As the Affordable Care Act — better known as Obamacare — moves forward, local health entities are being pressed to meet certain mandates to keep their nonprofit status.
One of these is a community health assessment every three years.
This year’s results, compiled by the Flathead City-County Health Department, Kalispell Regional Healthcare and North Valley Hospital, point out some interesting local health issues.
County health officer Joe Russell said it was a first for the data to be collected by all three.
“For us, this is a seminal event,” he said. “This is the first publishing in junction with the hospitals. It was generated through focus groups that looked at at-risk populations.”
The most interesting data might be the rates and causes of death.
Flathead County’s mortality rate of 8.6 per 1,000 people is less than Montana’s 9 but higher than the national rate of 8.13.
Heart disease and cancer are the leading killers in the Flathead, Montana and the United States.
Where the numbers get noteworthy are the next-leading causes of death.
Montana and Flathead County suffer from an unusually high rate of accidental death, making that the third leading killer. National numbers are 38.4 per 100,000, while Flathead’s 50.2 is dwarfed by Montana’s 62.8.
Flathead County motor-vehicle-related deaths exceed the state’s rate, however: 33 in the Flathead versus 25.5 statewide.
Suicide is the sixth-leading cause of death in Flathead County. Montana, the state that has suffered the most suicides per capita for the last 30 years, chalks up self-inflicted death at eighth while the nation is 10th. This means that even in disproportionately affected Montana, Flathead County sees a high rate of suicide.
“Flathead County, in some ways, sets the standard,” Russell said. “We have very high rates and we’ve invested public health funding toward suicide. The biggest thing is early detection awareness.”
The assessment estimates 24.5 Flathead residents per 100,000 people will commit suicide in the next year, compared to Montana’s 22.3 and the country’s 12.
It gets bleaker.
“The number of completed suicides each year is a small representation of those who have attempted suicide,” the document reads. “For every one completed suicide, there are approximately 25 attempts at suicide.”
That means the Flathead can expect around 612 suicide attempts this year. Men are more likely to complete the act, while women are more likely to try. More than half involve a firearm.
In better news for the county, Alzheimer’s death rates are well below both state and national levels. Only 19 people per 100,000 will die from the dementia-related disease a year, compared to Montana’s 26.2 and the U.S. rate of 25.7.
Flathead County also beats national and state rates on many other key factors, including heart disease, cancer, chronic lower respiratory diseases, strokes, diabetes, obesity and smoking.
However, Flathead residents are more likely to die from influenza and pneumonia than both Montanans and all Americans. That’s despite a high rate of yearly vaccination against the two diseases.
Liver disease and cirrhosis rates are high in Montana, with 14.2 per 100,000 in the state dying from one of the maladies. Flathead dips a bit to 12.3, but still well ahead of 9.9 nationally.
This, in part, comes from the Flathead’s rate of “heavy drinkers.”
The local rate of heavy drinking (men drinking more than two drinks a day and women more than one a day) is 6.5 percent, well above Montana’s 5.3 and the nation’s 5 percent. The rate of high school students who drink in the Flathead is 37.6 percent, less than the national 39 percent, but more local teens binge drink (25.3 percent) and drink and drive (10.6 percent) than in the country as a whole.
Russell said this is a socio-cultural facet of the Flathead. Drinking and driving do not have the stigma they should. He tells a story of a Montana Tech student killed in a drunk-driving accident and how that changed the hard-drinking, hard-driving culture in Butte. He said that it may take a tragedy like that to have the same effect in Flathead County.
Binge drinking in the Flathead — imbibing in five or more drinks on one occasion for men and four or more for women — is actually lower here than in the state and nation.
Residents of the Flathead beat Montana at large but fall below the national level in rates of colonoscopies and mammograms, but beat both in women’s pap tests.
As for sexual health, the Flathead misses marks here as well.
The rate of teen pregnancy in the county soars above the state and national rate. For every 1,000 teens in Flathead County, 57.1 will become pregnant, compared to Montana’s 48.8 and the United States’ 39.1.
“Those numbers are actually going down,” Russell said. “If your teen population is sexually active, you are going to have some teen pregnancies, that’s just a fact.”
The health of babies in the county beats Montana handily. Flathead babies receive more prenatal care in the first trimester and are born low weight and preterm far less than their statewide counterparts.
The sexually transmitted infection chlamydia is also prevalent in county, with 287 cases last year.
“This may sound self-serving,” Russell said. “But we are a very high-reporting county. We have a great relationship with our clinical labs. The numbers may look high, but a lot of that is because our detection is so good.”
Montana ranks 48th in immunization rates. The state only beats the national rate in just one category: a Tdap booster for adolescents. In some categories, such as the meningitis booster for adolescents, the national rate of 70.5 percent dwarfs Montana’s 39.8.
Russell said these rates are slightly misleading.
“Among school-age children, those numbers go up to 94 or 95 percent,” he said. “It is just that there are some difficult populations to reach and those numbers go down.”
Russell said this data will be helpful for the county and the hospitals as they look at the health of the community.
“We are going to use this data to develop our own public health strategic plan,” he said. “I know the hospitals are doing it too.”
Reporter Ryan Murray may be reached at 758-4436 or by email at firstname.lastname@example.org.