Tormohlen: Colorado health varies county to county
March 8, 2016
In this column, we've discussed many of the issues impacting the Aspen-to-Parachute region and how various organizations are responding. Now we'd like to give voice to people who are working to effect positive change.
Michele Lueck, president and CEO of the Colorado Health Institute, lived in the Roaring Fork Valley for 12 years but left five years ago to take her current position. During her time in the valley, she worked in the health industry, supporting health-related nonprofits including several in Aspen. Today, at the helm of the Denver-based Colorado Health Institute, she provides timely and relevant information to policymakers about decisions that impact Coloradans' overall health. The institute works closely with state legislators, the governor's health Cabinet and other key decision-makers.
We asked Lueck to respond to a recent report from the Robert Wood Johnson Foundation, the 2015 Colorado County Health Rankings, which compare various measures of overall health across the state.
Aspen Community Foundation: For residents of Pitkin and Garfield counties, what were the most salient points in the Colorado county rankings report?
Michele Lueck: Recently, many initiatives and nonprofits have focused on the disparities that we see between upvalley and downvalley residents. These include housing, transportation, education and income. Health is no different than these other dimensions — the County Health Rankings help us to understand how the challenges differ. At the highest level, obviously, Pitkin County ranks No. 1 overall for health outcomes, but Garfield comes in at 20th. When it comes to health factors such as clinical care, health behavior, social and economic factors and the physical environment, Pitkin County is fourth and Garfield County is 30th.
ACF: Were there important or revealing health-related differences between Pitkin and Garfield counties?
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ML: Garfield residents are insured differently than Pitkin County residents — with a greater percentage of the population insured through Medicaid. Pitkin County residents are more likely to be insured commercially — through their employer or purchasing their own individual insurance.
Measures of health — like obesity rates — also differ. Pitkin County reports an obesity rate of only 13 percent. Garfield reports a 20 percent rate, a little below the state obesity rate of 21.5 percent for adults. This is important because the higher the obesity rate, the more likely that residents could have a variety of health complications, including diabetes, hypertension, coronary heart disease and others.
It also looks like Pitkin County residents take the idea of "apres ski" quite seriously. An alarming 26 percent of adult residents report binge drinking. Garfield is right at the state average at 18 percent. A new study from Harvard's T.H. Chan School of Public Health finds that binge drinking at least six cocktails in one night may increase of the risk of heart attacks and strokes over the following week.
ACF: What are some of the current health-related issues that Pitkin and Garfield officials should bear in mind as they make policy decisions?
ML: One of the essential keys to better health is having insurance. The next vital step is that people retain that insurance coverage. Affordability of both insurance (premiums for employers and employees) and receiving health services (co-payments, high deductibles) is the most pressing issue of the foreseeable future.
Both Pitkin and Garfield residents have the highest health-insurance premiums in the country — not the state, the country. Insurance premiums on the Western Slope increased an average of nearly 26 percent between 2015 and 2016. Right now, both Pitkin and Garfield are included in a region with an uninsured rate of 11.7 percent, about 75 percent higher than the state average of 6.7 percent. Without more affordable premiums, that coverage gap will almost certainly widen.
ACF: Are there efforts underway, either locally or regionally, to resolve any of the problems cited in the report?
ML: We see local and regional efforts underway to address affordability issues. These are coming from both the private and public sector.
In the public sector, the Division of Insurance has modified insurance-rate regions to lessen the burden on Colorado's mountain areas. We fear this is a short-term fix. The Legislature last year also sanctioned the Colorado Commission on Affordable Care. The commission's charge is to make recommendations to the state Legislature on how to make health care more affordable.
On the private side, we see initiatives like the Valley Health Alliance in Aspen. It's a group of employers whose ultimate goal is to reduce insurance costs and improve health through prevention and wellness. Also, insurers like Kaiser are moving up the Interstate 70 corridor. The hope is that their presence will also drive down costs.
Tamara Tormohlen is executive director of the Aspen Community Foundation.
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