According to United Health Foundation’s America’s Health Ranking Annual Report, Arizona is struggling with graduation rates, children in poverty and drug deaths. These challenges have resulted in Arizona ranking at No. 30 for overall health in the country.
“I’m not shocked with our rating,” said Peter “Chip” Coffey, MAPC, LPC, NCC and director of therapy services at St. Luke’s Behavioral Health Center. “I see evidence of our ranking, especially related to drugs.”
According to the report, drug deaths have increased in the past two years by 13 percent — from 16 to 18.1 deaths per 100,000 people. Although this rate does not place Arizona in the bottom five states for drug deaths, it does place the state at No. 41 in this category.
“We see an increase in use of opiates,” Coffey said. “Heroin is extremely cheap, so people can get it easily on the streets. For instance, college kids will start abusing prescription drugs and then transition to heroin that they can buy for a cheap price on the street.”
Particularly within Maricopa Country, there has been a 44 percent increase in heroin deaths, according to Coffey. Overall, the number of drug deaths in the United States increased 4 percent, from 13 to 13.5 per 100,000 people. The Health Ranking Annual Report estimates the total healthcare cost of that results from illicit drug use at $193 billion within the United States.
“A lot of programs will teach people how to get off a drug, but they kick the person out as soon as they relapse,” Coffey said. “In order to reduce the rate of drug deaths, medical centers need to treat all the symptoms. We’re trying to educate them on relapse.”
While the drug death rate in Arizona may not be as low as physicians and residents would like, steps are being taken to reduce the number of drug related overdoses. One such precaution revolves around a pharmacist monitoring system. Pharmacies now have an online report protocol that notifies the pharmacist if a person is coming in repeatedly for the same drug.
“We regulate the system as best we can and we are sensitive to quantity limits on drugs,” said Steve Chakmakian, D.O, chief medical officer for Community Plan at UnitedHealthcare.
Alternate practices — such as e-prescriptions and counter-active drugs — have also been put into place. E-prescriptions are recorded and kept online, thereby preventing people from making copies and continuously refilling and abusing the same prescriptions.
“Narcan is a drug used to override overdoses,” Coffey said. “It’s about $25 and if a loved one finds someone who has overdosed, it can be administered.”
Narcan can either be given as an injection or a nasal spray. The drug acts as an opiate antidote by kicking the opioids out of the opiate receptors located in the brain.
“We don’t see as many young teens dying from overdoses, but one of the things that is a struggle, is a lack of investment in our education,” Coffey said. “We teach kids how to take a test, but we don’t have ways to motivate them and get kids invested in learning.”
According to the 2015 report, college graduates are expected to live five years longer than those who did not complete high school. Studies within the report illustrate that college graduates are more likely to find better job opportunities and thereby will have better access to healthier food and health insurance.
“The state could provide more support for higher education to lower out-of-pocket costs to students,” said Keith Lindor, dean of the College Health Solutions at Arizona State University. “Financial reasons are the main reason people drop out of college.”
Arizona ranks No. 44 out of 50 for overall graduation rate. Chakmakian suggests that healthcare officials need to work with the schools in order to increase healthcare and thus promote healthier living and behavioral patterns.
“As I read the report, I tied the results back to community and poverty,” Chakmakian said. “Arizona ranked No. 46 for children in poverty.”
Within the past 10 years, the number of children in poverty within Arizona increased 35 percent — from 21.1 percent to 28.5 percent of the state’s children. As one of the bottom five states for children in poverty, it is not far fetched to see the correlation between this rate and the absence of children who have healthcare.
“There is a bubble line that has to be met to reach the federal policy level,” Chakmakian said. “Many people often qualify for programs such as Medicaid, but they do not know they are a potential candidate for the program.”
Yet, the problem is not that there are not ample resources available to provide health aid, but rather, facilities are not given the opportunities to help patients without health insurance.
“There is a quality lack of health insurance within the state,” Chakmakian said, “and speaking as a chief medical officer, I think this is a big factor to our low ranking.”
However, when given the opportunity, Arizona has been making progress in other areas of healthcare. Over the past two years, the number of preventable hospitalizations decreased from 51.4 to 40.1 per 1,000 Medicare beneficiaries, according to the 2015 Annual Health Ranking report.
“We have a lower rate of preventable hospitalizations and that is a good strength to have,” Chakmakian said. “The low number of cardiovascular deaths is probably related to a lower obesity rate.”
Within the past year, physical inactivity in Arizona decreased 16 percent and cardiovascular deaths decreased 21 percent. Arizona ranked No. five for cardiovascular deaths in the country.
“I see fewer smokers and more people are caring for their physical health,” Coffey said.
Additionally, incentives have been put into place in order to continue decreasing the physical inactivity rate. According to the 2015 report, UnitedHealthcare promotes wellness incentives of $20 per month for families who visit fitness centers.
“Incentives can be effective and we have seen them work with health and fitness programs,” Chakmakian said. “However, these programs need to be smart and innovative, and should be continuously evaluated to ensure they are working.”
Although Arizona is not amongst the high rankers this year, physicians are hopeful that after seeing where the state stands, they can begin to make a difference.
“It is sad that we don’t react to these problems until it affects the larger community,” Coffey said.
