A quarter of adults in Ulster County smoke tobacco, compared with 14 percent nationally and 18 percent in the state. Smith noted the figure had improved slightly, to 24 percent, in 2013. Some 27 percent of adults are obese, compared to 25 percent nationally and statewide. In Ulster County, 23 percent engage in excessive drinking, compared to eight percent nationally and 17 percent in the state, a number that increased to 25 percent in 2013. The death rate from motor vehicle crashes was 14 percent, compared to 12 percent nationally and eight percent for the state. Sexually transmitted infections, at 211, was below the state number of 472. The teen birth rate, at 20, was also below the state number of 27. Finally, the ratio of primary-care physicians was 721:1, compared to 689:1 for the state and 631:1 nationally.
Although 19 percent of Ulster County residents had limited access to healthy foods in 2012, compared to 4 percent for the state, that number has been dramatically reduced to 6 percent for 2013, a tribute to the expansion of farmers’ markets, Smith said.
The county continues to earn lackluster marks in the Priority Health Indicators Comparison report card, a benchmarking mechanism set up by the UCDOH in 2010: a C for Access to Health Care, a B+ for adolescent smoking, a C- for adult smoking, an F for obese and overweight children and adolescents, a C for obese/overweight adults, a D for vaccination of adults age 65 and over, Bs for coronary heart and stroke deaths, a D for breast cancer deaths, a D for infant deaths, a C for motor vehicle crash deaths, and a B for air quality, a new category.
Poor water quality?
Though not listed on the chart, Smith said the county also did poorly in another new category, drinking water safety, with 37 percent of water-quality samples purportedly in violation. She questioned this result, noting that municipal water systems must comply with federal and state environmental drinking quality standards, and speculated the number is related to test samples being handed in late or some other factor unrelated to water quality.
“Some of the data is questionable,” she said, noting that the University of Wisconsin and Robert Wood Johnson numbers were based on a survey of 500 people, a small sample for a county population of 183,000.
According to the results of a 2011 Ulster County BMI (Body Mass Index) study of children, the numbers steadily increase as children get older, beginning with 32 percent of first-graders being overweight or obese and culminating in 60 percent of adolescents being overweight or obese. Smith said the county has responded to the problem by requiring chain restaurants to post the caloric values of their meals.
Substance abuse, which is often tied to mental illness, is a dire health threat. It is also expensive, with drug abuse costing the country an estimated $600 billion and alcohol abuse costing the nation $224 billion (a chart projected by Smith also listed other types of drugs, including prescription drug abuse, which had no associated cost listed). A survey conducted among seventh- through 12th-graders in 2012 by the county-funded Ulster Prevention Council indicated decreasing use of alcohol, cigarettes, and illicit drugs by youth since 2008, although Smith noted the findings had been based on self-reporting by teens. Marijuana use was level, with the incidence of use hovering around 26 percent.
The informal findings are intended to plant the seeds for an assessment of the county’s health challenges, in preparation for the plan to be submitted to the state in November. Smith promised a follow-up meeting in the early fall to track the county’s progress and refine strategy. She also encouraged participants to invite people affected by these problems to the meeting. “We welcome bringing high-risk people to the conversation,” she said.
