TDH commissioner touts state health initiative

By Thomas Wilson
star staff
twilson@starhq.com

  An initiative to improve the health of Tennesseans cannot succeed without the assistance of public, private, and religious entities who make public health a priority, according to the state's health commissioner.
  "It is time to act," Commissioner Dr. Kenneth Robinson told members of the Elizabethton-Carter County Health Board on Thursday afternoon. "We're not going to reach the top in one mayor's administration or one gubernatorial administration."
  Robinson met with local health officials this week as part of a statewide tour promoting the department's "Better Health: It's About Time!" initiative. The department is seeking to raise public awareness about the importance of a healthy lifestyle, to encourage individuals to take personal responsibility for their health and well-being, and to give newborn babies a better start in life.
  The lifestyle measure seeks to reduce diabetes, heart disease and stroke, and obesity among Tennesseans. The life start initiative sought to address health issues of infant mortality, teen pregnancy, and improved prenatal care for expectant mothers.
  The state ranks among the bottom 10 nationally in rates of teen pregnancies, infant mortality, and mortality from diabetes. Robinson said the initiative focused on lifestyle and life start measures.
  "We are trying to hit two clusters of health statistics in Tennessee," he said. "It is time to get Tennessee focused on getting itself off the bottom."
  When it comes to health, Tennesseans face serious problems particularly leading national killers of heart disease, hypertension, and diabetes. The mortality rate for heart disease and diabetes in ethnic minorities living in Tennessee is two and a half times higher than the state average.
  The risk for heart disease among the state's population is 21 percent above the national average, ranking Tennessee 48th among heart healthy states. In 2002, the age-adjusted heart disease death rate for black Tennesseans was 1.3 times higher than the rate for white Tennesseans. Factors that contribute to heart disease and stroke were high blood pressure, being overweight or obese, high cholesterol, and lack of exercise.
  Robinson said a contributor to poor heart health was a poor diet causing overweight and obesity. Obesity also contributes to certain types of cancer, type 2 diabetes, stroke, arthritis, breathing problems, and psychological disorders such as depression.
  "Sixty-one percent of Tennesseans are overweight or obese," Robinson said.
  Robinson said the state had also created a universal, faith-based initiative encouraging churches and religious-based groups to communicate healthy lifestyles to congregations. The department lacked the financial means or sway of religious organizations to reach state residents.
  "The translation is ideal," Robinson said. "The message is one of good stewardship of the body."
  The state's pregnancy rate for 10- to 17-year-old girls was 13.9 per 1,000 females in 2003, down from 14.1 in 2002. Despite the fact that adolescent pregnancies have decreased by 40 percent from 1993 to 2003, the pregnancy rate for black adolescents is still higher than the overall rate was a decade ago. In Tennessee in 2003, the adolescent pregnancy rate for black teens was nearly two and a half times higher than the rate for white girls of the same age. Robinson said the state's reduction in teen pregnancy rates mirrored a drop around the nation.
  Tennessee's infant mortality rate ranked fifth highest in the nation for 2001 exceeding the national rate by 29 percent. Low birth-weight infants accounted for 65 percent of all infant deaths recorded during 2002. Low birth weight, the use of alcohol, tobacco, or other drugs, and poverty are among the contributors to infant mortality.
  The news was worse for babies of black mothers living in Tennessee. The infant mortality rate for black babies in 2002 was two and one half times higher the rate for white babies.
  "They compare with the infant mortality rates in Third World countries," Robinson said.
  Prenatal care for expectant mothers often deflected problems associated with infant mortality. Basic prenatal care services are provided at all local health department clinics and include pregnancy testing, education, presumptive eligibility, referral for WIC, and referral for obstetric medical management.
  A physician, professor, and pastor, Robinson's own life has taken him through the world of health care and faith. He earned his medical degree from Harvard Medical School and his Masters of Divinity from Vanderbilt Divinity School. He is a diplomate of the American Board of Internal Medicine, formerly practicing and teaching general internal medicine as a faculty member for a decade at the Vanderbilt University School of Medicine.
  Robinson said health officials sought an improvement to scale of public health across the state. He reiterated improving public health required the participation of public and religious entities.
  "We know they talk the talk," he said. "We want to give them the tools to walk the walk."