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At Risk

Drive around any large to fair-sized city in Texas, and it appears there’s a new 24/7 gym popping up on virtually every corner. And no matter the time of day or the temperature, you can usually find bikers, runners and walkers out on our streets and trails. All of that, of course, is good! But don’t let the outward appearances fool you. By most metrics, Texas is not a particularly healthy state. In a recent ranking of healthiest states, the United Health Foundation ranked Texas in the bottom half, 34th among its sister states.

The many different ways to approach the topic make a discussion of health issues difficult. You could examine men’s health or women’s health, or health issues among certain racial groups, the elderly, or children. Any one of these health topics is worth an examination in itself, but to reduce the complications, we’ll cut across gender, ethnic and age lines and concentrate on the health issues generally considered the most serious by the Texas Medical Association and other medical authorities.

Standing at the top of the TMA’s list of Texas health issues is tobacco. Since the surgeon general’s first report on the health hazards of smoking, over 20 million Americans have died prematurely from the effects of tobacco. Today the annual death rate from smoking in the United States

is about 500,000 a year, and it’s not just smokers who are affected. People exposed to second-hand smoke have a 30 percent increased chance of heart disease and cancer.

In the face of this ongoing health threat, many Texas organizations have ramped up their anti-smoking

campaigns. A number of Texas cities have passed ordinances that essentially ban designated smoking area in public workplaces, restaurants, and bars. Smokers can still smoke, but to protect workers and other patrons, they must go outside to light up. Still, according to statistics compiled by the Centers for Disease Control in 2009-10, 50 percent of adult Texans were exposed to second-hand smoke, ranking Texas 39th among the states.

For the smokers, contrary to what some think, it’s never too late to quit, and doing so has almost immediate benefits. Your circulation will improve and your lungs will work better. And ten years after kicking the habit, your chances of getting lung cancer will be half of what they are now.

Ranking second on the TMA’s list of health issues confronting Texans is obesity. For adults, obesity is generally defined as having a Body Mass Index (BMI) higher than 30, while for children it’s defined as having a BMI higher than the 95th percentile for children of the same age and gender.

Due to a combination of circumstances including a lack of exercise and poor eating habits, among others, more than two out of three Texas adults are overweight or obese, along with one in three children ages 10-17. The National Health Foundation ranks Texas in 40th place among the states because of its extremely high obesity rate.

The costs of this health problem are tremendous, and are not limited just to those who are overweight or obese. According to TMA statistics, obesity costs Texas businesses about $9.5 billion each year due to higher employee insurance costs, absenteeism, and other issues.

A close corollary to obesity is metabolic syndrome or syndrome X. Individuals are considered metabolic syndrome patients if they have three or more of the following abnormalities: abdominal obesity of more than a 40-inch waist for men and 35-inches for women; triglycerides higher than 150; low HDL (the good cholesterol); blood pressure greater than 130/85; or an elevated fasting blood sugar level.

This combination of medical abnormalities increases the risk of hypertension, diabetes, heart attack and stroke, and Texas ranks 33rd among the states for cardiovascular- related deaths.

Fortunately for all of us, there are a number of easily accessible preventive measures. You should exercise three to five times a week, reduce portion sizes, and eat a balanced diet of fruits and vegetables, whole grains, beans, nuts, dairy products, seafood, lean meats, and poultry. Also, cut back on sugar-laden drinks and carbohydrates.

Still another area of health concern for Texas, according to the TMA, is mental health, including substance abuse disorders. According to a study published by the TMA, “Mental Health and Substance Use Disorders,” about 20 percent of adults in Texas had five or more mentally unhealthy days per month. Further, almost 30 percent of Texas high school students felt sad or hopeless almost every day for two weeks or more, almost 16 percent considered suicide and about 11 percent attempted suicide one or more times. Frightening statistics!

As to substance abuse, over 60,000 Texans on average enter publically-funded substance abuse treatment programs yearly. Among young people in 2010, 62 percent in grades 7-12 admitted using alcohol, while slightly over 26 percent had used marijuana. Further, there seems to be a correlation between substance abuse and mental health among adults and youth as 6 out of 10 with a substance abuse disorder are also diagnosed with some form of mental illness.

Fortunately in this area, Texas is doing much better than in other health categories. As a means of providing help for those suffering mental distress, the Texas Department of Health and Human Services maintains a 24-hour mental health hotline (1-866-260-8000) as well as a 24- hour text line (741741). As a result of efforts such as these by HHS, the United Health Foundation ranks Texas 6th among the states in dealing with mental health-related issues and 7th in drug-related deaths.

According to the TMA, immunization against disease is an ongoing health issue in the state. For example, according to the TMA’s most recent statistics, 59 percent of adults did not get a flu shot during the past year, and while 70 percent of infants between 19 and 35 months received the immunization recommended by the medical community, Texas still ranks 48th in childhood immunization. A complicating situation is the controversy swirling around potentially negative effects of immunization shots, a question that led the Texas legislature to pass legislation allowing parents or legal guardians of children to decline vaccinations.

Any examination of Texas health issues must note the effects of asthma and allergies. According to specialists at the Texas Allergy Center in Dallas, 80 percent of those suffering from asthma have underlying allergies, and many Texans suffer an almost constant barrage of irritants, cedar in the winter, tree pollens in the spring, and ragweed in the fall, complicated by a high mold count triggered by warm temperatures and high humidity. Unfortunately for asthma and allergy suffers, it’s expected that allergies will double and possibly triple during the next 20 years because of declining environmental conditions.

Finally, there is the inescapable Texas sun and its potentially harmful rays. While many consider a nice tan to be a fashion statement and even a sign of vigor and good health, in reality, tanned skin is damaged skin. Nationally, cases of basil cell and squamous cell carcinoma are skyrocketing, especially among women, and recent studies indicate that one in three Texans has some form of skin cancer.

If caught early, most forms of skin cancer can be treated successfully. One of the keys is self-examination, looking for anything that looks suspicious, using what dermatologists call the ABCDE rule for cancer determination: asymmetry, borders, color, diameter, and elevation. If you note anything suspicious, see your dermatologist immediately. Rain or shine, the American Academy of Dermatology recommends using a sunscreen with a Sun Protective Factor (SPF) of 30 or higher.

There is some good news to come of this discussion of Texas health issues, and that’s that none of them are foregone conclusions! With a bit of awareness and the application of some common sense and discipline, many of these health risks can be minimized and possibly even eliminated.

David Buice is a freelance writer based in Irving and can be reached at

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