Thursday, September 2, 2004

Hawaii women
rank high in health

A CDC report finds lower risks
here for major causes of death

Isle rankings

Hawaii has the lowest death rate per capita for women in the nation, according to a study released yesterday by the Centers for Disease Control and Prevention.

According to the report, titled the Women's Health and Mortality Chartbook, Hawaii women were at the lowest risk for a number of major causes of death, including cancer, heart disease and lower respiratory diseases. The study also ranks Hawaii among the top 10 states for women with the highest levels of health insurance coverage and recent routine checkups.

"It's not surprising that we're the best," said Dr. Virginia Pressler, vice president for women's health at Kapiolani Medical Center. "We've consistently ranked high in women's health categories.

"One of the reasons is that we have a large population of Japanese, Chinese and Filipino women and other Asians who frequently have healthy behaviors and better statistics."

However, Pressler said the report does not break down Asian ethnicities, but instead lumps them with native Hawaiians and Pacific Islanders, who have high levels of obesity and smoking.

The result, she said, is that the numbers mask a segment of the population with serious health problems.

"Native Hawaiians and Pacific Islanders die younger, have more heart disease and cancer," Pressler said. "And the smoking and obesity rates are major drivers in the health statistics of these populations.

"You lose the whole picture when you pool those groups together."

According to the CDC report, Hawaii's overall ranking for obesity is second lowest in the nation, while the percentage of women smoking is the fourth lowest. In the Asian/Pacific Islander category, there is a 14.2 percent rate of obesity and a 16.6 percent smoking rate.

But numbers compiled by Kapiolani Medical Center and state health officials show another story by breaking down the ethnic groups further. Native Hawaiians have a 30.5 percent obesity rate, while other Pacific Islanders have a 47 percent obesity rate. Obesity rates for Asian women include 7.8 percent for Japanese and Chinese females and 10 percent for Filipinos, the numbers show.

The rate of native Hawaiian women and Pacific Islanders smoking is at 26 percent, while Chinese are 9.2 percent; Japanese, 10 percent; and Filipinos, 12 percent, according to Pressler. Those local numbers are part of a joint report titled "Hawaii Women's Health Status: Databook for Planning and Development," which is slated for release in the next few weeks.

"The CDC report is technically correct," Pressler said. "However, by lumping together the lowest- and highest-risk ethnic groups ... you mask health problems facing a segment of our population.

"You really need to break it all down."

Some of the other highlights of the CDC report include Colorado having the lowest rate of obesity at 15 percent, while Minnesota ranks best in terms of health coverage at 94 percent.

CDC officials said that while no one state scored the best in all indicators, there were a number of health patterns that emerged. They include Colorado, Hawaii and Utah having the lowest death rates for heart diseases and cancers. Also, eight out of 10 states with the highest stroke death rates were in the South, while a high portion of women with recent mammograms and cholesterol screenings were in the Northwest.

The report said "state differences also reflect the racial and ethnic makeup of the state's population" and that states with large Hispanic populations such as Texas, California, Arizona and Colorado all had "relatively lower rates of insurance coverage, reflecting a pattern for Hispanics in general."

Kapiolani Medical Center


Hawaii ranks
well for women

In a ranking of the 50 states, Washington, D.C., and Puerto Rico, Hawaii fared well in many health categories. Low numerical rankings indicate better health status.

Major causes of death among females
(rate per 100,000)*

All causes 1
Heart disease 2
Coronary heart disease 1
Total cancer 3
Breast cancer 2
Colorectal cancer 1
Lung cancer 3
Stroke 19
Chronic lower respiratory diseases (age 45 and over) 1
Diabetes-related 21
Influenza and pneumonia 2
Unintentional injuries 5
Suicide 33

Health risk factors (percent)**

Diagnosed high blood pressure 14
Obesity (2000-2002) (age 20 and over) 2
No leisure-time physical activity (2000-2002) 11
Binge drinking 11
Smoking currently (2000-2002) 4
Eats 5+ fruits and vegetables a day (2000-2002) 40

Preventive care (percent)**
Cholesterol screening in past 5 years 26
Mammogram in past 2 years (2000-2002) (age 40 and over) 29
Pap smear in past 3 years (2000-2002) 5
Routine checkup in past 2 years (1998-2000) 6
Early and adequate prenatal care all (all ages) 27

Health insurance coverage (percent)
Health insurance coverage (2000-2002) (ages 18-64) 3

* Estimate age-adjusted and for all ages unless noted.
** Estimate age-adjusted and for 18 years of age and over unless noted.

Source: Centers for Disease Control and Prevention



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