Major gains, some setbacks in local health status during past decade
This article first appeared in the St. Louis Beacon, Dec. 4, 2012 - Overall health conditions in St. Louis and St. Louis County have improved in the past 10 years, with the city outpacing the county in a few areas, according to a report released by the St. Louis Regional Health Commission. While acknowledging that health disparities remain widespread, the report notes that some city-county and black-white gaps have eased somewhat due to more access to care.
The document, "Decade Review of Health Status," was developed through a joint effort by Dr. Dolores Gunn, director of the St. Louis County Health Department, and Pamela Walker, director of the St. Louis Department of Health.
Posted on the commission's website, the report is a review of community progress in improving the health status of city and county residents since the release of a similar document in 2003. In addition to being used to guide health initiatives, the data will be a starting point for community conversations in the coming year about health issues and how to address them, says Robert Fruend, CEO of the RHC.
“We see substantial improvements in health,” he says. “Although there is much to celebrate as we look back, there is still a long way to go until health equity is achieved.”
Among information that might surprise some is the fact that the number of poor female-headed families declined in St. Louis between 2000 and 2010, but the number of such families has increased by 56 percent in St. Louis County, the report says.
It also noted that while unemployment rates remain consistently high in St. Louis, the number of jobless people fell in the city between 2000 and 2010, but the number rose in St. Louis County.
• The city and county have experienced sharp drops in deaths attributed to chronic health conditions, such as heart disease, stroke, diabetes and cancer.
• Although the region has seen gains, the trends in obesity, tobacco use and physical inactivity continue to be problems. These trends are worth watching and addressing because they are associated with many social determinants of health, the report says.
• While the negative health outcomes generally remain more prevalent in the city, the city-county gap in some health conditions has narrowed.
For example, the study said overall mortality rate for heart disease fell 29 percent between 2000 and 2010. The drop was most pronounced among white women. Their rate dipped from 226.4 for every 100,000 in 2000-01 to 150.3 in 2009-10. For white men, the mortality rate was 337 for every 100,000 in 2000-01 and 241.9 in 2009-10. For black men the rate dropped from 472.6 in 2000-01 to 333.2 in 2009-10. But the decline was not nearly as steep for black women. Their rate fell from 296.3 to 228.5.
Diabetes continues to be a serious problem in St. Louis and St. Louis County, especially among blacks, the report said. It pointed to a 3.7 fold difference in mortality rates between black men (42 for every 100,000) and white women (11 for every 100,000) in 2009-10.
Uncontrolled asthma also remains a big problem in north city and north county, the report said. But the rate of hospitalizations for asthma among children on Medicaid fell between 2000 and 2009, and the number of emergency visits among people on Medicaid dropped about 5 percent.
The declines point to a difference resulting from access to primary care mainly through health clinics, Fruend says. He says this access has led to an additional 120,000 more patients in clinics in a decade.
“That’s the take away in this report – the improvement in health-care coverage, and the health gap between the city and county is narrowing. However, disparities still exist and we need to address them.”