URBANA – If Dr. John Stoll could focus the community's attention on just one big health improvement, it would be lowering the alarming rate of childhood obesity.
"You're seeing this childhood obesity that is just going to be disastrous," said Stoll, an internal medicine physician and vice president of quality at Carle.
Stoll took a closer look at a report out last week, America's Health Rankings, which ranked Illinois in about the middle as the 29th healthiest state in the nation.
The report showed obesity climbed nationally by 132 percent since 1990.
In the past decade, obesity in Illinois has risen from 20.9 percent to 27.3 percent of the population.
The health ranking report, done annually by United Health Foundation, ranked Vermont the healthiest state in the U.S., followed by Massachusetts. Mississippi came in last.
Among the encouraging notes this year: America's violent crime, infectious disease, cardiovascular deaths and preventable hospitalizations all declined.
Some alarming trends pointing to not enough people getting the message about quitting smoking, eating healthier and exercising:
– Obesity has risen from 11.6 percent of the population in 1990 to 26.9 percent this year.
– Tobacco use is at a 21-year low, but it's still unacceptably high.
– The number of adults with diabetes is up 19 percent over 2005.
– Last year's 1 percent improvement in health nationally is better than the previous decade, but it's still falling short of the gains in better health that were occurring in the 1990s.
– There has been a steady increase in the number of children living in poverty since 2007, to 20.7 percent this year, hindering the ability to maintain a healthy population.
How does Illinois stack up, health-wise?
The report listed Illinois' strengths as: a low occupational fatalities rate, ready access to early prenatal care, a ready availability of primary-care physicians and a high rate of high school graduation.
Illinois' challenges include a high prevalence of binge drinking, a high rate of preventable hospitalizations, high levels of air pollution and a high violent crime rate.
Stoll said he was heartened to see 86 percent of pregnant women in Illinois receive prenatal care in their first trimester, but unhappy to see a high prevalence of binge drinking (18.5 percent of the state's population) and a high rate of preventable hospitalizations in the state.
Medical providers can't do much about high violent crime rates except treat the victims, Stoll said, but they can take steps to reduce other health risks for their patients. Some steps under way at Carle, he says:
– A focus on increasing the number of doctors who discuss body mass index and the importance of good nutrition and physical activity with more patients ages 3 to 18 and their families.
– Electronic medical records already indicate whether patients smoke, but improvements coming up will include alerts for doctors that will hopefully prompt more discussion about smoking when patients come for appointments.
– Patients with diabetes or ischemic vascular disease are listed on registries to make sure their care outside the doctor's office is being monitored and they're up-to-date on needed tests, etc.
"If you take good care of those diseases from the outpatient side, you're going to limit hospitalizations for those diseases," Stoll said.
– A nurse coordinator is following up for at least 30 days with patients who were hospitalized for a heart attack to make sure they're following the instructions they received when they were discharged – a step intended to reduce readmissions.
– In 2011, Carle plans to widen its focus on reducing readmissions to include patients discharged after hospitalization for congestive heart failure and pneumonia.