O.C. Is Rated Near Top in Health Study

Orange County is the second-healthiest of California’s largest counties, ranking at or near the top on most indicators of health status, according to a report issued Monday by the county’s Health Care Agency.

Health officials attribute the relative well-being of the county’s 2.6 million people to the area’s affluence, demographics and relatively good access to health services.

“Orange County is a wealthy community and, as a rule, poverty is associated with adverse health status,” said Len Foster, acting public health director. “We have more hospitals, more doctors and a more aware and educated population.”

The report, which compares statistics on death and illness with other counties and with state and national benchmarks for 1994 through 1996, showed Orange County ranking first, second or third in 19 of 25 health status indicators.

Only Santa Clara County in Northern California ranked higher among the state’s eight counties with populations of more than 1 million people, according to the analysis.

Health care officials said the two counties are similar in populations and both have a heavy suburban makeup. The report used state statistics in drawing its comparisons.

Santa Clara, which includes San Jose and the Silicon Valley, had the fewest deaths due to drugs, firearm injury, heart disease, homicide, cancer, breast cancer, car crashes, suicides and infant morality.

Among the state’s eight most populous counties, Orange County had the lowest rate of stroke deaths, the lowest African American infant mortality rate and the smallest percentage of infants with dangerously low birth weights.

By comparison, Los Angeles County ranked first in the rates of AIDS cases, syphilis cases, tuberculosis cases, homicides and firearm-related deaths.

Orange County has long been known for its active, outdoor lifestyle and devotion to healthful pursuits.

On Monday, Eric Biefeld, a La Habra firefighter, was out just before sunset getting in one of his thrice-weekly runs. He stays in shape with exercise at work and with a moderate diet. “I try to watch what I eat, but I keep active so I can indulge a little,” he said. “But I don’t eat steak five nights a week.”

Biefeld has another reason for working at staying healthy. “In my job, you survive longer and keep injuries down if you are fit,” he said before heading out on a six-mile jaunt. The health study results released Monday pleased Orange County public health officials.

In particular, Foster singled out demographics for playing an important role in the county’s high statistical rankings. For instance, he said, the county “would have had a higher infant mortality if we had a greater number of African Americans because African Americans have an infant mortality rate twice that of the [general] population.”

Also playing a key role was the “excellent health infrastructure that provides good access to health care, particularly for those with insurance but even for others in emergency events,” he said.

Others in the health fields echoed Foster’s conclusions about demographics and prosperity.

Pamela Austin, project director of the Orange County Health Needs Assessment, which will issue its report on the state of county health in the next two months, said another key factor is the unique way the county’s Medi-Cal population is handled.

CalOPTIMA runs a countywide agency that places virtually all of the county’s publicly insured into HMOs or other managed care programs, ensuring that they have a primary care physician and easing access to specialist treatment.

“I think CalOPTIMA makes a big difference because some years ago, it was harder for that population to find a doctor who would accept Medi-Cal,” Austin said. “Having that certainly helps tremendously, and it is [virtually] unique to Orange County.”

The county did poorly when it came to the rate of Asian and Latino infant mortality cases, heart disease deaths, breast cancer deaths and tuberculosis and measles cases.

The statistics are compiled by the state for each county, using an average in each category for the three-year period from 1994 through 1996. The state uses an average to get a statistically more valid number to use in its comparisons, said Jack Wagner, who manages research and planning for the Health Care Agency.

The report also drew comparisons with the 15 most populated counties, in which Orange County did well. But county officials think the comparisons with the million-population counties are “most valid because these counties share common characteristics, including urban centers, demographics, economics and others,” Wagner said.

The agency began working on the report late last spring, shortly after the state issued the final California-wide average statistics for 1994-1996, Wagner said.

“This is the first-ever report card on Orange County health, and it will be published on a yearly basis,” he said.

Over a six-year trend, Orange County did almost as well, showing a decrease in 20 of 25 categories, including stroke and lung cancer fatalities, instances of AIDS and syphilis, and infant mortality.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

How O.C. Compares

Orange County ranks first, second or third in 19 or 25 health indicators, making it second healthiest urban county in California. The county has better rates than the state in 24 of the 25 categories; better than the U.S. in 18 of 22. Here are the comparisons:

(chart)

Note:

1. Mortality rates are age-adjusted rates per 100,000 using 1940 U.S. standard population

2. Morbidity rates are crude rates per 100,000

3. Infant mortality rates are number of occurences per 1,000 live births

4. Births to adolescents are the number of births per 1,000 females ages 15 to 19.

5. Low birth, weight, late prenatal care and inadequate prenatal care are percentages

6. Inadequate prenatal care is derived using Kasner index method

7. U.S. rates based on 1996 data; Orange Couny and California rates based on three-year averages contained in County health Status Profile, 1998

Sources: California Department of Health Services, California Department of Finance, Orange County Health Care Agency