in Providence.
Effort aims to improve length, quality of life
Rhode Islanders ages 25 to 44 eat fewer fruits and vegetables than any other age group.
Thirty percent of people in the state with household incomes of $75,000 exercise regularly, while only 19 percent of those with incomes of less than $25,000 exercise.
Nearly half of all high school seniors in Rhode Island smoke.
These statistics, and countless more, are contained in a series of recent reports on the health of Rhode Islanders, compiled by the state Department of Health under the umbrella initiative “Healthy Rhode Islanders 2010.”
The reports are an attempt to gauge the state’s overall health status and then sketch a blueprint for improving public health throughout the decade. Similar initiatives were undertaken in the 1980s and 1990s, following a groundbreaking U.S. Surgeon General report in 1979 on health promotion and disease prevention, which created the national “Healthy People” program.
The idea, health officials say, is to start with a baseline of the health of Rhode Islanders. Objectives then are developed to improve the population’s overall health, and strategies are selected to achieve those goals by 2010.
The program’s two overarching goals are to improve the length and quality of life of Rhode Islanders, and to eliminate disparities in the health of different groups of people. For example, health officials would like to eliminate whatever socioeconomic factors determine why 19 percent of Rhode Islanders with a high school education are obese, as opposed to 13 percent of college-educated residents.
An August report from the Department of Health lists the 10 health indicators that combine to reflect the population’s health as a whole. The report breaks them down by age, gender, geographic area, income and education levels and disability. They include:
• Physical activity
• Overweight and obesity
• Tobacco use
• Substance abuse
• Sexual behavior
• Mental health
• Injury and violence
• Environmental quality
• Immunization
• Access to health care
Of those 10 factors, the first three – exercise, weight and tobacco use – largely represent the keys to success, according to Bill Waters, the deputy director of the health department who has overseen the Healthy Rhode Islanders 2010 project. Those three indicators are the most important determining factors of heart disease, cancer, diabetes and other life-threatening illnesses, he said.
“If we want to improve public health by 2010, those are the three indicators that we really need to work on,” Waters said.
But it will be an uphill battle. Past efforts have shown that those indicators are the most difficult to improve.
Why? Because those are the ones that require people to change their own personal habits – to start excising or quit smoking, for example – as opposed to, say, improvements in environmental quality or immunizations, which can be achieved largely through public policy.
“Between 1990 and 2000, we seemed to make the most progress in areas that required environmental or structural changes, but we made the least amount of progress in changing personal behavior,” Waters said. “Behavior change at the individual level is not easy to do.”
The department last month also issued a report that lists the evidence-based strategies and best practices that will be used in an effort to improve the 10 indicators.
One example: reducing the cost of smoking-cessation programs to make it easier for people who want to quit smoking.
The next step: The health department will sponsor a conference on Oct. 30, where a draft of the 2010 plan will be presented to health constituencies from around the state. Waters said the department expects to use suggestions from the conference in the final version of Healthy Rhode Islanders 2010, which he said should be completed by the end of this year.
For access to all the reports associated with the Healthy Rhode Islanders 2010 initiative, visit the health department’s Web site: www.health.ri.gov/ chic/healthypeople/home.htm.
The data used to compile the reports were gleaned from behavioral-risk surveys,
funded via a program from the federal Centers for Disease Control and Prevention,
Waters said.
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