Tuesday editorials: Broken hearts
The numbers are chilling:
•Women in Jefferson County are 17 percent more likely to be hospitalized for heart and circulation problems than those elsewhere in Missouri.
• Women in St. Francois County are 38 percent more likely to die from heart disease.
• Women in St. Louis have twice the rate of preventable hospitalization for congestive heart failure of other Missouri women.
It comes as no real surprise, then, that the American Heart Association named St. Louis among the nation’s least heart-friendly big cities for women. Only Nashville was worse. We’d come in very high on a list of least heart-friendly big cities for men, too.
St. Louis has some of the nation’s finest hospitals and doctors. But as demonstrated by the rate of preventable hospitalizations for congestive heart disease, we also have plenty of health problems.
Preventable hospitalizations are those that could have been avoided if the patient had received care and medication earlier. As Post-Dispatch medical writer Blythe Bernhard reported this week, many people in the St. Louis region don’t eat right, many smoke and they rarely exercise. All are factors that increase the risk of heart and circulation problems.
But there are also significant numbers of people who have no health insurance who cannot afford to see a doctor or fill a prescription. As a result, they put off addressing their health concerns, which means they’re often much sicker when they finally get care.
One of the missed opportunities of the legislative session that ended last week was the failure to extend health insurance to working parents with poverty-level incomes. Most of those parents are single mothers. They can’t afford to buy health insurance on their own, and it’s not offered to them through their jobs.
The heart association study looked only at metropolitan areas. But many rural counties in Missouri and Southern Illinois have even higher rates of heart disease.
High rates of hospitalization and premature death are costly for all of us, not just the families of those who fall ill. They drive up hospital prices and insurance rates and result in higher business costs through absenteeism and lost productivity.
Many places that ranked high in the heart association’s survey, such as Minneapolis, have taken aggressive steps to encourage exercise and prevent disease. The St. Louis region needs larger, more coordinated health promotion efforts to change eating habits and encourage exercise.
Meanwhile, women can and must take steps to reduce the individual risks within their control. They should educate themselves about the symptoms of heart disease — some of which are different from those experienced by men. And they should follow their doctor’s advice to quit smoking, exercise more and, if prescribed, regularly take medicine to reduce cholesterol and control high blood pressure.
Heart disease and heart attacks already have taken a large toll on our region. All of us — women and men — must work together to prevent new heart disease and the heartbreak it causes.
(2 votes, average: 2 out of 5)
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The editors identify preventable hospitalizations from heart disease which boils down to noncompliance with medications. A minority of patients do not take medications because they were never prescribed, but it would be safe to assume most of the cases identified were due to patients not taking medications that were prescribed.
You may say some people cannot afford their medications. I would say that is not true. Most of the medications that have a large impact on measurable endpoints of heart disease are generic and can be bought for <$5 per month and most patients need no more than 3 medications less than the cost of lunch which many of these patients ought to skip anyway.
All of the people with preventable admissions to hospitals should take care of themselves if they want to improve their health. Whenever the PD editorial board says something like “The St. Louis region needs larger, more coordinated health promotion efforts to change eating habits and encourage exercise” it doesn’t mean they plan to start or join a private organization to help with the problem — they mean they want to take your money and give it to someone else.