Health summit faces issue of Durham's decline in rankings

Mar. 22, 2013 @ 06:49 PM

Durham County has fallen in the most recent North Carolina county health rankings.

But local health and social service leaders insist that the decline can be stopped and that Durham can become “a community of health” if more emphasis is put on what are called the social determinants of health and well-being.

“Health is really beyond just taking care of patients,” noted Victor Dzau, the CEO of the Duke University Health System, at the 12th Annual Durham Health Summit on Friday. It is “about poverty, education, homelessness and other factors. These are the factors we need to consider if we are to develop our sustainable community of health.”

Speaking to a summit audience of more than 400 at the Durham Convention Center, Laura Gerald, the state health director, pointed out that Durham “remains a relatively high-performing county” when it comes to health measurements. It’s still in the top 20 of the state’s 100 counties, she said.

But “there has been a decrease,” she acknowledged.

In fact, Durham dropped from 8th to 17th overall in the rankings that measure 25

physical and social factors that affect health, such as rates of childhood poverty and smoking, obesity levels, access to physicians and more.

And North Carolina itself does not rank well among states.

In 2012, it was No. 33 nationally, even if that was a step up from 2011’s ranking of 35th.

“I’m here to tell the truth, but don’t you all shoot me or throw anything,” Gerald said. “We are not doing as well as we should be doing. We’re better than Alabama or South Carolina, but no one is pleased with where we are. We’ve got a ways to go.”

Durham’s decline in the rankings was mostly attributable to an increase in the proportion of children in poverty and consistently high unemployment.

“This is not about the quality of our institutions,” Gerald explained. “This is not about our clinical care. This is about social and economic factors. What we’re finding, unfortunately, is that place matters when it comes to your health.”

There is, she went on, “a strong, strong, strong correlation between economic factors and your health outcomes. You can’t do well in health outcomes if you do not do well in economic outcomes.”

Looking at those outcomes, Gerald noted that the county’s high school graduation rate, unemployment rate, violent crime rate and rate of children in poverty are all worse than the state average.

What that adds up to is that Durham ranks 31st in social and environmental factors and 15th in physical environment.

“Those are the two areas you need to focus on,” Gerald said.

Speakers at the summit said they would, specifically targeting issues like homelessness, poverty and education.

Gayle Harris, Durham’s public health director, told the group that “your government is committed to improving [these] social determinants of health.” And Dzau implored the audience to “imagine what we can be in the future; what we need to weave together to make a healthier Durham.”

Terry Allebaugh, the executive director of Housing for New Hope, spoke of attacking the problem of homelessness, but he just as easily could have been referring to the broader issue of what to do about health factors and issues in the county.

“It doesn’t matter who is to blame,” Allebaugh said. “We’re all responsible.”