As housing gets more expensive, we're killing the people who are the backbone of our economy, the service and construction workers," Coleman said.

"Two parents making minimum wage used to be a good living; it's not anymore," she said.

"People can't afford to take care of their children's health," she said.

Carmen Chavez, Vidal and Paulina Garcia's mother, knows about struggling to keep her children healthy.

Her husband, Tomas Garcia, is the family's sole breadwinner, with a $7-an-hour job as a carpenter's assistant.

Chavez, who also has three children 18 and older, now takes her younger children to the school-based clinic at Roy W. Martin Middle School, one of Ludwig's projects.

Vidal and Paulina get monthly check-ups and free medicine at the clinic and no longer suffer from bronchial attacks in the winter, Chavez said.

The clinic is paid for with tobacco settlement money, private funds that are distributed by a state task force.

But Chavez remembers well the nights she was in an emergency room until 1 a.m. and walked away with prescriptions costing $21 a month.

"It's sad ... not being able to do anything for your children," Chavez said.

"What can you do? Where can you go?"

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