A picture of health in northern New York

We have all heard the adage, “Health isn’t everything, but if you don’t have your health, you don’t have anything.” Yet, it is amazing, but we sometimes take our health for granted. This is true despite how basic and essential good health is to existence. But when a sudden illness strikes, our health, or lack of it, rises to the top of our consciousness; it is all we can think about. The massive healthcare industry is the result of this, our primal desire to be healthy. It consumes time and resources on a grand scale in the United States. Good health is so essential to a life well lived that we spend a lot of money looking for it.

The United States spent $2.9 trillion on healthcare in 2013. Source: Federal Center for Medicare and Medicaid Services. Graphic: Joann Sandone Reed

The healthcare/money connection has been around a long time

Although Mahatma Ghandi wasn’t the first one to connect good health and wealth, he said, “It is health that is real wealth and not pieces of gold and silver.” A good reminder, but what he didn’t mention is health and healthcare doesn’t come cheap.

The United States spent an average of $9,086 per person — 17 cents of every dollar of gross domestic product – on healthcare related expenses in 2013, according to the World Health Organization (WHO). With that kind of budget, we should be the healthiest nation on earth. The numbers tell a different story.

Since healthcare spending takes such a big chunk of our resources, and health is so important to wellbeing, it makes sense to try and understand how it all works and how healthy we really are.

On a national basis, the United States has the highest per capita healthcare expenditures among comparable high-income countries. However,  at 79-years-old, we have the shortest life expectancy of all other comparable high-income countries. If you had the good fortune to be born in Switzerland for example, you pick up four years and have an average life expectancy of 83.

The United States has the shortest life expectancy at birth among high-income comparable countries. Source: Peterson- Kaiser Health System analysis of Organization for Economic Co-Operation and Development (OEDC) 2011 Health Data.  Graphic: Joann Sandone Reed

Elements of healthcare

In order to understand the status of healthcare in northern New York, we’ll look at the overall health of the population, the quality of the healthcare services delivered, how much it costs, and how the population accesses those services. These metrics are usually presented in comparative analysis, as in, how does northern New York compare with the rest of the state? How are we doing compared to the rest of the country?

If this sounds like a lot of information, you are right, it is. But that doesn’t mean we can’t try to get a better understanding of what it means and what it takes to be healthy. Stay tuned to NCPR as we present a picture of health in northern New York, dished out in bite-sized, easy-to-digest articles.

Does easy access to hiking and outdoor recreation help make residents of northern New York healthy? Photo: Edward Reed

What does being “healthy” mean?

The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The healthcare industry, which includes doctors, hospitals, and pharmaceuticals, is a large part of this equation, but lifestyle choices are often the overlooked but key ingredients to a healthy life. The influence on health of where and how we live is part of our story and harkens back to the history of healing in the Adirondacks.

Healthcare metrics

The healthcare industry is famous for generating massive amounts of data and statistics — measurements. This metric-driven approach to healthcare is founded on the concept of making decisions on the basis of verifiable data and statistical methods, rather than assumptions and guesswork. The optimistic idea is, “You get good at what you measure.” We have plenty of data to consider and, ultimately, it will tell the story.

We have to start somewhere, so the first data point we reviewed might be considered the most important: the cause of death.

Leading Causes of Death by County, New York State, 2013. Source, New York State Department of Health. Graphic: Joann Sandone Reed

We included data from 13 northern New York counties in our analysis: Clinton, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Oneida, Oswego, St. Lawrence, Saratoga and Warren. The data collected is from the year 2013, which is prior to the full implementation of the Affordable Care Act.

Heart disease and cancer

Heart disease was responsible for the most deaths in northern New York and killed 2,746 residents of the 13 counties in 2013. A close second was cancer, which took 2,629 lives.

Premature death

Because the risk of death increases with age, we looked at premature deaths; people who died “before their time.” Premature deaths are measured in “Years of potential life lost” or “Potential years of life lost (PYLL).” This is an estimate of the average years a person would have lived if he or she had not died prematurely. It is a measure of early mortality. Anyone who dies before they are 75-years-old is considered to have died prematurely.

Premature death rates – 2013. Years of potential life lost (PYLL) Source: Center for Disease Control, National Center for Health Statistics – Mortality files. Graphic: Joann Sandone Reed

Hamilton County appears to the most troublesome spot in our region with higher than state averages for heart disease, cancer, and premature death. St. Lawrence County is a close second in this dubious category.

In future installments, we’ll dig down and peel away layers in an effort to figure out what some of these numbers mean. For example, what is different in Hamilton County that makes more people die of heart disease than die from the same ailment in Saratoga County? But first we need to set the stage for how the healthcare system works; next time we’ll learn who the players are and how they play together.

Tags: Healthcare, northern NY, picture of health