The state of West Virginia seems to be the bellwether of bad health, portending major problems before they become severe on a nationwide scale. The worst outcomes just seem to happen there first, as if they are the canary in the coal mine, explains Dr. Michael Brumage a West Virginia University public health expert.
Nationwide the drug overdose death rate for all American is now at where the West Virginia rate was 10 years ago; and the nationwide suicide rate is now where West Virginia’s rate was close to 20 years ago. Obesity was also most common in West Virginia before it became widespread across the rest of the nation; and life expectancy in West Virginia started to tumble before it began to decline across the country.
The USA life expectancy has steadily been declining since 2014 after decades of increases. The decline is driven in part by suicides and drug overdoses which are referred to as the diseases of despair. Obesity is also driving the decline, worsening diabetes death rates and stalling progress in the country’s leading killer which is heart disease.
West Virginia’s percentage of people affected by diabetes, obesity, and heart disease eclipses most other states; it has the nation’s highest rate of drug overdose deaths for years running; highest obesity rate; highest rates for diabetes and high blood pressure; and has the highest suicide rates among the states east of the Mississippi River.
U.S. health officials released life expectancy predictions at a neighborhood level for the first time; an Associated Press analysis of the data found widespread disparities in towns and cities. Hawaii was found to have the highest life expectancy; West Virginia was the second lowest, just behind Mississippi.
Oklahoma, Mississippi and a few other states have disease and death rates that are about as bad as West Virginia, and in some cases worse; but those areas have unusually large populations of low income black or Native American residents who suffer from a disproportionate share of disability, disease, and death.
West Virginia is 94% white, nearly 80% of the Americans dying each year are white, death rates rose in white men and women last year, but were flat or declining in blacks and Hispanics. So white deaths, especially those of people who are not elderly, are mainly responsible for the country’s declining life expectancy.
10 years ago Huntington, West Virginia was described as the unhealthiest place in America by the Associated Press based on health survey data from the CDC that put it on the bottom of the charts from over a half dozen measures. While the attention was not welcomed, it was motivating to the residents prompting changes in school food programs and improvements to parks and sidewalks. Huntington looks somewhat better in health surveys these days being only a few points above the national median rather than 20. However it is clear some big problems still remain such as ranking the worst metro area in measures such as those who smoke, have high blood pressure, and have had a stroke.
As Huntington was trying to tackle obesity it was struck by a new crisis of opioid addiction, the city’s reputation as the overdose capital was crystalized on one chaotic day with responders going to 28 overdoses within 6 hours which included 2 deaths. West Virginia has the distinction of having the country’s highest drug overdose death rate, with the body count surpassing 1,000 for the first time last year; the epidemic produced ripple effects such as spikes in numbers of children taken into foster care due to addicted or deceased parents.
The opioid epidemic has been prioritized over other health crisis by politicians, but obesity still presents an ever growing, pun intended, and towering threat. West Virginians exercise less than that of other Americans, only Mississippi has a larger proportion of adults drinking pop/soda and other sugar sweetened beverages every day.
State policies are not exactly helping in some cases either such as West Virginia’s unusually harsh cost control barriers making it difficult for severely obese people to be approved for bariatric surgery which can help certain obese individuals whom conventional diet and exercise programs have no lasting effects.
In a sign of change the soda tax has been imposed which should give consumers second thoughts about choosing those kinds of drinks. Grants are being paid to students to build a 5K trail to explore creating a teen cross country running group; and another towards restoring a greenhouse to help people learn to garden. Such projects may be baby steps, but they are steps forward none the less.
Other parts of the southwest corner deep in the heart of coal country such as Mingo County life expectancy has never been high due to jobs in the lumber and coal industries being notoriously dangerous, doctors being hard to find, and violence such as feuds playing out in the hills, and labor battles between miners and coal companies. Williamson the largest municipality in the county has become a center for abuse of prescription opioid painkillers. While this crisis is playing out a series of programmes have been created aimed at health culture spawning community gardens, vegetable delivery service, running clubs, health workers being sent to homes of diabetics, and a federally funded treatment program is in the works for those addicted to drugs.
Researchers from the University of Washington have calculated the healthy life expectancy for West Virginia to be 62.5 years, which is among the lowest of all states. Black lung disease rates and coal mine injury rates are up, it is at the top of the charts for hepatitis B and C infection rates, and the state is still weathering a hepatitis A outbreak and HIV outbreak which are associated with injection drugs users. Clearly the state still has health problems, and an uncertain future, however there are signs of change; and that’s a good thing.
