America’s health habits show little improvement

By Lindsey Tanner

Associated Press

CHICAGO — Americans are buckling up but chugging down, and getting cancer screening tests yet still smoking too much, according to government research showing mixed results when it comes to healthy habits nationwide.

State-by-state surveys of adult health trends in the 1990s reveal disturbing increases in binge drinking — rising in more than a third of the states and falling in only three. Most states showed increases in seat-belt use, mammography exams and even adult vaccinations, yet smoking increased in almost a third of the states and declined in only one.

Washington state did not log a statistically significant increase in seat-belt use — up 4.3 percentage points from 73.2 percent in 1991 to 77.5 percent in 2000 — and was noted as one of four states without a significant increase in mammograms for women over 40, though the rate increased 4.8 percentage points from 69.7 percent to 74.5 percent.

The state did have significant increases in influenza vaccinations — up 16.9 percentage points from 49.3 percent in 1993 to 66.2 percent in 1999 — and pneumococcal vaccinations, up 21.1 percentage points, from 35.3 percent to 56.4 percent.

Smoking declined in Washington but not significantly — from 22 percent in 1991 to 20.4 percent in 2000.

Nationally, "It’s a mix of good and bad news," said Dr. David Nelson, who helped conduct the research for the federal Centers for Disease Control and Prevention.

Improvements in insurance coverage for some cancer screening tests may explain some results, but reasons for other changes are unclear, Nelson said, calling the study "a jumping-off point for people to answer the ‘why’ questions."

Results appear in today’s Journal of the American Medical Association.

As might be expected, the study found obesity has increased in all 47 states surveyed, and "just confirms that this has been a nationwide problem," Nelson said.

Among the most surprising findings was the rise in binge-drinking, defined as downing five or more alcoholic beverages at least once in the past month, said Nelson, now with the National Cancer Institute.

Increases were concentrated in the South and Midwest, where Wisconsin had the highest amount of binge drinking in 1999 — 19.6 percent, compared with 16.4 percent in 1991. Illinois had the greatest increase during the study, jumping from 7.3 percent to 13.9 percent.

Psychiatrist Dr. Daniel Angres, who heads an alcohol and drug dependency program at Chicago’s Rush-Presbyterian-St. Luke’s Medical Center, said one reason may be that young adults, especially in the Midwest, tend to view alcohol as "the lesser of two evils" and more acceptable than harder drugs.

Also, Angres said, as women have become more equal in the workplace, many have turned to "the drinking culture," where doing business over drinks is part of the office dynamic.

Minnesota was one of just three states that saw binge drinking decline significantly, perhaps due to extensive programs to reduce drinking and driving, fetal alcohol exposure and adolescent drinking, the researchers said.

Washington state reported a slight decrease in binge drinking, from 10.7 percent in 1991 to 10.1 percent in 1999 — a drop that is not considered statistically significant.

The researchers compiled results from monthly state telephone surveys of adults 18 and older, collected randomly from 1991 to 2000.

Participants were asked about 11 health behaviors: smoking, drinking, physical inactivity, obesity, seat-belt use, mammograms, Pap tests, colorectal cancer and cholesterol screenings, and flu and pneumococcal vaccines.

Data were incomplete for some measures and some years, and were not available for Wyoming and Washington, D.C.

New York showed the overall best results, with improvements in eight measures. Three states tied for the most declines. Iowa, North Dakota and South Dakota each worsened in four measures.

Copyright ©2002 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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