Mental health concerns and chronic diseases are on
the rise across the nation, according to the 29th annual ranking from the
United Health Foundation.
December 19,
2018 - Mental health issues, behavioral health concerns, and chronic
diseases are on the rise for individuals in the United States, creating
significant challenges for healthcare providers in many regions of the country,
according to the United Health Foundation’s latest population health report.
Despite some laudable
public health successes and a slight uptick in the number of practicing
healthcare providers, the annual America’s Health Rankings overview
shows that much more work is still required to eliminate disparities and
improve outcomes.
“This year, the
report finds increases in mortality and chronic disease such as obesity that
continue to impact the nation’s health,” says the report, now in its 29th year
of tracking socioeconomic and clinical trends across the nation.
The obesity rate
ticked upwards by 5 percent over the past year, now affecting one in three
Americans.
“This means more
people will likely develop obesity-related chronic diseases like cardiovascular
disease (CVD), diabetes and cancer,” said Dr. Rhonda Randall, chief
medical officer of UnitedHealthcare National Markets, and an adviser to
America’s Health Rankings.
There has been a
concurrent rise of deaths from CVD, with 112,403 more deaths reported in 2018
than in 2015. CVD is most likely to claim the lives of black adults, and
is significantly more common among men of any race or ethnicity than women.
And while the overall
mortality rate from cancer is decreasing, more than 30 states have seen a rise
in cancer deaths or have seen little positive changes since 1990.
In Oklahoma, for
example, cancer deaths have increased by 12 percent during that time
period. In Mississippi and Kentucky, deaths from the condition have
increased by 11 percent since 1990.
Source: United Health Foundation
“Deaths from these
chronic diseases and others contribute to the nation’s premature death rate —
the number of years lost before an individual reaches age 75,” the report
stated. “This rate increased for the fourth straight year, driven by suicide
and drug deaths with 7,432 years lost per 100,000 people this year.”
Drug deaths have
jumped by 25 percent in the past three years, while suicide has increased 16
percent since 2012.
Mental and behavioral health issues
which contribute to these outcomes are also on the rise.
“More Americans are
also reporting poor mental health for 14 or more days out of the last month,
with frequent mental distress now impacting nearly one in eight adults,” says
the study. “In fact, self-reported mental distress measured by the Behavioral Risk
Factor Surveillance System increased 7 percent over the past two years.”
However, the report
does offer some hope. Despite numerous forecasts of provider shortages, the number of
practicing clinicians has increased over the past year. The national rate
of mental healthcare providers has increased by 8 percent, from 218 providers
per 100,000 people to 234.7 clinicians.
Primary care
physicians are also entering the field at a net-positive rate. The nation
has seen a 5 percent increase in PCP availability, with 156.7 provider per
100,000 people now available.
But these providers
are not evenly distributed, leaving some states with significant shortfalls –
and lower scores on measures of wellbeing.
“The national rate of
health care providers is increasing. mental health providers per 100,000 people
is more than six times greater in Massachusetts, the healthiest state for this
measure, compared to Alabama, the state with the lowest concentration of mental
health providers,” the report explains.
Source: United Health Foundation
124 million Americans
currently live in mental healthcare shortage areas, according to the Kaiser
Family Foundation. Rates of mental distress are significantly higher in
rural regions, where access to care is also traditionally more difficult.
“Similar disparities
are found in primary care, as the number of primary care physicians per 100,000
people is three times greater in Rhode Island, the healthiest state for this
measure, compared to Idaho, the state with the lowest concentration,” the brief
continued.
The Health Services
& Resource Administration (HRSA) estimates that an additional 6900 primary
care providers will be required to close the gaps in access to basic health
services.
Many of the
disparities included in the assessment can be attributed to the social determinants of health, the report
notes.
Educational
attainment appears to be a particularly strong predictor of wellness, the study
observed.
“Disparities emerge
among many measures across the states when analyzing health behaviors, clinical
care and outcomes by education level (less than a high school education, high
school graduate, some college and college graduate),” said the report.
Source: United Health Foundation
High school
graduation rates vary significantly between ethnic and racial groups both
between and within states.
“The highest high
school graduation rate for black students is lower than the graduation rate
among white students in 28 states, while the state with the fifth highest
graduation rate for black students is lower than the graduation rate among
white students in 42 states,” said the brief.
While obesity,
physical inactivity, smoking, diabetes, and low birth weight are most common
among those with less formal education, excessive drinking is actually more
common among the college-educated.
Excessive drinking is
most common in the Great Plains and Midwestern states, but is also prevalent in
Alaska, Hawaii, and Massachusetts.
Meanwhile, obesity
and its associated chronic conditions remain entrenched in Appalachia and the
southern section of the country. More than 38 percent of residents in
West Virginia are obese, and 31 percent report habitual physical inactivity.
Fifteen percent of residents have been officially diagnosed with diabetes.
“Contributing factors
[to obesity rates] include poor diet, physical inactivity, social and physical
environment, genetics and medical history,” the report explains. “Populations
that experience a higher prevalence of obesity include non-Hispanic black and
Hispanic adults compared with white and Asian adults, and adults living in
nonmetropolitan counties compared with adults living in metropolitan counties.”
These regions also
experience high levels of tobacco use, higher numbers of children living in
poverty, higher cholesterol and blood pressure rates, lower rates of
immunizations for common preventable diseases, and decreased access to dental care.
The uninsured rate is
also very high, with between 10 and 17 percent of individuals lacking health
insurance in Florida, Mississippi, Georgia, North Carolina, and South Carolina.
Louisiana, which
ranked last in overall health, has an uninsured rate of 9.4 percent, measurably
higher than the nation’s overall 8 percent uninsured rate.
“While these findings
paint a concerning picture of America’s health this year, United Health
Foundation recognizes that federal, local and state leaders are working to move
the needle on these markers and is encouraged by the improvements being made in
communities across the country,” said the study.
On the other end of
the scale, Hawaii was named the healthiest state in 2018, followed by
Massachusetts and Connecticut.
These states ranked
highly on the core measures of behaviors and lifestyle choices, community and
environmental factors, clinical care, and longer-term outcomes.
Overall, the report
reveals a number of opportunities for healthcare stakeholders to engage in
impactful population health management programs to
address chronic diseases, outcomes disparities, and the underlying social
determinants of health.
“We encourage health
professionals, public health officials and elected leaders to use these
findings to explore opportunities to better support people in their communities
in all aspects of their health,” Randall concluded.
https://healthitanalytics.com/news/us-patients-see-rising-burdens-of-mental-health-chronic-disease
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