RE-FOCUS ON HEALTH

By David Blodgett, MD, MPH

SWUPHD DIRECTOR AND HEALTH OFFICER

In our annual report this year, we highlight the leading causes of death in our area (see page 30). COVID-19 has dominated our attention for the last three cold and flu seasons. We will continue to hear about COVID-19 as additional variants make headlines. Additionally, like the flu (influenza), COVID-19 will continue to present a threat to those that are at high risk for a severe infection. However, there are now reliable medications, effective vaccines, and many of us have immunity from infection. The recommendations for avoiding and minimizing the effects of COVID-19, like influenza, will not change. It is wonderful to have so many tools for those at highest risk. However, COVID-19 has not been the leading cause of death in our area. I think it is helpful to remind ourselves of the principles that contribute to good health, that even proved to be important factors of how severe COVID-19 cases were. Heart disease and cancer have been the leading causes of death historically, and continued to be so throughout the pandemic. Even though we have some of the lowest rates of death from both causes of death in the state, it highlights areas where we can focus our attention in the quest to help lead the healthiest life possible. Heart disease has always been the number one cause of death, usually by a wide margin. This last year, however, cancer has caught up with heart disease. Statistically, there really isn’t a difference between the two causes of death in our area. It is a success story of sorts; rates of both causes of death have decreased over the past thirty years, but the rates of decline have flattened out, with heart disease decreasing enough to allow cancer death rates to catch up with heart disease. Unfortunately, this good news doesn’t reflect fewer people being diagnosed with - and living with - heart disease and cancer, but shows that better treatments are keeping people alive longer with those diseases. In fact, if you look at the indicators that reduce chances of chronic disease, they are headed in the wrong direction. I’d like to remind you of the four factors that would reduce chronic disease by 60 percent:

FACTOR #1: CIGARETTE SMOKING STATUS

Our area has very low rates of smoking, at 7.6% for adults.

Even better, only 2.6% of our high-school aged teens use tobacco. Unfortunately, 25% of high school students report experimenting with e-cigarettes, while 8% report using e-cigarettes on a regular basis. We have much lower rates of cigarette smoking than the national average, which contributes to the overall good health status of Utahns when compared with the rest of the country.

FACTOR #2: EXERCISE FOR 150 MINUTES A WEEK

Our district also does very well in this category, with 69% of those questioned reporting that they met the standard. This is significantly higher than the Utah state average of 55% and the US average of 50%. Additionally, high school students reported the second highest rates of exercise in the state. The benefits of exercise are well established and far reaching in improving overall health and well-being. If exercise is part of your daily routine, I salute you! If it isn’t, adding it - even in small amounts - will be something you won’t regret.

FACTOR #3: FRUIT AND VEGETABLE CONSUMPTION The standard calls for 4.5 servings (1 cup-sized) of fruits and vegetables per day. Our area meets this requirement at about the same rate as the rest of the state and nation, which isn’t good, at 12%. When you probe a little deeper and find out how many of us eat even two servings a day, only about 33% make the mark. Unfortunately, low rates of consumption of fruits and vegetables contributes to the fourth factor, which is obesity rates.

FACTOR #4: MAINTAIN A HEALTHY WEIGHT

Obesity, defined as a BMI (body mass index) over 30, has been increasing rapidly. Being overweight, defined as a BMI over 27, has been increasing even more rapidly. While our area’s rates of obesity at 26% are lower than the rest of the State at 30%, it is still an alarming statistic. Obesity contributes to diabetes, a rapidly increasing risk to health and well-being, heart disease, cancer, and many other chronic conditions. Roughly 2/3 of all of us are overweight or obese. Abundance has made it more difficult to maintain this standard. In high school-aged youth, rates of obesity are also increasing, with about 10% considered obese. So, what percentage of us are able to report meeting all of the four factors? About 10%. The reward for doing all of the four factors is a reduction in the risk of chronic disease by 60%.

BONUS FACTOR #5: ADEQUATE SLEEP

HEALTH Magazine has featured several articles in the past few years about how chronic sleep deprivation contributes to a wide range of negative health conditions. Our young people seem to be taking on the bad habits of their parents by not getting enough sleep, which can begin to negate the benefits of the first four factors of healthy living. You’ll be hearing more from us on the vital role of getting enough sleep in the near future.

Moderation continues to be the best policy for good health, as it is for most things in life. I was intrigued to hear that a new term has been coined; “orthorexia”, which is an obsession with eating healthy. It turns out you can do too much of a good thing. I think it is easy to think that we need to go above and beyond common sense guidelines for wellness, but the evidence shows that small, simple changes yield the largest benefits, while going to extremes can be counterproductive. The most benefit is realized during the first 30 minutes of exercise; the return on investment after that decreases, with extreme amounts of exercise actually causing damage rather than improving health.

Given the likelihood that few of us are doing all four of the factors outlined above (plus getting adequate sleep), imagine the dramatic improvements we would see in the health of the community, decreased health care utilization, and individual quality of life if we each made it a priority to add the missing factors until we were living all of them most of the time.

As a community, we put in a tremendous effort to respond to COVID-19. Never before has such a large-scale response been attempted, with so many resources devoted to one health issue. As we consider what our priorities should be as we look to the future, perhaps re-focusing even a portion of that effort towards improving these simple lifestyle habits would do wonders for the long-term health prospects of humanity.