Montana Health Report

Individual health depends on many factors, but how does where we live influence our level of health?  The Robert Wood Johnson Foundation partnering with the University of Wisconsin Population Health Institute can now tell us just that.  They take it further by measuring how healthy people are all around the United States county by county.  Looking at our entire state the United Health Foundation ranks Montana  25th, putting us in the middle of the pack, while we ranked 12th in 1990.

The health factors Montanans have in our favor include a lower prevalence of obesity than most other states, although still much higher than previously.  The complete 2011 report reveals 23.5 percent of Montanans are now obese (180,000 adults) versus only 15.9 percent a mere ten years ago.  The rate of obesity for non-whites is considerably higher.  With increases in obesity come increases in health complications, one of which is diabetes.  Currently Montana still has fewer diabetics than most states at 7 percent of our population.  Since obesity is a contributing factor in the development of diabetes, our increasing obesity rate may cause this percentage to increase in the future.

Montana can also boast lower levels of air pollution than most other states.  Anyone suffering with respiratory challenges really appreciates our clean air, which can make all the difference in quality of life and be an influencing factor for retirees looking for clean air and a healthy environment.

One challenge Montana faces is a lower immunization rate than most states at only 83.3 percent of children ages 19 to 35 months being immunized against common childhood diseases.  This places our most vulnerable children at increased risk, especially considering that “herd immunity” may no longer provide the protection previously available.  (Herd immunity occurs when people benefit from a lower likelihood of contracting a disease because others around them are immunized.)

The number of smokers in the state has remained the same for the last 10 years at 18.8 percent of adults (144,000 people).  So many preventable illnesses and death are related to smoking that work continues in the public health arena to decrease this number.  

With many of Montana’s employment opportunities in extractive industries or agriculture, we have a high rate of occupational fatalities although lower than at the turn of the century.  

Predictably, there is high geographic disparity within the state.  Around Montana the Bozeman area of Gallatin county ranks first in health compared to Missoula (4th), Billings (Yellowstone county, 14th), Helena (Lewis & Clark, 20th), Great Falls (Cascade county, 21st), and Butte (Silver Bow, 39th).

Rankings by county were made by looking at the programs and policies in place that support health (for example, trail systems encourage exercise, smoking bans discourage tobacco use, etc.).  Then they looked at health factors and ultimately health outcomes.  

To be more specific, rankings were based on programs and policies in relation to the physical environment (the built environment and environmental quality) and health factors (education, employment, income, family and social support, and community safety).  The health factors rankings involved clinical care (both access to care and quality of care) and health behaviors (tobacco use, diet and exercise, alcohol use, and unsafe sex).  These rankings were then evaluated for health outcomes:  mortality (length of life) 50% and morbidity (quality of life) 50%.

Two summary ranks per county were then listed:  health outcomes (how healthy that county is) and health factors (what influences the health of that county).  The mortality ranking was based on a measure of “premature death”:  the years of potential life lost prior to age 75.  The morbidity numbers were for quality of life and birth outcomes combining self-reported fair or poor health, poor physical health days, poor mental health days, and the percent of births with low birth weight. Mortality and morbidity factors were then determined. (Graphic for this on p. 3 of www.countyhealthrankings.org/montana)

While health rankings may be interesting, their significance comes from measuring strengths and weaknesses so improvements can be made.

The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute are providing this information to empower local communities to take steps to improve their rankings.  Their “Roadmaps to Health” project wants to share the encouraging news on what can be done to promote good health everywhere in the United States and provides grants to coalitions and partnerships among policymakers, business, education, public health, health care, and community organizations to improve overall health.  Tools and resources that have proven successful in other areas of the country are freely shared so each location is not trying to reinvent the wheel and funding is available for the best efforts.  

As Margaret Mead would say, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”  If you are interested in learning how to improve your health and that of your family, neighbors, community, town, and county, more information is available at www.countyhealthrankings.org where an action center will provide specific ideas to empower you as well as how to fund those ideas and connect you with others working to improve the health of their communities.

Each of us ultimately make choices every day that enhance or harm our health and can benefit from encouragement and support from our communities to take action in positive directions.  For those of us living in Montana who personally rank us first in quality of life, in addition to role modeling healthy lifestyles, we can come together using the systems developed by organizations like the Robert Wood Johnson Foundation to improve the health and lives of our friends and neighbors in our great state.  Together we can accomplish what is not possible on our own.  Regardless of whatever rankings may show for varying measures, to those of us fortunate to call Montana home, in our hearts we know and love Montana as truly “The Last Best Place.”

Montana’s Overall Health Ranking**

25th out of 50 states

Montana's Best Health Rankings

#6 for Obesity

#7 for Diabetes

#9 for Air Pollution

Montana's Worst Health Rankings

#46 for Annual Dental Visits

#46 for Occupational Fatalities

#50 for Immunization (children 19-36 months)

**Information obtained from the United Health Foundation. 

More detail available at http://www.americashealthrankings.org/

“Montanans excel at healthy lifestyle overall.” 

Dr. Pam Hiebert

“Childhood immunizations are important to prevent life-threatening diseases. At Billings Clinic, we are streamlining immunization reporting and improving our ability to send reminders to busy parents.”

Dr. Michelle S. Pierson, Department Chair of Pediatrics at Billings Clinic

“Bariatric surgery has consistently demonstrated superior weight loss with improvement or remission of virtually all obesity related conditions.” 

David A. Rohrer, MD - Bariatrics, General and Laparoscopic Surgery