March 20, 2013

Report: Somerset County's poverty spurs obesity, smoking, overall poor health

By Matt Hongoltz-Hetling
Staff Writer

Somerset County adults are more likely to smoke and to be fat than adults of any other county in the state, two of the key factors that led to its dismal showing in a statewide ranking of Maine's counties, by health.

Link between smoking and bladder cancer
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High rates of obesity and smoking -- the products of Somerset County's poverty -- contribute to making the western region's health rates among the worst in Maine, according to a study by the Robert Wood Johnson Foundation.

AP file photo


The following is a ranking of Maine's counties by level of health -- the ranking relies on data compiled by the Robert Wood Johnson Foundation on everything from the percentage of people who smoke to the violent crime rate to the teen birth rate.

1. Hancock (healthiest)

2. Cumberland

3. Sagadahoc

4. York

5. Knox

6. Androscoggin

7. Kennebec

8. Franklin

9. Penobscot

10. Waldo

11. Lincoln

12. Oxford

13. Aroostook

14. Washington

15. Somerset

16. Piscataquis (least healthy)


In all, the rankings compared counties on 30 different measures. Here are some of the areas in which Somerset County ranked significantly worse than the state average.

Factor Somerset County Maine
Percentage of babies with low birthweight 7.8 6.5
Percentage of adults reporting poor or fair health 17 13
Percentage of adults who smoke 26 19
Percentage of obese adults 35 28
Percentage of physically inactive adults 27 23
Motor vehicle crash deaths per 100,000 people 18 13
Teen births per 1,000 girls aged 15-19 37 24







Other counties in central Maine are healthier, with Waldo ranked 10th, Franklin eighth, and Kennebec seventh among the state's 16 counties, according to national county rankings released Wednesday by the Robert Wood Johnson Foundation, a philanthropic organization devoted to public health.

People in Maine's low-ranking counties are still better off than those in many other areas of the country because Maine is the ninth-healthiest state in the nation, according to the foundation.

The three healthiest counties in the state are Hancock, Cumberland and Sagadahoc, in that order. The study did not rank counties nationally, however.

Somerset County's poor showing explains why its residents are more likely to die of a heart attack or lung cancer than anywhere else in Maine, a state expert said.

The underlying cause is poverty, experts said, with poor people more likely to be obese and smoke.

In Somerset County, more than 1 in 3 adults, or 35 percent, are obese, compared to a statewide average of 28 percent, according to the foundation.

That percentage has risen dramatically since 2004, when the county and the state averages were the same, about 24 percent.

Smoking rates are also high in Somerset County, with more than 1 in 4 adults, or 26 percent, smoking. The statewide average is 19 percent.

The number of smoking adults, however, is decreasing in Somerset County and across the state, a county health advocate said.

Obesity and tobacco use are "the biggest contributors to people being sick or dying earlier," according to Tim Cowan, of MaineHealth, a statewide group of health care and health advocacy organizations.

About a third of cancers are linked to tobacco and a third are linked to obesity, Cowan said.

Cowan said Somerset County's high smoking rate is why people there are more likely to die of lung cancer than anywhere else in the state.

In Somerset County, 70.5 per 100,000 people died of lung cancer, the highest rate statewide and significantly higher than the state average of 59.1 deaths per 100,000, according to the Maine Center for Disease Control's 2012 annual cancer report.

Somerset County joins Franklin County as having the highest mortality rates because of heart attacks, according to a 2011 MaineHealth Index report.

Deadly poverty

In Somerset County, 18.6 percent of the population lives in poverty, the second-highest rate in the state, according to a 2012 report on poverty by the Margaret Chase Smith Policy Center.

That fact, more than any other, contributes to the high obesity and smoking rates, experts say.

Somerset County is just one example of many poor, rural counties with poor health, said Bill Primmerman, director at the Greater Somerset Public Health Collaborative.

"When you look at public health, the economic climate of the community has a lot to do with the health of the community," he said, in part because people in poverty are less able to afford healthy food and less able to access exercise options.

Cowan said Somerset County smokers aren't ignorant about the link between cigarettes and death, but they have a harder time quitting.

"It's not as if they don't want to quit. Most of them are trying," he said.

More than half of Maine smokers, rich or poor, have tried to quit during the last 12 months, Cowan said, with poor smokers making the effort as often as their well-to-do counterparts.

Poor people don't succeed as often, he said, because smoking is more widely accepted in social groups.

(Continued on page 2)

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