Our Continuing Quest for A Healthier Mississippi

Good morning!

Most weeks I like to end this column with the phrase, “A Healthier Mississippi.”  I see these words as a reminder of what our ultimate mission is and, at the end of the day, what we’re all working toward.

This week, the United Health Foundation’s 2017 America’s Health Rankings Annual Report reminds us of just how big a challenge we face. The Foundation follows trends in national public health and provides a state-by-state ranking based on a high-level set of measures that reflect health status.

The headline for this year’s report is that Mississippi finished last in the ranking.  (Massachusetts was No. 1.)  That was really no surprise, since we finished last in 2016.  Indeed, in the 27 years the report has been published, Mississippi has never moved out of the bottom three states in the ranking.

The United Health Foundation’s website provides a useful interactive map that allows quick comparisons between states.  Most of the lowest scoring states are in the deep south.  Our immediate neighbors Alabama, Arkansas and Louisiana rank 47^th through 49^th, respectively.

The report groups its metrics into two broad categories, including determinants – individual behaviors, community and environment, policy, clinical care – and outcomes. 

A few data points from the 2017 study:

Among behaviors, Mississippi ranked 49^th overall.  More than a third (37.3%) of our adult population is obese, and more than one in five people (22.7%) smoke.  On the other hand, our state fared better on alcohol abuse, ranking 4^th overall with 14.7 percent of adults regarded as problem drinkers.

Among factors associated with the community and environment, Mississippi ranked 50^th for children living in poverty, with 29.9 percent classified as such (50 percent of African American children).  We also lagged in 48^th place for occupational fatalities, with 9.3 deaths per 100,000 workers.  We rank No. 1 in cases of pertussis, or whooping cough, with the fewest cases per 100,000 population – a result of our strong childhood vaccination law.

Among policy factors that relate to health status, Mississippi gets poor marks for its relatively large uninsured population (12.3%), ranking 45^th.  And while we’re a leader in pre-kindergarten immunization, Mississippi lags the rest of the states, ranking 50^th, in adolescent immunization against meningococcus, human papillomavirus (HPV), and tetanus, diphtheria, and acellular pertussis (Tdap). 

In measures of clinical care, Mississippi finished 50^th.  We have too few dentists (42.2), primary care physicians (106) and mental health providers (132.6) per 100,000 population.  Eleven out of every 100 babies born have low birthweight, worst in the nation.

When we look at health outcomes, Mississippi ranks 48^th in cancer deaths and 50^th in deaths from cardiovascular disease.  We also rank 50^th in premature death, with 10,950 total years of  life lost per 100,000 population.  That’s about nine years, on average, for every citizen of our state.  Overall, Mississippi is 48^th in health outcomes for 2017.

Clearly, this report is discouraging.  Being in last place in anything does not sit well with me.

At the same time, the report does provide me with an unexpected sense of satisfaction that we are focused on the right things.  In almost every area cited, we have programs or projects in place to improve the status quo.  They range from our recent grouping of a number of established research programs into a Center of Excellence in Perinatal Research for the comprehensive study of problems like infant mortality, low birthweight and prematurity, to our nationally ranked telehealth program and its focus on delivering health services to citizens in rural areas.  For every problem – obesity, mental health and dental health services, tobacco use, cardiovascular disease, and so on – UMMC is working on solutions.

Of course, some problems such as poverty, which underlies so much of Mississippi’s health disparity, are endemic and can’t be fixed by UMMC or any other single entity.  That’s why it will take many players in our state, all pulling together, to address the larger issues that keep Mississippi at the bottom of rankings like these.

All of this is very challenging, but that doesn’t mean we will shy away from it.  Just the opposite.

When I think of insurmountable odds, I always remember President John F. Kennedy’s 1961 speech in which he declared the United States would go to the moon before the decade of the 1960s was over.  His words:

“We choose to go to the Moon in this decade and do the other things, not because they are easy, but because they are hard; because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one we intend to win.”

Achieving a healthier Mississippi differs in an important way from the U.S. moonshot of 1969.  Ours is a never-ending commitment to put our very best efforts in the service of our missions of education, research and patient care.  It’s a journey, not a destination.  But it’s a challenge all the same, and one we intend to win.