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Task force takes aim at heart disease

With county deaths from the disease higher than the state average, health leaders plan to help residents lose 1-million pounds and stop smoking.

By WILL VAN SANT
© St. Petersburg Times
published December 15, 2002


Heart disease kills more Hernando County residents than any other medical disorder, and a recent study provides worrisome insights into the scope of the problem.

The report, prepared by the North Central Florida Health Planning Council, found that county residents are dying from heart disease at a higher rate than the state average, with 258 deaths per 100,000 in population compared with 250 statewide.

This might not come as a surprise in a community with a large senior population, but the study found that even younger residents -- those in their 20s, 30s and 40s -- are dying from heart disease at a rate higher than in the rest of Florida.

"It's scary to think that people that young are dying from heart disease," said county social services director Jean Rags. "We are talking about productive lives lost."

Rags is one of 40 members of the Hernando County Heart Disease Task Force. The group was recruited in February and March after the Hernando County Health Care Advisory Board identified heart disease as the most pressing health issue facing residents.

The task force is charged with implementing a three-part plan based on the Health Planning Council study to help residents change behaviors that contribute to heart disease, an umbrella term for a host of disorders including high blood pressure and hardened arteries. It is the most common cause of death in the United States.

The study examined Florida Department of Health statistics from 1997 to 1999, during which time more than 1,900 county residents died from heart disease. As part of the study, residents were telephoned and questioned about behaviors that increase their heart disease risk.

Results were grim.

According to data collected in 1999, nearly 34 percent of Floridians are overweight. Slightly more than 59 percent of Hernando County residents contacted in the survey, however, identified themselves as being on the chubby side. Study designers say the percentage of residents who are overweight may be higher, as the condition is often underreported.

While nearly 22 percent of county residents smoke, based on the telephone survey, 20.6 percent of the state population are smokers, the study reported.

Finally, while 11 percent of Americans have mild to moderate hypertension, according to federal statistics compiled in 1996, 30 percent of Hernando residents who were familiar with their blood pressures reported having mild to moderate hypertension, according to the survey.

"We are not eating properly and not exercising enough," said Elizabeth Callaghan, a task force member and administrator of the Hernando County Health Department. "We need to do something about it."

Unfortunately, Callaghan said, it is difficult for people to make caring for their bodies a priority while living in a hectic world where all manner of demands clamor for their attention. It's still more difficult in a place such as Hernando County, she said, where many main roads lack sidewalks on which to walk and exercise but boast plenty of fast-food restaurants.

"We live in a very fast society today," Callaghan said. "What we need people to recognize is that you can't drive through at that fast-food restaurant and eat all that fried food you are eating."

Income and the nature of the county economy may also be playing a role in the disproportionate number of heart disease deaths, some involved in preparing the study said. White-collar jobs are few in Hernando County, where the median household income in 2000 was $34,817, compared with $38,118 for the state.

Hernando County has a predominantly service-sector, small-business economy, according to Jeff Feller, a senior health planner with the Health Planning Council who worked on the study. The working-age population in such circumstances typically does not have access to health insurance, Feller said.

"It's beyond their means, whether their companies offer it or not," he said. "It's still too much."

Lower-income earners lacking health insurance tend to visit doctors only for episodic conditions rather than for annual checkups and the kind of preventive care that reduces the risk of heart disease, Feller and Callaghan said.

While a lack of income may prevent access to health care, Rags said, anybody can make behavioral changes that will help lower heart disease risk, regardless of how much money they make.

"Any resident in this county, no matter what their income or class . . . can go out there and walk or go for a run," Rags said.

After reviewing the data on heart disease, task force members have set the goal of reducing deaths from the disorder by roughly 20 percent by 2012. That would mean bringing the mortality rate from heart disease to 207.9 deaths per 100,000 people.

To do so, task force members plan to help obese and overweight residents lose a total of 1-million pounds by the end of 2004 through countywide exercise and nutrition initiatives, cut in half the number of adults who smoke and the number of teenagers who have tried cigarettes by 2012 and provide heart disease screening and early diagnosis for at least 25 percent of the population by 2007.

The screening and diagnosis program is to focus on children, adults between the ages of 35 and 64 and minorities, who disproportionately suffer from heart disease.

While proposals abound, actual guidelines and steps for how to achieve the objective have yet to be drawn up. When it comes to the 1-million-pound weight-loss goal, however, there are some firm ideas.

According to Callaghan and Feller, community groups and businesses will field or sponsor teams of would-be weight losers. The teams will periodically weigh in at designated centers and compete against other teams to see who can take off the most pounds.

Such community weight-loss initiatives have been tried elsewhere with varying degrees of success. Nearly 26,000 Philadelphia residents took part in an effort last year to lose 76 tons in 76 days. The city, which missed the mark by 65 tons, according to news reports, had been named the fattest in America by a national magazine in 2000.

According to Rags and Feller, some of the objectives will be achieved through grant allocations, which they hope will jump-start further community involvement.

The Health Planning Council and the Hernando County Health Care Advisory Board are scheduled to meet in January to discuss what steps must be taken to achieve the three objectives and how to implement them.

In the meantime, Callaghan has some advice.

"Set aside time at least three times a week to walk or work a treadmill," she said, "anything that increases your heart rate so that you have a healthy body."

-- Will Van Sant covers Hernando County government and can be reached at 754-6127. Send e-mail to vansant@sptimes.com .

Slimming down

The Hernando County Heart Disease Task Force plan for reducing deaths that result from heart disease includes three objectives:

-- Help obese and overweight residents lose a total of 1-million pounds by the end of 2004 through countywide exercise and nutrition initiatives.

-- Cut in half the number of adults who smoke and the number of teenagers who have tried cigarettes by 2012.

-- Provide heart disease screening and early diagnosis for at least 25 percent of the population by 2007.

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