Health snapshot: How healthy are Linn, Johnson counties?
Public health data reveals trends in each county
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CEDAR RAPIDS — How healthy are the people living in Linn and Johnson counties? A Gazette analysis of 10 years of public health data gives a snapshot, revealing trends such as high diabetes hospitalization rates in Linn County and rising suicide rates and declining heart attack hospitalizations statewide.
Data for this story is presented in five-year spans to show more reliable rates if there are small numbers on the county level. The last year of the five-year spans are shown on the charts.
The Iowa Department of Public Health (IDPH) used a variety of sources to come up with its data sets, including birth certificates, U.S. Census Bureau data, death certificates, statewide outpatient database and the statewide inpatient database, among others.
Diabetes appears to be a serious problem in Linn County — the most recent diabetes hospitalizations rates were well above state rate — with 131.71 per 100,000 people in Linn County compared with 111.79 per 100,000 statewide.
Public health data also show that emergency room visits rose sharply in the state and Linn County since 2003. But while the county was below the state rate for ER visits in the 2003-2007 time period it eventually outpaced state rates by 2009-2013.
• State rate ER visits were 133.34 in the 2003-2007 time period and rose to 161.91 by the 2009-2013 time period.
• Linn County ER visits were 126.74 in the 2003-2007 time period and rose to 162.06 by the 2009-2013 years.
“We're seeing the same trends with diabetes prevalence,” said Kaitlin Emrich, with Linn County Public Health. “I'd feel better even if we were just steady.”
Health officials could not pinpoint why Linn County rates are so much higher than state rates, but noted lifestyle choices certainly have played a role in the increase in diabetes.
Obesity rates — a major risk factor — have risen alongside diabetes rates. IDPH data shows that obesity rates have risen steadily since 1995. In 2010, 31.8 percent of adults in Linn County were overweight and another 24.6 percent were obese, according to data.
“We see lots of young people, even teenagers,” said Dr. Abha Saxena at UnityPoint Health Clinic-Diabetes and Kidney Center. “That's really alarming.”
Saxena said more education and awareness is needed, and it needs to start earlier.
“We need to tell children how this can affect them,” she said.
Linn County Public Health as well as the hospitals periodically hold education and awareness events. And a new program at the YMCA is targeting those at risk of developing the disease.
The yearlong program, which kicked off in January, works with participants to reduce their body weight by 7 percent and increase their physical activity by 150 minutes per week. It also gives them a chance to share struggles and successes.
Kim Jass-Ramirez, executive director at the Marion and Mercy Health Plaza YMCAs, said research has shown that group support especially aids those who are working to lose weight. The program has seen success so far, she said.
“This is a strong, evidence-based, research-based program,” she said.
Suicide death rates are up across the state as well as in Johnson and Linn counties. Over the years, state rates rose from 11.28 per 100,000 people in the 2003-2007 time period to 12.98 per 100,000 in the 2009-2013 time frame.
Here in Linn County, rates rose from 10.36 to 12.3 during the same time periods, while Johnson County rates spiked from 8.41 per 100,000 to 12.25 per 100,000.
“It's trending upward, which is, of concern, because this is a preventable cause of death,” said Doug Beardsley, Johnson County Public Health director. “If you look nationwide, our rates are not that much different.”
Data from the Johnson County Medical Examiner's office show that men between the ages of 18 to 59 years old comprised the majority of suicides in 2014. And Linn County Public Health's Emrich said between 2008-2012, 83 percent of suicides in Linn County were men and about two-thirds of all suicides were people aged 25 to 64 years old.
Keri Neblett, community intervention director at the Johnson County Crisis Center, said 2009 was a bit of an anomaly — there was a high-profile murder-suicide and a few high-profile suicides. That, combined with recovery from the 2008 flood, led some stakeholders in Johnson County to call a town-hall meeting during which individuals discussed barriers to getting help and gaps in services, Neblett recalled.
“We decided as a group to continue to meet about the problem,” she said of the creation of the Johnson County Suicide Prevention Coalition.
When it comes to suicide prevention, Neblett said both the Crisis Center and coalition focus on a multipronged approach — access to services, education, training and reduction in means to commit suicide. The Crisis Center has chat, text and phone services available 24 hours a day for those who need to talk with someone — and it recently won a contract to expand those services statewide.
“We want to make it easy for someone to get to us,” Neblett said.
It also periodically provides training to teach people about warning signs and what to look for, she said.
“People are afraid to talk about suicide,” she said. “They think it will push the person over the edge. When that's exactly what's needed.” (See related story, Page Ax.)
Heart Disease is the leading cause of death in Johnson and Linn counties as well as statewide. But the rate of heart attack hospitalizations has started to drop in the past decade.
• Statewide the rate steadily has fallen, data shows, dropping from 184.61 persons per 100,000 in the 2003-2007 time period to 150.73 per 100,000 in the 2009-2013 time period.
• The Linn County rate rose to 192.21 per 100,000 in 2006-2010, up from 180.52 per 100,000 in 2003-2007. But then it began to fall, down to 171.44 in 2009-2013.
Dr. Ersin Atay, a cardiologist at UnityPoint Health-Cedar Rapids said it's hard to know why there was a sharp rise in Linn County before rates ticked downward as the data does not include specific demographic information, such as age, race or gender.
“It's hard to come to specific conclusions because there are so many factors,” he said.
The rate of heart failure also is down across the state and in the Corridor, data shows:
• State — 2003-2007 had a rate of 252.81 persons compared with a 2009-2013 rate of 200.49
• Linn County — 2003-2007 saw a rate of 202.79 compared with a 2009-2013 rate of 176.47
• Johnson County — 2003-2007 recorded a rate of 183.54 compared with a 2009-2013 rate of 168.38.
“There's no question, (heart disease) still is the biggest killer around,” Atay said. “Prevalence increases with age, so as the population gets older and people live longer, there could be a higher percentage of people with heart disease.”
But a new emphasis in healthy living could help, he said, adding that “it's hard to know where we will land.”
The birthrate remains relatively stable across the state and in Linn and Johnson Counties, while the teen birthrate has dropped, which experts say is good news.
“Any time births are planned and intended, that is a good thing,” said Shari Stucker, Community Adolescent Pregnancy Prevention program director at Eyes Open Iowa, a Des Moines-based group that advocates for teen sex education.
The overall birthrate for the state from 2003-2007 rate was 13.44 per 1,000 people compared with the 2009-2013 rate of 12.98. But the teen birthrate fell from 30.97 per 1,000 in 2003-2007 rate to 27 in 2009-2013.
Similar trends were seen in Linn County when the overall birthrate hovered between 14.16 from 2003-2007 and 13.25 from 2009-2013, while the teen birthrate dropped from 30.13 in 2003-2007 to 24.66 from 2009-2013. Johnson County saw a steady overall birthrate as well as teen birthrate.
• The overall birthrate was 12.98 in 2003-2007 compared with a 13.44 rate in 2009-2013
• The teen birthrate was 9.98 in 2003-2007 compared with a 9.29 rate in 2009-2013
“Iowa is mirroring the national declining teen birthrate,” Stucker said.
Stucker explained this is happening for several reasons — teenagers are receiving consistent age-appropriate sex education in schools or other youth-oriented groups, and they also have access to birth control, including long acting reversible birth control such as implants and intrauterine devices.
“That makes a huge difference,” Stucker said.