Utah Ranks Fourth in U.S. Health Care Report

By Sun Advocate

Utah earned a fourth place rating in the United Health Care 2002 nationwide rankings.
Along with determining the national ratings, the evaluation identified the strengths of the individual states.
Utah’s strengths identified in the national report included:
•Reporting the lowest prevalence of smoking in the United States at 13.2 percent of the general population.
•Registering 19 percent below the national average in heart disease related risk, with 197.9 deaths reported per 100,000 population occurring across the state.
•Posting the lowest number of cancer deaths at 167.8 per 100,000 population.
Utah also ranked among the top 10 states recording low violent crime numbers, strong high school graduation figures and few limited activity days as well as low total, infant and premature mortality rates.
In addition, the evaluation identified the challenges facing Utah regarding health care.
The challenges include the state’s low 57.6 percent adequacy of prenatal care and high 14.8 percent uninsured population.
The data compiled as part of the evaluation process confirmed that disparities currently exist within Utah, with 39.9 percent of pregnant Native Americans receiving adequate care compared to 58.4 percent of white women in the state.
Since 1990, heart disease has dropped from 282.6 to 197.9 deaths per 100,000 population and motor vehicle deaths have declined from 2.3 to 1.3 fatalities per 100 million miles driven in Utah.
Numerous factors may affect the decrease in cardiovascular disease mortality, noted the Utah Department of Health.
The factors include more effective medical treatment, increased emphasis on reducing controllable risks like high blood pressure or cholesterol, smoking, physical inactivity, obesity and diabetes as well as improved treatment for heart attack and stroke patients.
In 1977, the health department started funding a statewide blood pressure control program.
The state’s public health agency added a cholesterol component in 1987. As a result, more than 90 percent of all Utah adults have had blood pressures checked and 63 percent have had cholesterol levels tested.
Utah’s smoking rate continues to be the lowest in the country, pointed out the state health department.
Nevertheless, tobacco use is still the leading preventable cause of death in Utah.
Tobacco kills approximately 1,200 Utahns annually and about 200,000 residents at locations throughout the state smoke.
The United Health Foundation considers the combined occurrence of acquired immunodeficiency syndrome, tuberculosis and all hepatitis case counts as representative of major infectious diseases within a state. The numbers are based on a three-year running average.
The primary reason for the significant improvement in Utah’s infectious disease status from 1990 to 2002 is that hepatitis A has declined significantly, explained the state health department.
Continued focus on public health prevention measures and prompt interventions should result in future declines in the number of Utah citizens suffering from the diseases.
The amount of miles driven in Utah has almost doubled since 1990. Motor vehicle deaths have also increased, but at a slower pace, according to the state health department.
The statewide traffic fatality rate remained fairly constant from 1991 to 2001, then dropped significantly in 2002.
Traffic deaths involving teenage drivers, alcohol and speed-related fatalities all decreased from 2001 to 2002, noted the state health department.
Decreasing fatality rates since 1990 may be contributed to a combination of factors specific to Utah:
•Safety belt use increased from 39 percent in 1990 to 78 percent in 2001.
•Passage of graduated driver licensing laws in 1998.
•Passage of numerous driving under the influence of an intoxicant laws.
•Beefed up law enforcement and educational efforts from the Utah Highway Safety Office as well as state and local health departments.
•Improved emergency medical services response and trauma systems.
•Improved safety of roads for motor vehicles.
On a national level, the manufacturing of safer motor vehicles and air bag requirements are recognized as factors contributing to decreasing traffic accident vehicle deaths, added the state health department.
Utah ranks 49th in the nation for adequacy of prenatal care, defined as the percentage of women receiving care in the first trimester and logging an appropriate number of visits throughout the pregnancy.
For example, women should have approximately 13 visits during a pregnancy to be classified as having received adequate prenatal care.
The United Health Care report indicated that only 57.5 percent of pregnant Utahns obtained adequate prenatal care, based on birth certificate data. Two basic groups of women contributed to the low percentage of adequate prenatal care, pointed out the state health department.
Women who started the first trimester with prenatal medical supervision, but neglected to follow up with an adequate number of visits accounted for two-thirds of the Utahns who did not receive adequate prenatal care.
The second group of pregnant women entered into prenatal care after the first trimester.
The groups differ demographically, indicated the state health department. Utahns obtaining prenatal care during the first trimester resemble the state’s general population, while women initiating medical contact later in a pregnancy have characteristics considered high risk for poor outcomes. The high risk characteristics include becoming pregnant at a younger age along with lower educational and socio-economic levels.
Utah’s overall violent crime rate decreased 4 percent in 2001. However, the state recorded increases in the homicide rate at 60 percent and rape at 1.33 percent.
Almost one-third or 32 percent of the homicides involved domestic violence and the relationships were undetermined in 15 percent of the incidents.
Fifty-three percent of the homicides in the state were not domestic related, concluded the Utah Department of Health.