Bad report card

Located where agriculture meets the great outdoors, Butte County evokes the image of healthfulness. Bicycling is a popular sport here. Chico, Oroville and Paradise all feature trails for pedestrians and cyclists, along with spacious parks and up-to-date hospitals. Farmers’ markets abound. Health-food grocers flourish.

Perception and reality don’t always mesh, though. In a study recently released by the University of Wisconsin, Butte County ranked 44th among California’s 58 counties in overall health of its citizens.

North State neighbors didn’t do much better. Out of the 56 counties studied, Tehama ranked 53rd, Yuba 51st and Shasta 43rd. Glenn ranked 27th and Colusa, interestingly, ranked 11th.

The numbers for Butte County are all the more striking when compared to the previous two years: 35th in 2010 and 39th in 2011. Go to www.countyhealthrankings.org to read the study.

Health professionals are obviously concerned. Dr. Matthew Fine, chief medical officer and director of patient safety at Oroville Hospital, has parsed the numbers carefully, looking for conclusions to draw—without jumping to unsubstantiated conclusions—as well as lessons to learn.

“Scorecards are always interesting to people,” Fine said. “We know the issues we face here and how we have to deal with them, and how we’re looked at from the outside.”

Fine said the University of Wisconsin study “supported a lot of things I’ve seen over the years”—in particular, smoking and eating habits. The County Health Rankings notably show:

• 21 percent of Butte County adults smoke (compared to 14 percent statewide and nationwide);

• 25 percent are obese (24 percent statewide, 25 percent nationwide);

• 17 percent drink excessively (matching the statewide number but more than double the nationwide rate of 8 percent);

• 14 percent are in poor or fair health (19 percent statewide but 10 percent nationwide).

In addition, and perhaps most disturbing, Butte County experienced nearly a third more premature deaths than state and national averages.

Socioeconomics seem to be a driving factor. The top-ranked healthy counties are also among the most affluent, with Marin ranking No.1 and Santa Clara, in the heart of the Silicon Valley, ranking No.2. (Colusa is an anomaly, with a high unemployment rate—20.4 percent—but also a large number of affluent farmers, Fine pointed out.)

Butte County has an unemployment rate of 13.9 percent—a full point and a half higher than the state average—and 25 percent of its children living in poverty. Perhaps reflecting this demographic, 55 percent of the county’s restaurants are fast-food establishments, 6 percent more than the state average and nearly double the national average.

Phyllis Murdock, Butte County’s director of public health, finds a strong correlation between poverty and poor health.

“Anytime you have fewer people working, where they may have less insurance than they had when they were working, their ability to access medical care before things become urgent is impacted,” she told Action News. “You might not necessarily have such an easy time finding employment in a more rural county. That means there’s less disposable income and sometimes you buy foods that are less expensive rather than foods that are maybe slightly more expensive but are healthier and better for you.”

That may be why, despite the plethora of local farms, Butte County comes up short in the study’s “limited access to healthy foods” category at nearly triple the state average.

Fine also zeroed in on the smoking rates. (That’s understandable for an internal-medicine doctor who specializes in pulmonology—conditions of the respiratory system.) He has seen progress through smoking-cessation programs but says getting people to quit nowadays is “harder, because the low-hanging fruit has been plucked.” Indoor smoking bans have helped, but he worries about measures that would add onto current cigarette taxes, for fear of adverse consequences such as smuggling.

Still, action needs to be taken. Fine stresses the importance of education, particularly for stroke and heart patients. He also has a novel suggestion: “Stores that sell cigarettes shouldn’t be able to sell prescription drugs. That would raise cries from storeowners, but it would be more successful than taxes. It would make [tobacco] less accessible.”

In other words, a pharmacy selling medicines to help cure people’s ailment shouldn’t also profit from such a deadly product as cigarettes. Likewise, more graphic warnings on tobacco packaging would make an impact, he said—“anything that makes you think twice is good.”

Air quality is another drawback in Butte County, as in much of the Northern Sacramento Valley. Recently, the American Lung Association gave Butte County an F on its State of the Air Report Card, based upon California Air Resources Board monitoring stations in Chico, Gridley and Paradise.

Fine suggested programs aimed at wood-fire burning would help with wintertime exposure to large particulates in smoke. “That we have control over,” he said. “It’s an issue we could address.”

Meanwhile, emphasizing exercise would also go a long way toward improving the county’s health grade.

“Our education system has failed physical education; we have cutbacks and we cut physical education,” Fine said. “I think that’s nuts!

“As a society, there’s a lot we can do. We’re still in a system where health care is not health maintenance and living a healthy life—it’s separate. … [As health-care providers] we’ve addressed these things within our ability, but as a society, we haven’t done so much.”