BENNINGTON >> Vermont remains the second healthiest state in the Union for the second year in a row, behind Hawaii and ahead of Massachusetts.
Vermont has a low population of uninsured, as well as low violent crime, and infant mortality rates. Keeping it down are health statuses due to education levels, a high prevalence of excessive drinking, and whooping cough, according to a report from the United Health Foundation released in December.
"This report is something to celebrate for the state, because a lot of initiatives that occur, don't occur just county-by-county," Dr. Trey Dobson, Southwestern Vermont Medical Center's chief medical officer said, "and so you can't break up populations by county when you're looking to do change. So I do think this is something to celebrate. We've done extremely well."
Tobacco use, physical inactivity, obesity and substance abuse are also among the threats Vermont faces. About one in five adults, or 19 percent in the state don't exercise, compared to the 22.6 percent nationally, while 16.4 percent of residents smoke versus the 18.1 percent nationally. The report's Healthy People 2020 Goal proposes the smoking rate will decrease to 12 percent in five years.
"Every specific location has its challenges, and most always that's attributed to socioeconomic situations," Dobson said. "All counties have areas that they're weak and strong in. Bennington has a lower socioeconomic rank. That has to do with the health trends."
For Bennington County, the rate at which teens are birthing children is eight percent higher than the state's overall percentage of 19. Children in poverty is a similar issue in the area sitting at 21 percent while the state average is 15 percent. One being a health behavior and the other a socioeconomic factor.
"Obesity and tobacco use are the main drivers. What we have to do is start realizing we can affect people's choices," Dobson said. "If you're working hard to make ends meet and you don't have much time to go to store with kids and see candy at the checkout. We can affect that by helping people choose better."
In "Giving All Vermonters a Fair Chance at Health," state commissioner of health Harry Chen said that people living in Chittenden, Washington and Addison counties are healthier than those in Essex, Orleans and Bennington counties. Health behaviors and socioeconomic differences divide these sectors.
Hawaii remains number one, and has sat in the top six since 1990 because it has low obesity rates, few mental health days, and low rates of preventable hospitalizations. On the contrary, Hawaii still scores low for immunizations among adolescents for the DTap vaccine and above the national average for excessive drinking and Salmonella presence.
Other national challenges include obesity, diabetes, drug deaths, children in poverty, and premature deaths. Over the past two years, obesity increased 7.2 percent from 27 to 29 percent, whereas in 1990, it was less than 12 percent of adults who were overweight. The same trend is true for diabetes in which 10 percent of adults self-reported, and 20 years ago it was 4.4 percent of the adult population.
Overall, Dobson thinks that tobacco use is the country's number one challenge as well as in Bennington.
"Cigarette smoking: It's going to be the number one or two cause of death, disability, and premature leaving the workforce, and an incredible amount of health care dollars," he said.
In order to make progress on the challenges Vermont currently faces, Dobson urges to make healthier options easier and less expensive as well as to recognize the main challenges.
"One of the reasons we're at the top healthiest in the country is because we have effected that choice and have put in local foods. But we can do more," Dobson said. "Anything that we can do to help people to make the choices to not smoke and the choice to eat healthier and easier for them to do, it's going to help those metrics."
Chen suggests acknowledging that health care does not equal health.
"It is estimated that only 10 percent of what determines our health results from care provided in doctors' offices and hospitals," Chen said in his opinion piece. "While genetics certainly plays a role, the greatest determinant of health by far is behavior: what we eat, whether we exercise, smoke or drink, if we text and drive, use our seat belts, etc."
A new health project, Health in All Policies (HiAP) informs individuals about the health, equity and sustainability consequences of policy options during development process. This way, aspects of life are analyzed in how an individual is impacted, such as transportation, land use, housing, education and agriculture.
"The goal is to built a culture of health in our state and assure a healthier future for all Vermonters," Chen said. "Our culture highly values individual choice and resists limiting it. If there were no candy at the checkout counter, we'd buy less candy."
Recent initiatives to fulfill the state's goal include a Farm-to-School network, work site wellness programs, and the state government's commitment to purchase healthy and local food, according to the article.
More than 50 percent of all deaths are caused from cancer, heart disease/stroke, lung disease and diabetes, which are all a result of poor nutrition, physical inactivity and tobacco use.
"This is truly a life-or-death issue," Chen argued. "We must take on the challenge of building and reinforcing a culture of health in our policies and decisions in government and in our communities all across the state. We can't afford not to do this."
Makayla-Courtney McGeeney can be reached at (802)-447-7567, ext. 118.