Last week the Robert Wood Johnson Foundation released the annual county health rankings. Whatcom County was ranked as the fifth-healthiest county in Washington. At first glance, a ranking of fifth out of 39 counties seems like a wonderful accomplishment. And it is. What the overall ranking conceals, however, is the fact that we have vulnerable populations who are at increased risk for poor health outcomes.
We can be proud of what Whatcom has provided in the way of public health resources and opportunities for many in our population. But we can't sit on our laurels and forget that many of our most vulnerable citizens don't share in this good fortune. Research shows that health outcomes are directly linked to income. For instance, those with an annual household income less than $20,000 have higher rates of obesity and diabetes. Our rate of diabetes is six percent overall but 10 percent for low-income residents. And 36 percent of our low-income residents are obese compared to 26 percent overall. According to the rankings, the percentage of Whatcom County children living in poverty rose from 16 percent in 2012 to 18 percent in 2013. We can expect that as childhood poverty increases so will the likelihood that more Whatcom County children will experience poor health outcomes.
It is essential that the community as a whole identifies and addresses priority issues with the goal of improving health for all Whatcom County residents, especially the most vulnerable and those with the poorest health outcomes. For example, while our overall rate of premature death is improving, American Indians and blacks in Whatcom County are still more likely to die early. Our goal may not be easy to reach, especially when we are living in a time of declining revenues at local, state and federal levels. But working together we can achieve the goal of better health for all.
Whatcom County Health Department and Peace Health St. Joseph Medical Center are leading an effort along with many community partners to develop a Community Health Improvement Plan for our county. Community leaders completed an in-depth review of available health data and obtained input on health issues people believe are most impacting community members. As a result of this work, four strategic priorities emerged to address some of the gaps in our current system.
First, we must support healthy child, youth and family development. All families must be strong and stable with children who enter school safe, healthy and ready to learn so that they graduate from high school prepared for bright and healthy futures. We know that educational achievement is a critical factor for health outcomes and that those with more education are more likely to have good or excellent health status.
Second, place matters when it comes to health. For example, those residing in rural Whatcom have higher rates of obesity. Therefore, we must promote healthy, active living by ensuring that all people live in safe and affordable homes with opportunities for healthy active lifestyles nearby.
Third, we must ensure that health care is available for vulnerable populations. All people, especially those with complex needs, should have access to essential health care services and receive supports that optimize health. They should feel welcomed into the health care system and should be satisfied with their health care experiences.
Finally, the issue of substance abuse in our community must be addressed in order to have a major impact on the other strategic priorities. Illicit drug use is significantly higher in Whatcom (9.9 percent) than the national average (8.1 percent) and there is a growing upward trend in heroin use. Substance abuse impacts children and families, results in increased crime in our neighborhoods and often adds to the complexity of care for many of our community members.
The next step in development of our Community Health Improvement Plan is to establish measurable goals to document our progress. Every organization and every individual in our community can contribute to this effort. Our goals will not be easily attained. There is a recognition that a great deal of work needs to be done however, progress is possible when the community works together to achieve a vision of health for all, not just for most.
ABOUT THE AUTHOR
Regina Delahunt is the director of the Whatcom County Health Department.