Statistical data over the past several years has shown a direct correlation between socioeconomic status and general health and the same is true for Montcalm County, which ranks in the bottom third in median household income
But despite serious health concerns in the county, Mid-Michigan District Health Department Director Dr. Marcus Cheatham said Montcalm County is “doing better than it should looking at the data” in overall health, where it ranks in the top half (27th) of Michigan counties in 2013, according to data collected by the Robert Wood Johnson Foundation, who conducts a national study. The county was 37th the prior year.
The health ranking came as a slight surprise to Cheatham, who said when looking at the economic data of the county, Montcalm should rank lower.
“Social and economic conditions drive health. Other things matter too, but at the root of it all is our ability to take care of ourselves and our family’s social and economic conditions,” he said.
And Montcalm County doesn’t fair well against the rest of the state economically.
Montcalm County’s unemployment rate (around 15 percent) is higher than the state average (12 percent); college graduation rates in the county (around 13 percent) are half that of the state rate; the number of residents under the poverty level (around 18 percent for Montcalm) is around two percentage points higher than the state; and the county’s median household income of $40,000 is around $8,000 less than the states median.
The correlation and what it means
Citing data from the Robert Wood Johnson Foundation study, Cheatham said the rates of chronic diseases such as obesity and diabetes in the county trend right along with education and income levels; the lower the income, the more likely someone is to be obese.
Typically those with lower incomes and less education are more likely to be without health insurance, thus not having access to care, officials said. They are also unlikely to eat properly, exercise or in some cases even have transportation to health services.
“This (the correlation) is due in large part to lack of access to health care and/or healthy lifestyle choices,” said Jodie Faber, United Lifestyles executive director. “Healthy food tends to be more expensive and requires knowledge of proper preparation. It is very difficult to educate when people living in poverty do not have the basic adequate food preparation supplies such as a stove, hot water, refrigerator, pots and pans, can openers, etc.”
And on top of that, data shows those with lower incomes or living in poverty tend to be less active.
“They do not have access to healthy physical activities outside their homes,” Faber said. “In many cases, people do not have transportation and that is a huge barrier to adequate health care and limits their access to food and physical activity.”
But despite the information, Montcalm County ranks relatively high in over health when compared to the rest of the state.
“These correlations like this, between the household income and health outcome rankings are very high and very strong from a statistical perspective,” Cheatham said, except when it comes to Montcalm County. “We actually are not among the unhealthiest counties in the state. We are in the good half, just barely, but we are in the good half, which is just remarkable.”
But he did offer a reason for Montcalm County bucking that trend.
“I think our problems are relatively recent. We do not have generations of poverty here. The factories just shut relatively recently. We had a lot of folks with good union jobs with health care, all that kind of stuff,” he said, which shows promise for the area. “I think we can come back and turn the corner before too much damage is done.”
Health concerns still exist
While it ranks in the top half of counties in the state in overall health, Montcalm County still has relatively high rates of chronic diseases such as obesity, diabetes and high cholesterol.
Compared to the rest of the state, Montcalm County has higher rates of several different chronic conditions.
Nearly 33 percent of Montcalm County’s residents are considered obese, compared to less than 31 percent statewide.
“This is really at the root of our chronic disease problems,” Cheatham said.
The county also has higher rates of diabetes (9.7 percent) than the state (9.4 percent) and high blood pressure (36 percent compared to the state rate of 30 percent).
“Chronic disease is our main challenge and we really have to focus on getting healthier,” Cheatham said.
The leading cause of death in Montcalm County in 2009, the most recent data, is heart disease at just more than 24 percent of deaths. Cancer is the second leading cause, also just around 24 percent. The health field, however, has improved to the point where heart disease mortality rate in Montcalm County has dropped from 264 deaths per 100,000 in 2000 to 206 in 2011.
What can be done?
When looking at how best to improve the county’s health, Cheatham said the strategy is pretty clear, get to the root of the cause.
“Over and over again, education makes a huge difference. And then the same thing for income,” he said. “In order to move the dial, we need to focus on those who are most vulnerable.”
He said goals like increasing the number of primary care providers, adding school health-based programs, reducing substance abuse, promoting healthy eating and improving mental health services can all help greatly.
“We need to get to the root cause of the problem, income, education and employment,” he said.