Though available data arent good enough to help the community prioritize which health-care concerns here are most important to address, someincluding obesity, injuries, and substance abuseare certainly worthy of greater focus, the countys top health officer says.


Spokane County Health Officer Dr. Kim Marie Thorburn says new health-care trend data are just now being collected and analyzed, and that the methodology to study the data is being changed, so the most recent data the health department has to work with are from 2001.


That said, Thorburn says the Spokane area faces three disturbing trendsin obesity, injuries, and substance abuseall three of which she discussed Jan. 27 in her state of Spokanes health policy agenda report to the Spokane Regional Health District board of health.


Obesity, a national epidemic, is commonly attributed to the sedentary lifestyle and poor nutritional habits of U.S. society, says Thorburn.


Obesity is an important population risk factor for chronic diseases such as heart disease and certain cancers, she says. Obesity rates are climbing in Spokane.


Spokane County obesity rates are higher than the state average, says Thorburn, but she does now know how they compare with national rates.


As the countys health officer, Thorburn says her role isnt to treat health problems, but to prevent them.


To curb obesity, she suggests mandating sidewalks and bike lanes in all new developments here; installing healthy, low calorie snacks in school vending machines; and requiring all K-12 students to participate in physical education classes.


Injuries are the most common cause of death in Spokane County among young children, and are a major reason for hospitalization in all local age groups, says Thorburn. Among such unintentional injuries are those caused by motor-vehicle accidents, falls, and drownings, she says. Notably, alcohol-related motor-vehicle deaths had been decreasing prior to 2000, but now are increasing again, Thorburn says.


Another category of injuries is called intentional injuries. Included in that category are suicides and attempted suicides. Spokane County ranks above both the state and national averages for suicide. In 2001, there were 11.86 suicides per 100,000 residents in Washington, but 14.05 suicides per 100,000 in Spokane County. The national average that year was 10.8 suicides per 100,000 population.


Two factors leading to the high local suicide rate are a high percentage of elderly population, with elderly men at risk, and the easy access to firearms seen in much of the community, says Thorburn.


The male suicide rate in Spokane County in 2001 was 23.68 for every 100,000 people, compared with 4.81 for females. National data show that women are more likely to attempt suicide than men, but men are much more likely to use more violent methods of suicide and thus to be more successful, says Thorburn. Women often overdose on medications or drugs and are discovered and revived before a suicide attempt is fatal, she says.


Local suicides are commonly seen among teens and elderly men, says Thorburn. She cautions the media about extensive coverage of teen suicides, saying the copy cat syndrome associated with such suicides is a real problem.


Increased alcoholism


In addition to an increase in alcohol-related motor-vehicle fatalities, Spokane County also has a high rate of alcoholism, says Thorburn. Thats supported by a 2001 telephone survey that was conducted by the U.S. Center for Disease Control and Prevention and included questions about binge drinking, she says.


It floored us to learn that more than one-third of local males surveyed between the ages of 18 and 34 had consumed five or more drinks in a short period of time within the previous 30 days, says Thorburn.


She says that alcohol is the most prevalently treated drug problem in Spokane County, and that prescription drug opiates and methamphetamine also are problems. The drug of choice for teens, in addition to alcohol, is marijuana, says Thorburn. She says data show that about 50 percent of Spokane-area high school seniors have at least tried marijuana.


Meanwhile, efforts at tobacco prevention have been successful during the past few years, but need to be continued, she says, adding that tobacco use, though declining, is still above state rates. Nineteen percent of Washington adults use tobacco products, while in Spokane County, 23 percent do.


Alzheimers and diabetes


Thorburn did share some relatively new data, from 2003, on Alzheimers disease and diabetes death rates in the county. Both rates have increased each year since 1999. Alzheimers deaths jumped from 27.4 per 100,000 population in 1999 to 38 per 100,000 in 2003, making the disease the sixth leading cause of death in the county that year. Over that same time span, diabetes deaths rose from 23 deaths per 100,000 to 28 deaths per 100,000, making it the seventh leading cause of death here.


The leading causes of death in Spokane County in 2003 were: diseases of the heart (25 percent); malignant neoplasms, (23.6 percent); cerebrovascular disease, (7.8 percent); chronic lower respiratory disease (6.9 percent); and accidents and external causes (5.5 percent). Rated 10 th on the list, at 1.7 percent, was suicide.