Health and Death

How do you prioritize the spending of public health dollars? One way is to look at death. I can’t speak for the whole board, but I am pretty sure, the board unanimously wants to postpone (perhaps even eliminate) death for folks in Snohomish County (and everywhere for that manner).

Our health officer, Gary Goldbaum, gave a great talk today on death rates, and how they affect funding priorities for the Snohomish County health district.

First, he compared the leading causes of death in 1904 to the leading causes of death today. Communicable diseases like the influenza, pneumonia, and tuberculosis were the leading causes of death in 1904, but today, cancer and heart disease are the leading cause of death. This is no coincidence. Health districts all over the country have done an excellent job at controlling and eliminating communicable diseases, which is the major reason why today’s average life expectancy is now over 70.

However, to get the whole health story, we need to look at death rates a different way: a way that examines death rates for the younger generations. In an analysis called “Years of Potential Life Lost”, folks who die after 65 are not counted, and younger folks are given greater weight than folks who die closer to 65. This analysis shows that younger folks are primarily killed by unintentional and intentional injuries.

Another very glaring fact is that chronic diseases, like heart disease and cancer, dominate the death charts no matter how you look at them. Goldbaum also cited a study showing that adverse childhood experiences can be very detrimental to an individual’s long term health. Many of the chronic diseases are also attributable to the decisions that folks make, like smoking, drinking, and over-eating.

Goldbaum concluded that the health board should have four priorities:

1) Communicable disease control and prevention (we don’t want go back to the days of 1904).
2) Chronic Disease Prevention (Heart Disease and cancer dominate the death charts no matter how we look at them, and these diseases can be prevented by good life choices.).
3) Emergency Preparedness (a way to reduce unintentional injuries and insure that the work for public health can still be effective despite a sudden massive demand for services).
4) Early Childhood Development (so we can get folks off to a good start, making good decisions for their long term health)

Thanks goes to Gary Goldbaum for a very good talk.