Poor health rooted early in life

Residents of Grays Harbor County have shorter lifespans than any other county in the state. Local health officials say the key to reversing the trend is focusing on the early development of children age 2 and younger, instructing the parents of young kids how to spot the signs of normal childhood development and giving those parents the tools to provide their children with an environment that will lead to a healthier lifestyle as they grow.

“What we have to do is look below the surface, and the underlying, real causes of premature death,” said Grays Harbor Public Health and Social Services Director Karolyn Holder. “We’re looking at what’s behind the causes of unhealthy behavior.”

The life expectancy for men and women in Grays Harbor County was 76.61 years in 2014, compared to the state average of 79.99 years and the national average of 79.08. The county’s life expectancy actually dropped by .05 years from 76.66 in 2013, a rare decline after decades of slight improvement.

The study calculates the average life span and also points out the risk factors that can lead to an early death for each county in the nation.

“Looking at life expectancy on a national level masks the massive differences that exist at the local level, especially in a country as diverse as the United States,” explained the report’s lead author Laura Dwyer-Lindgren. “Risk factors like obesity, lack of exercise, high blood pressure, and smoking explain a large portion of the variation in lifespans, but so do socioeconomic factors like race, education, and income.”

ACEs

Local health officials say the way to boost the health of Grays Harbor County is to focus on children from birth to about 2 years old, instilling them with a healthy lifestyle while their brains are still developing. It is also important for parents of young children to realize the environment they provide their children has an impact on their health that can span generations.

“We have something we call ACEs,” said Holder. “Those are Adverse Childhood Experiences, and they have a lasting effect when experienced by developing minds.”

For parents of young children, it is critical for their overall health and development that they be in an environment they perceive as safe. If they witness physical violence, emotional abuse, negative health habits, fights, anything that puts them in fear, makes them feel unsafe, can lead to negative health outcomes in the future, according to Holder.

Holder said their Parents as Teachers program helps parents of young children “understand what normal child development is. We provide support to help them identify proper development and help guide them into more healthy behavior.”

The program, in its third year, currently helps about 75 families. Space in the program is very limited, as it is an intensive two-year course that requires not just a great deal of commitment from case workers, but from the parents themselves. For more information about the Parents as Teachers program, call the Grays Harbor Family Support Program at (360) 500-4065 or visit ghfamilysupport.org.

“We have our first mother graduating the program this year,” said Holder. “When she started she was living under a bridge and had lost her children. Now she is getting her kids back and is even enrolled in college.”

Adults and ACEs

Beth Mizushima, Deputy Director of the Grays Harbor Public Health & Social Services, pointed out a graphic from the department that showed the number of adults in the county with three or more Adverse Childhood Experiences in their past. The number ranges from 31 to 51 percent throughout the county, compared to the statewide average of 25 percent. The numbers vary widely by community; the highest occurrence can be found in more isolated areas in the county, including Moclips, Taholah, Quinault and Neilton to the north, and Elma, McCleary and Oakville in the southeast part of the county. More populated areas, like Aberdeen and Hoquiam, average 21 to 33 percent, while the southwestern most part of the county came in even lower at around 25 percent.

The early experiences create adults who are more likely to perpetuate the same level of fear and instability for their own children, who then pass it down to their children. “And these types of behaviors tend to cluster,” said Holder, as the history of unhealthy behavior is handed down from generation to generation.

Unhealthy behavior

A direct connection between an unstable environment as a young child can be made to unhealthy behavior. The obesity rate in the county is very high; according to the study, 39.14 percent of men in the county were obese in 2011, up substantially from 28.77 percent in 2001. In women, the rate has gone from 33.73 percent in 2001 to 42.83 percent in 2011, far above the state and national average.

Smoking rates in Grays Harbor County are well above state and national rates. Among all men in 2012, 28.14 percent smoke, while the state average is only 19.44 and the national average sat at 22.16. This is only a slight decrease from the 1996 numbers, but statewide and nationally smoking rates dropped significantly over the same time period. Diabetes rates among men and women have also increased significantly, from just under 11 percent in 1999 to just under 15 percent in 2012.

Hope matters

When it comes to overall public health, “Hope matters,” said Holder. This is especially true in low-income populations, she said. “If you have to worry about if you’re going to be safe walking to the bus in your own neighborhood, if you have to worry if your car is still going to be parked where you left it the night before when you get up for work,” she said, and other factors like lack of a nutritious food and even a positive peer group lead to bad health choices and lower life expectancy.

Medicine vs. Health

“People aren’t purchasing health, but health care,” said Holden. She explained, when a person visits a physician it’s because of an illness that is identifiable and often treatable. But the root of the problem, what caused the ill health in the first place, is often left unexplored.

Grays Harbor County is woefully short on primary care physicians. And, while the state is ahead of national averages in many categories, even it hasn’t reached the national benchmark goal of 93 physicians per 100,000 population; the state in April of last year sat at 84 physicians per 100,000, while Grays Harbor County had only 45.

“It’s probably even worse now, with the number of doctors we’ve seen leaving just recently,” she said.

It could be worse

Some shocking numbers came out of the recent Institute for Health Metrics and Evaluation report. Oglala Lakota County, South Dakota — a county that includes the Pine Ridge Native American reservation — revealed the lowest life expectancy in the country in 2014 at 66.8 years, comparable to countries like Sudan (67.2), India (66.9), and Iraq (67.7).

Clusters of counties with low life expectancy were also identified in Kentucky, West Virginia, Alabama, and several states along the Mississippi River. Several counties in these states and others saw decreases in life expectancy since 1980, while much of the country experienced increases.

it could be better

However, a cluster of counties in Colorado had the highest life expectancy in the U.S., with Summit County topping the list at 86.8 years, followed by Pitkin County (86.5) and Eagle County (85.9). By comparison, at the country level Andorra had the highest life expectancy in the world that same year at 84.8, followed by Iceland at 83.3.

Help is available

Dozens of professionals working in numerous programs in the county that can help individuals and families get back on the road to health. These can be anything from help with family planning to food to mental health issues. A list of programs and how to apply can be found at HealthyGH.org.