Poverty, poor health combine in needless deaths
Published November 22, 2015
Editorial by Fayetteville Observer, November 22, 2015.
The tight link between health and wealth is no surprise. People with more money can afford health insurance and good preventive care. They also tend to be better educated and know how to live a healthier life - which means they're likely to live longer.
And so it goes, as a story in Friday's Observer related, with the regions of our state. If you live in a wealthier county, chances are you also live in a healthier one. And if you're in a chronically impoverished county - like Robeson, Columbus or Scotland, in this region - you'll see health outcomes dramatically worse than the state average.
That's also true in Cumberland County, where a new study finds we have 419 avoidable deaths each year, compared with the state's top-performing counties.
Researchers from the Robert Wood Johnson Foundation and the University of Wisconsin studied North Carolina's health outcomes, county by county, and identified the top 10. Then they determined how the remaining counties are doing compared to the healthiest.
Cumberland, they found, performed 31 percent worse. Scotland was 33 percent behind the best. Columbus lagged by 34 percent and Robeson, 37 percent.
The bottom line is that there are 5,500 avoidable deaths in North Carolina every year. The culprits are no strangers: smoking, sexually transmitted infections, obesity and a lack of health insurance.
Those 5,500 deaths are costly and need to be addressed as a matter of public policy. End-of-life care can be extraordinarily expensive when disease has long gone untreated. And for uninsured, impoverished patients, the care is largely covered by the taxpayers.
The easiest place to start is by expanding our state Medicaid coverage to include the "working poor." That's part of the Affordable Care Act's design, and federal funding will cover most of the cost. Getting hundreds of thousands of low-income residents into preventive-health programs will pay immediate dividends.
The next steps are harder, but not impossible. We need to step up public-health initiatives to include more smoking-cessation efforts and education about healthier lifestyles. Those efforts need to expand in our schools, as well.
And the state needs to redouble its economic-development initiatives in our rural counties, where poverty and poor health outcomes go hand-in-hand.
As North Carolina's wealthier counties already know, investment in better health pays a substantial dividend.
