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Cos' health ranking is state's lowest

February 24, 2010
WHITEFIELD — A new study has determined that Cos County ranks the lowest on overall health as compared to other counties in New Hampshire. Overall health is measured by looking at death and illness rates.

The report found that Cos is at the bottom of the list, while neighboring Grafton County, which includes Hanover and Lebanon, is the healthiest. On factors that influence health, like health behaviors and social and economic factors, Cos ranked 10 out of 10.

The study by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation looked at every county in the nation and ranked them — within each of the 50 states — in order of health based on a number of factors, including longevity that considers death before age 75 as premature, low birth weight, adult smoking, teenage pregnancy, obesity, and the number of uninsured adults.

"We've known for some time that Cos faces challenges, such as cardiovascular disease, obesity, diabetes, and oral health that disproportionately affect North Country residents," said Martha McLeod, executive director of the North Country Health Consortium (NCHC), in a Friday afternoon interview at the rural health network's King's Square offices.

"This report — a broad snapshot of our community's health — gives us additional information that we can use to work with community leaders and residents on a strategy for changes that will improve health in our region," she said. "This is a good mobilizing tool as we all begin to better understand what these numbers mean and how we can seek strategies to get the most bang for our buck."

The county-by-county figures will be reworked to provide regional data, she said, making them more useful for public health regions. The Consortium includes northern Grafton County towns, such as Woodsville and Littleton.

"We need to align the data to the actuality under which we are organized and then work together to look at the indicators," Ms. McLeod explained. "We must look to see the correlations with activities and programs and then advocate for their retention or expansion and seek additional funding, including from the federal government.

"We need to grow out leadership capacity and to work closely with economic development organizations," she said.

"Cos does have access to services that can improve health, such as community health centers which provide access to quality primary health care services.

"The toll-free Tobacco Quitline, available across the state, can be reached at 1-800-879-8678.

"The Diabetes Education Program focuses on working with all the state's community health centers to provide the recommended standard of diabetes care for everyone, with special emphasis on the underserved." Cos ranked well on diabetes screening, Ms. McLeod noted.

"The Women, Infant & Children (WIC) program provides nutrition education and nutritious foods to help keep pregnant women, new mothers, infants, and pre-school children healthy and strong," she noted.

Unfortunately, some of the statistics used in the study are already out of date, Ms. McLeod pointed out. The number of Cos residents who are unemployed and no longer have health insurance has undoubtedly risen, as mill closings and the ripple effect of today's economic downturn have taken their toll.

The number of "preventable hospital stays" is high, Ms. McLeod said, indicating that some Cos residents are skipping routine checkups, likely in an effort to save money. This scenario, however, means that a more expensive emergency room is their main source of care, which sometimes leads to a hospital admission for a condition that, picked up earlier, could have been treated with outpatient care.

The county continues to maintain three 25-bed critical care hospitals, but in order to remain sustainable, the Upper Connecticut Valley Hospital (UCVH) is only able to staff six beds.

"This report is not about who ranks highest or lowest, it's about being able to use this information to address the specific needs of a region," said state Public Health Director Dr. José Montero in a press release. "It's our hope that our regional and local partners will use this to see what is impacting the health of the people who live and work there. We see this as an opportunity for communities to rally together to find solutions that will help improve the lives of their residents."

New Hampshire's County rankings are as follows: (1) Grafton; (2) Rockingham; (3) Merrimack; (4) Cheshire; (5) Hillsborough; (6) Belknap; (7) Strafford; (8) Carroll; (9) Sullivan; and (10) Cos.

"While this county-by-county comparison is useful it should be noted that in New

Hampshire, most public health services are not organized by county," the state press release reads. "New Hampshire has been moving towards organizing public health services by 15 designated Public Health Regions, also known as All Health Hazard Regions.

The state Department of Health and Human Services (NHDHHS) is currently planning for a state health report, which will analyze health status by public health regions. It may incorporate indicators from the county health rankings report, but other indicators are being considered to make the report most valuable for assessing our public health priorities. The study's authors have offered to consult with New Hampshire on this process. The results of this further report are expected to be available at some point in the coming year.

To view the report in its entirety, go to www.countyhealthrankings.org. The report includes a snapshot of each of the 10 counties with a color-coded map comparing their overall health.

Martin Lord & Osman
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