By the numbers
$1.5 trillion: Projected total cost of chronic disease between 2016 and 2030 in Ohio.
7 million: People with one chronic disease in Ohio.
2.9 million: People with two or more chronic diseases in Ohio.
Source: Partnership to Fight Chronic Disease
Healthy Springfield: About this series
Many readers responded to a report late last year that ranked Springfield as the least healthy city in Ohio. That response — including wanting to make a positive difference — prompted the Springfield News-Sun to take a closer look at the community’s health. This year, the News-Sun will dig into the public health issues facing the city, including teen pregnancy rates and school lunch programs and efforts to improve them. Next week, the News-Sun will investigate physical education in schools.
MORE ONLINE: For all of our Healthy Springfield content, log on to SpringfieldNewsSun.com/healthy-springfield.
Clark County residents live shorter lives on average than the rest of Ohio and the U.S. — and more than 60 percent of their deaths are from preventable causes.
The life expectancy for Clark County men is three years less than the U.S. average. For Clark County women, they can expect to live about 3.5 years less than the average American woman.
Heart disease has been the leading cause of death in Clark County for each of the past 15 years, followed by cancer and stroke, said Gabe Jones, an epidemiologist at the Clark County Combined Health District.
These chronic diseases often can be prevented by physical activity, eating healthier and not smoking, Jones said.
“It seems very simple and you would think almost everybody knows it,” Jones said. “But people really need to practice it … Part of our job is to figure out how to make it easier for community members.”
The costs of treating chronic diseases in Ohio alone is $1.5 trillion, according to the Partnership to Fight Chronic Disease.
As part of the 2016 Community Health Improvement Plan, seven task forces have been created to improve health in Clark County — all of which play a role in preventing chronic disease.
Community Mercy Health Partners also will open a facility in Clark County similar to its chronic care clinic in Urbana, which has significantly reduced hospital re-admission rates in the past year.
Genetics often play a role in these chronic conditions, said Dr. Narinder Saini, a Springfield-based internal medicine specialist, but other bigger factors contribute, such as stress and a poor diet.
Saini himself fought back from a heart attack in 1990 and has educated many people in Clark County about chronic diseases since then.
“Genes are just like a trigger,” Saini said. “If you don’t pull the trigger, it’s not going to fire. The genes are there, but if you exercise, eat right, perform stress management and take your medications … It can be done easily.”
Life Expectancy
Clark County ranked 76 out of Ohio’s 88 counties for length of life, according to County Health Rankings data.
Between 1985 and 2013, life expectancy rates in Clark County increased 4.1 years for men and 0.3 years for women — below the national averages for men (5.5 years) and women (3.1 years), according to the Institute for Health Metrics and Evaluation at the University of Washington.
Those numbers should be a cause of concern, said Bill Heisel, the institute’s director of global engagement.
Clark County ranks among the bottom counties in the Miami Valley for life expectancy, according to the institute's interactive health map. While Clark County has remained stagnant, Heisel said, other nearby counties, such as Greene County, have seen three to four years worth of an increase.
Higher rates of obesity, daily smoking and hypertension have slowed the increase of life expectancy here compared to nearby counties, Heisel said. Other local factors typically play a role in life expectancy nationwide that can’t be measured by the study, he said, such as types of work places or traffic safety.
Economic and social factors play a role in life expectancy, but Heisel said that’s often overemphasized while health education is underplayed. With more education, people will make better decisions for themselves and their children, he said, including preventative care, diet and exercise.
“There’s just all these ripple effects from basically getting more education, which is not the same thing as just saying you have to earn more money,” Heisel said. “There are plenty of places that are lower on the income scale but still quite high on life expectancy.”
By changing eating habits, communities can often see a big increase in life expectancy, he said.
“Dietary factors combined are the biggest driver of poor health in the U.S. and in most countries,” Heisel said.
Leading cause of death
Heart disease has been the top cause of death in Clark County, as well as Ohio and the U.S. for many years. Last year more than 614,000 people nationwide died from heart disease.
It consists of several different illnesses from coronary heart disease to deep vein thrombosis.
“For the most part, a lot of those are going to be preventable,” Jones said. “A good, healthy diet is going to be one of the biggest contributors to having a healthier heart.”
A poor diet can clog arteries and cause other issues, he said, which over time wears down the heart.
“Whenever you have something like a heart attack, it can ultimately lead to your death,” Jones said.
Mental wellness and stress — for all types of people, rich and poor — also can contribute to heart disease, Jones said.
“Being in a state where you’re very agitated, you can feel your heart racing,” Jones said. “Now imagine that hours on end throughout the day. Your heart can’t handle that kind of stress all the time.”
Stress often now starts at a younger age, said Anita Biles, a health educator with the Clark County Combined Health District. About 21 percent of middle school students surveyed by the health district last year had seriously considered suicide.
“If you’re at that level of stress in middle school and it continues on, by the time you’re an adult, you’re receiving another level of damage,” Biles said.
The heart is a muscle, Jones said, and the more it’s used, the stronger it becomes.
Exercise like running, swimming and cycling will make the heart stronger but any physical activity — including walking or gardening — is also effective, Biles said.
“It’s all about ‘Get up and move’,” she said.
Keep busy
Four years ago Springfield resident Charlene Kennedy suffered a stroke and couldn’t walk. She also has diabetes.
“I had to learn to walk all over again,” said Kennedy, a retired teacher.
Before her stroke, she had been going to Step Up Rehabilitation and Fitness Center in Springfield after being referred there by Saini.
But after her stroke, she had problems with her eyesight and was forced to stop driving.
A month ago Sue Fisher, her friend and fellow gym member, began bringing her back to the fitness center three days a week. Kennedy can already notice a difference.
“I feel so much better since I started coming here,” Kennedy said. “I’m walking better. It’s also the social part of it, getting out of the house and seeing people. I feel so much better.”
Exercise is the key, she said.
“Keep busy,” Kennedy said.
Access to care
Clark County has fewer doctors for people to see on a frequent basis, Jones said, and other doctors have long waiting lists — meaning people with chronic diseases often head to the emergency room.
“That’s not always the place we want those people to go in those kind of situations,” Jones said. “Ideally it would be a primary care provider. But if they can’t get in, then they have no other options.”
The Rocking Horse Community Health Center often treats patients with one or two chronic illnesses at a much younger age, Medical Director Dr. Yamini Teegala said. By the time they reach 50, most people have at least three diagnosed diseases, she said, often caused by not making health a priority and a lack of access to care.
She rarely sees patients who are solely looking for a primary care physician.
“Preventive health care has never been so disabled as it is right now,” Teegala said.
Hypertension, diabetes and high cholesterol typically all occur together, Teegala said. Chronic mental health issues also contribute to these medical illnesses.
“Integrated care is the way to go to prevent all of this,” Teegala said. “If people would treat the body as a whole, we would see less and less poor outcomes out of chronic disease management.”
Managing chronic diseases
Many people go to the hospital for chronic illnesses but don’t follow up with doctors after their release — which often leads to a re-admission for the same condition.
The health district wants to cut those re-admissions by establishing primary-care providers for congestive heart failure patients who don’t have doctors by 2018.
Community Mercy Health Partners will open a new facility this summer on the former Mercy Medical Center Fountain Boulevard campus designed to reduce re-admission rates for chronic disease patients — similar to the Urbana clinic. The Champaign County center opened a year ago and since then the re-admission rate for those patients dropped from 14 percent to 4 percent, Nurse Practitioner Sue Berger said.
“It really makes a difference when you can get your eyes on people and see what’s going on with them,” Berger said.
The new Clark County clinic will allow patients here to receive a follow-up visit five to seven days after their hospital stay and help them find a doctor.
“We take care of their immediate needs, we get them on track,” said Mariann Potina, Community Mercy vice president for mission integration.
It will also have an area to educate patients who suffer from chronic conditions, such as diabetes and congestive heart failure.
“They can learn from professionals what’s the best way to take care of themselves,” Potina said.
Rocking Horse also is working with an outside service to call and check in with chronic disease patients between visits, Teegala said.
“We see chronic conditions every day,” Teegala said.
‘You do feel better’
Susan Baker, a former coronary care nurse at Community Hospital, deals with her hypertension and high cholesterol with medication and exercise.
She hasn’t had any major health problems but knows after working at the hospital for decades that it doesn’t take much to have heart issues.
“I could see the writing on the wall,” Baker said.
She’s been going to Step Up fitness center, 1031 W. First St., for several years, also referred there by Saini.
The camaraderie also helps, she said.
Plenty of health education is available in Clark County, Baker said, but people don’t pay attention to it.
“They just sit home and see it on television,” Baker said. “Some days it’s an effort to get up and come, but once you’re here, you do feel better.”
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