Maui County ranked third out of four counties in the state in a county-by-county health survey, but a state health official downplayed the report and the ranking.
The City and County of Honolulu was the healthiest and Hawaii County the least healthy in the County Health Rankings report by the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation.
The report released Wednesday was the first to rank the overall health of counties in the 50 states, more than 3,000 in total, by using a standard formula to measure how healthy people are and how long they live, a news release about the report said.
Researchers, who used various data sources including the National Centers for Disease Control and Prevention, U.S. Census and National Center for Health Statistics, employed measures to assess overall health, such as the rate of death before age 75 and the number of days people report being in poor physical or mental health.
The report also considered factors that affect people's health, including health behavior, clinical care, social and economic factors, and physical environment.
Maui ranked third in the state in both the overall health and health factors categories.
Alice Silbanuz, a public education coordinator, said state Department of Health officials reviewed the data and indicated that nothing in the Maui County numbers stood out.
"For the most part, the state as a whole is pretty much the same," she said in a phone interview Thursday. "There is not a lot of variation. . . . There isn't one group that is way off the charts.
"Maui is on par with the rest of the state."
For a large state like California, with scores of counties, this report format might offer significant data, but "it's not as relevant for us because there are only four counties," said Silbanuz with the Health Department's Healthy Hawaii Initiative.
Hawaii is rated in other surveys as one of the more healthy states in the nation, and the county-by-county report needs to be put in that context, Silbanuz said. Hawaii came in fourth in the nation in the 2009 America's Health Ranking that was released recently.
"Overall as a state, we continue to rank high (in health)," she said.
Some of the significant numbers for Maui County in the report:
- Adult obesity. The county had 23 percent of adults, 20 years and older, with a body mass index of 30 or higher - which is considered obese; that percentage was the highest in the state. BMI measures a person's body fat. Estimates of obesity were calculated by the CDC's National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, using 200608 data.
- Adult smoking. 19 percent of adults reported currently smoking every day or most days and having smoked at least 100 cigarettes in their lifetimes. The data was obtained from the CDC's Behavioral Risk Factor Surveillance System survey for the years 2002-08.
- Binge drinking. 17 percent of the adult population reported consuming more than four alcoholic beverages for women and five for men on a single occasion in the past 30 days. Data comes from the CDC's Behavioral Risk Factor Surveillance System survey for the years 2002-08.
- Chlamydia rate. 356 new cases reported per 100,000 population; this is an indicator for sexually transmitted diseases. The data comes from a 2006 CDC National Center for Hepatitis, HIV, STD, and TB Prevention survey.
- Teen birth rate. 45 teen births reported per 1,000 women ages 15 to 19. Data for 200006 was obtained from the National Vital Statistics System at the National Center for Health Statistics.
- Poor or fair health. 13 percent of more than 7,500 respondents to a Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System survey answered the following question with "fair" or "poor": "In general, would you say that your health is: Excellent, very good, good, fair, or poor?"
- Uninsured adults. An estimated 12 percent of residents ages 18 to 64 have no health insurance coverage, based on census data.
- Primary care provider rate. There were 158 primary care providers in the county or 112 providers per 100,000 residents, the lowest rate in the state. Oahu had 143 primary care providers per 100,000 residents. Primary care providers were defined as practicing physicians in general practice, family and internal medicine; pediatrics and obstetrics/gynecology in the Health Resources and Services Administration's Area Resource File for 2007 and the American Medical Association's Master File for 2006.
- Diabetic screening. 530 diabetics signed up for Medicare between 2003-06; 83 percent of those residents had their blood sugar screened in the past year using a test of their glycated hemoglobin levels. This helps assess the management of diabetes over the long term by providing an estimate of how well patients managed their diabetes over the previous two to three months. When hyperglycemia is addressed and controlled, complications from diabetes can be delayed or prevented.
- Hospice use. 15 percent of chronically ill Medicare patients enrolled in hospice care in the last six months of their lives. That is the lowest percentage in the state; Hawaii County was No. 1 with 25 percent enrollment. The information comes from the Dartmouth Atlas of Health Care using Medicare claims data for 200105.
White the County Health Ranking report had 25 health indicators, Silbanuz touted the Hawai'i Health Matters Web site that offers more than 100 health indictors with color-coded charts. The site, hawaii healthmatters.org, is sponsored in part by the Health Department's Healthy Hawaii Initiative.
On the Net:
* County Health Rankings for Maui County:
www.countyhealthrankings.org/hawaii/maui
* Lee Imada can be reached at leeimada@mauinews.com.
