By Beth Beasley De Bona
Times-News Online
Where you live in North Carolina could affect your life expectancy by as much as a decade, according to a report by NC Child.
The report card shows where each county stands in terms of factors such as access to prenatal care, low birth weight, food insecurity and poverty.
Life expectancy is 79.3 years in Henderson County, which is 2.4 years shorter than the life expectancy for a resident of Orange County, the top-ranking county for longevity in the state.
“Across indicators we see that a distance of fewer than 100 miles can mean the difference between positive or negative outcomes in children’s lives, a fact that simply cannot be explained by random chance or genetic predisposition,” said Laila A. Bell, director of research and data at NC Child.
“These geographic disparities are a stark reminder of the profound impact the environments where our children live, play and go to school have on their long-term health opportunities,” Bell added.
The county with the lowest life expectancy in North Carolina was found to be Swain County, at 73 years; similar to the life expectancy of children in Cambodia.
Not surprisingly, poverty is a detrimental factor for early childhood health, often with lifelong effects.
According to the report, 20.1 percent of Henderson County children live in poverty.
“The connection of poverty and health has many facets, but certainly one factor is access to health,” said Richard Hudspeth, chief medical officer at Blue Ridge Community Health Services.
Erica Woodall, outreach coordinator for Smart Start of Henderson County, also had insights into the poverty/health connection.
“Young children are at a higher risk of living in poverty than any other age group,” Woodall said. “Children born into and growing up in poverty are less likely to have access to the services and opportunities that all children need to lay the foundation for their future academic and developmental success.”
Steven E. Smith, director of the Henderson County Department of Public Health, sees data as a fairly subjective way of looking at the reality of health issues in any given county.
“In general, I would say access to services in Henderson County is fairly robust, with uninsured and underinsured populations having a variety of options through the Health Department, Free Clinic and Blue Ridge Community Health Services,” Smith said.
“Our hospitals and medical community also provide a substantial amount of charity care, and many community organizations also help with this need.”
However, he observed that this county, like others in the state, struggles to make available some services related to mental health, developmental disabilities and substance abuse — factors such as these are not emphasized in the NC Child report.
Progress on health behaviors, as well as social and economic factors, are the most challenging elements to address, Smith said, but they collectively represent 70 percent of the equation to improve health.
Bell, who compiled the data for NC Child, noted that the health issues detailed in the report are avoidable and that “smart public policy decisions can help enhance local efforts” to promote the health of children.
According to the data card for Henderson County, one in 35 births in the county is to a mother who received “very late or no prenatal care.”
Blue Ridge Community Health Services will see a pregnant woman regardless of whether paperwork is complete, unlike other clinics, according to Hudspeth.
“We also work with DSS so that our patients can begin the process of applying for Medicaid while they are here,” Hudspeth said. “That can make a difference in getting early prenatal care to women.”
The one in 15 babies born at a low birth weight in Henderson County puts children at greater risk for developmental delays or future health complications, including infant mortality, according to NC Child.
As a Pregnancy Medical Home, a Medicaid pregnancy program, BRCHS works closely with Medicaid care managers to identify women at risk for pre-term birth as well as risk factors that might contribute to low birth weight. They also extend this “risk screening” to all populations beyond Medicaid, including the uninsured.
“Recent statistics from the program suggest that since the program’s inception, these rates have fallen in NC,” Hudspeth said.
Smoking cessation, and substance abuse counseling and cessation before pregnancy, are two of the biggest behavioral changes.
“Research on brain development is changing how we think about early childhood,” Woodall said. “We now understand that brains are biologically prepared to be shaped by experience and that early learning experiences determine our future learning capacities, behaviors and our health.”
Food insecurity plays a role in the precariousness of the promise of a longer life; the report found that more than 5,150 children in Henderson County — more than 23 percent — are estimated to not have enough healthy, nutritious food. Hudspeth said BRCHS dieticians are helping area families make healthy, nutritious food choices within their budgets.
Almost 10 percent of Henderson County children lack insurance, which is another factor influencing life expectancy.
Smith believes access to care also can be influenced by underlying factors such as transportation, and the reluctance to miss work if pay will be reduced.
Source: Report Puts County Residents’ Life Expectancy at 79 Years.