It’s no secret that you could live longer on the Palouse in rural Washington than the three northeastern counties – Ferry, Pend Oreille and Stevens – between Spokane and the Canadian border.
Even though both areas are rural, the Palouse is more affluent, and with two state universities, it offers more access to education – just a couple of the social and economic factors that impact longevity.
In Whitman County and Idaho’s Latah County, the life expectancy is 81 years. In the northern counties, life expectancy dips to 77 years. The national average is 78.8 years, according to the Centers for Disease Control and Prevention.
A new life expectancy map – released last month by Virginia Commonwealth University Center on Society and Health and the Robert Wood Johnson Foundation – shows the health discrepancy between the Palouse and the northeastern counties, confirming what is already well documented.
To health advocates, community groups and nonprofits, the new map highlights the importance of the work already happening to improve health and longevity not just in rural areas, but within cities, too. It’s a public health trend that’s gaining momentum across the country.
“We really are on the cusp of some big health improvements for our region,” said Alison Carl White of Better Health Together, a nonprofit that works to improve health. It is a subsidiary of the Empire Health Foundation, the region’s largest charitable foundation, which manages an $86 million endowment earmarked for improving health outcomes in seven Eastern Washington counties. It was created in 2008 with proceeds from the sale of two nonprofit hospitals – Deaconess Medical Center and Valley Hospital.
Eastern Washington has some of the worst health statistics in the state, among them: 31 percent of adults are overweight or obese and 1 in 4 children live below the poverty level.
Ferry County ranks last in the state for health outcomes and Pend Oreille County ranks 30th out of Washington’s 39 counties, while Stevens County ranks 29th, according to the University of Wisconsin Population Health Institute’s 2012 county health rankings. In contrast, Whitman County on the Palouse ranks fourth highest. Spokane ranks 25th.
Only 10 percent of early death is due to inadequate health care, according to the CDC. The rest can be attributed to environmental, social and economic conditions: poverty, education, jobs, affordable housing, availability of nutritious food, places for physical activity and clean air.
Locals began focusing on the idea that where you live, work and play influences your health when the Spokane Regional Health District released a report in 2012 that revealed that a resident living on Spokane’s South Hill could live 18 years longer than someone living just a few miles away in Hillyard.
“That study was really a landmark moment in time because the statistics were just so shocking,” White said about the Odds Against Tomorrow report, which showed the life expectancy for Spokane residents living in the Southgate area between 37th and 57th was 84.03 years compared to 73.62 years in Hillyard.
“That was the beginning of a deep understanding that just built and built and built,” she said.
Derek Chapman, the associate director for research at VCU’s Center on Society and Health and principal investigator for the life expectancy map project said researchers picked Eastern Washington because they wanted to feature rural areas so “people would understand that place effects were not limited to large urban areas.”
Another reason was Spokane was a 2014 Robert Wood Johnson Foundation Culture of Health Prize winner, which highlighted community efforts to keep young people in school and prepare them for jobs and healthier lives.
The Mapping Life Expectancy project includes 16 areas or cities including Atlanta, Chicago, Denver, New York and Mississippi.
“This project is just about raising public awareness and providing information that local health officials can start conversations about determinants of health and in cases where things are going well, highlight programs and policies that promote good health,” Chapman wrote in an email interview.
In Spokane, the 2012 Odds Against Tomorrow report outlined four main areas of intervention: education; employment and income; reducing discrimination and segregation; and a focus on neighborhoods and communities at greater risk for poor health outcomes and high-risk behaviors.
“Where you live down to the neighborhood level can certainly have an impact on your life expectancy,” said Lynn Kimball, the executive director of Aging and Long Term Care of Eastern Washington.
She added that local coalitions have formed to look at whole-person health that goes far beyond just medical care. Those coalitions are also working in the rural counties of Eastern Washington.
White said one of the successes of Better Health Together is increasing the number of people with health insurance in the region. Today only about 4 percent of Spokane County residents remain without coverage.
Other focuses are reducing obesity and rates of diabetes and hypertension, providing access to dental care, and helping the homeless – both in cities and rural areas, including students – find stable housing. Another goal is offering more fruits and vegetables at food banks instead of just high calorie, filler foods.
In North Idaho, the regional health districts are concentrating on improving mental health and reducing rates of obesity and diabetes.
Melanie Collett of the Panhandle Health District said one of the major highlights was the December opening of the 24-hour mental health crisis center in Coeur d’Alene, which gives people experiencing acute episodes related to mental illness or addiction a place to go other than the emergency room or jail.
Mental health ranks as one of the top public health concerns in North Idaho, which has consistently high suicide rates.
“There’s just so much more that affects your health than whether you can get into a primary care provider,” White said.
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