Distinctly Montana Magazine

D I S T I N C T LY M O N TA N A • W I N T E R 2 0 1 7 60 MONTANA HEALTH REPORT 2016 BY RACHEL ROCKAFELLOW, RN Ultimately good health comes down to all those little choices each of us makes every day that enhance or harm our health. e World Health Organization defines health as: "… a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Based on that definition, the United Health Foundation compiles rankings by state and county in the United States in four broad categories: Health Behaviors (everyday activities that affect personal health); Community and Environment (factors that influence quality of life and life expec- tancy: clean water and air, affordable and secure housing, sustain- able and economically vital neighborhoods, and support structures such as violence-free places to be physically active); Clinical Care (access, quality, appropriateness, and cost of care); and Policy (avail- ability and resources to encourage and maintain health). Taken all together, these factors intertwine to determine the health of our communities. Based on the United Health Foundation rankings, Montana's health-enhancing strengths include a low incidence of Salmonella, low prevalence of obesity, and low levels of air pollution. at first one was a surprise as most of us don't think too much about Sal- monella and public health, but according to the Centers for Dis- ease Control, this foodborne illness that causes diarrhea, fever, and abdominal cramps lasting four to seven days accounts for 19,000 hospitalizations and 380 deaths a year, so I am glad Montana is doing well on this front as no one wants these symptoms! While Montana is doing relatively well on the obesity front at 26.4 percent of the adult population being obese, this data is rela- tive to other states. e obesity trend has been escalating rapidly in our country since it first started being tracked in 1990 when Mon- tana only had 8.4% of our population considered obese. e nation as a whole now lists 35.2% of adults as overweight and 28.9% of adults obese using BMI (Body Mass Index), which is calculated us- ing height and weight. (Less than 18.5 BMI is underweight, 18.5 to <25 equals normal, 25.0 to <30 BMI is overweight, and a BMI of 30.0 or higher is obese.) Between 2014 and 2015, Montana was one of only four states to decrease their obesity rate (Minnesota, Montana, New York, and Ohio), which is the first time any states have experienced decreases since tracking began. Since obesity is a risk factor in many chronic illnesses, let's hope this trend continues. Happily, Montana continues to earn the moniker "Big Sky Country" with better air quality than most states. Anyone with respiratory challenges can appreciate our clean, crisp air. Most of us take this health benefit for granted, but around the world, many major cities are not so fortunate. Air pollution significantly shortens lifespans. Other areas where we rank in the "top 10 best states" include 19.6 percent of residents claiming physical inactivity (paradoxically mean- ing our residents are more physically active than residents of most other states). Rates of diabetes are lower as well, at 8.8 percent of our population, which correlates with our lower obesity rate. e "where" within the state of Montana matters too. While most of our population is located in the seven largest cities of the state, there is a wide range in the health rankings of these areas. e Bozeman area in Gallatin County continues to rank number one as the healthiest county in the state. Overall rankings of Mon- tana's seven largest cities are as follows: H OW DOES LIVING IN MONTANA AFFECT OUR HEALTH? DISTINCTLY MONTANA LAST PUBLISHED A "MONTANA HEALTH REPORT" IN 2012. Let's look at how Montana is doing four years later. Our overall ranking is 23rd in the nation for a healthy lifestyle, slightly ahead of the 25th ranking in 2012 yet significantly worse than 12th in 1990. Looking at these numbers, what determines health? LARGEST HEALTH POPULATION CITY COUNTY RANKING 1 Billings Yellowstone 19 2 Great Falls Cascade 24 3 Missoula Missoula 6 4 Bozeman Gallatin 1 5 Butte Silver Bow 41 6 Helena Lewis & Clark 12 7 Kalispell Flathead 8 MT

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