Every few years our Public Health Department (PHD) publishes a Community Health Status Report. Its kind of a State of the Union address from us to our community. How healthy (or sick) are we compared to the rest of California? Are we getting fatter? Smoking more? What diseases are most likely to kill us? One of the core functions of the PHD is to keep a finger on the pulse of Santa Barbara County, and hopefully prevent it from going into cardiac arrest.
The following are the basic conclusions of our hot-off-the-press report. After all the data was scrubbed and polished and arranged in pretty pie charts, a clear theme emerged: there are three unhealthy behaviors (poor diet, physical inactivity, and tobacco use) that contribute to four diseases (vascular disease, cancer, lung disease, and type 2 diabetes) that cause over 50 percent of the deaths in our county.
We aptly named this 2014 report “3-4-50”.
What’s intriguing to me is this: More than 50 percent of us are dying from our own lifestyle choices. We are killing ourselves--literally. If that sounds harsh, let’s take a look at the data. We know that unhealthy eating behaviors, defined as diets high in sugar, saturated fat, and salt, directly coincide with increased risk for type 2 diabetes, vascular disease, and cancers. In our county, 56.5 percent of adults reported they were overweight or obese. This is a little better than the state-wide rate of 59.8%, but not much.
Although opportunities for outdoor activities abound in Santa Barbara County, we still struggle with physical inactivity. The California Health Interview Survey found that only 25.3 percent of county children were physically active for at least an hour every day in the previous week, compared with the California rate of 32.6 percent. We also know that low activity levels, when combined with a poor diet, result in childhood obesity.
Type 2 diabetes is an important disease in the 3-4-50. It is associated with being overweight or obese and lack of physical activity, and has recently earned the urban slang of “diabesity” due to the strong correlation with obesity. Diabetes causes blindness, kidney failure, weakened immune system, and death. The good news is that Santa Barbara’s rate of type 2 diabetes (5.8 percent) is below California’s rate (8.4 percent.)
The third behavior we identified, after poor diet and inactivity, was tobacco use. We know it kills us, we know it’s expensive, but we still do it--or at least 12 percent of us do. Although this percentage is in line with the rest of the state, it is far from optimal. Tobacco use leads to heart disease, lung disease, cancer, and stroke, to name just a few. Within just days of quitting smoking the heart rate and blood pressure are reduced, and sense of taste and smell improve. Even if you’ve smoked all your adult life, quitting at age 50 cuts premature death risk in half. The second leading cause of death in our county was cancer, with lung cancer being at the very top. Smoking, and exposure to secondhand smoke, is the major cause of lung cancer. Lung Disease, or Chronic Obstructive Pulmonary Disease (COPD) was responsible for 115 deaths in 2012. Smoking is also the primary cause of COPD, and there is no cure.
What happens when we combine poor eating habits, lack of activity, and/ or tobacco use for a sustained period of time? Vascular disease, both in the head (called a stroke) and in the heart. Heart disease was the leading cause of premature and all death in Santa Barbara County in 2012, accounting for 773 deaths. Heart disease generally refers to clogging of heart arteries with cholesterol and fat deposits that restrict blood flow and oxygen to the heart.
Overall, based on the data in our 3-4-50 report, Santa Barbara County residents are healthier than other Californians in several categories, such as lower mortality rates for cancer. We have also displayed improvement over time in other areas, such as rates of tobacco use. Our county ranks 14th out of 57 California counties in Health Outcomes and Health Factors according to the 2013 County health Rankings.
The most promising insight from the data is the high percentage of premature deaths that could be prevented through behavioral changes alone. Although it can feel overwhelming to even know where to start when one decides to get healthy and get active, every person who has crossed that bridge (including me) tells the same story: it happens one banana at a time. One brisk walk at a time. One cigarette-free day at a time.
Our goal in presenting this report is to educate and encourage our community to continue to engage in healthy behaviors. Together, we can literally change our own fate.
The full Community Health Status Report will be found at HYPERLINK "http://www.sbcphd.org" www.sbcphd.org within the next month.
Charity Thoman MD, MPH is the Health Officer of the Santa Barbara County Public Health Department.