By Hyun Namkoong
How healthy is North Carolina, and how does it compare to the rest of the nation? These are questions the Centers for Disease Control and Prevention answers annually with Health, United States, which highlights emerging trends of chronic and infectious diseases and the health status of the nation.
This year’s report covers a broad range of topics, from life expectancy to adolescent sexual behavior and leading causes of death. Findings from the report show that North Carolina has made significant progress in a number of areas, such as death rate and infant mortality. The findings, however, are not all positive, indicating, for example, that racial disparities in health persist, as they do for most of the nation.
The report also includes a special feature on the use of all prescription drugs, with a focus on what the CDC calls an “unprecedented” epidemic of prescription opioid use that’s plaguing the nation and driving up deaths from overdose.”
Use of prescription medications has skyrocketed in the past 25 years; almost half of all Americans report taking at least one prescription drug. One in 10 Americans report taking five or more drugs in the past month, a phenomenon known as polypharmacy. Polypharmacy is of particular concern because some people, especially seniors, may take drugs that interact badly with one another. Polypharmacy can also cause people to confuse their dosages, timing and medications.
Opioid pain relievers, such as OxyContin and Vicodin have been implicated in 75 percent of all prescription-drug overdoses and caused more than 16,000 deaths nationwide in 2010. While North Carolina’s overdose death rate from opioids is slightly below the national rate, some 700 North Carolinians died from a prescription-drug overdose in 2010.
Overdose deaths caused by prescription drugs now surpass the combined total of overdose deaths caused by illegal drugs such as heroin or cocaine .
NC top of the bottom
The data show that North Carolina continues to trail most states in many health indicators, including infant mortality and the number of physicians per 10,000 people.
Infant mortality rate is widely considered a reliable health indicator that reflects the overall well-being of populations. Health care experts believe many factors, such as access to health care and nutrition, affect the health of infants, the most vulnerable demographic.
In 2013, North Carolina had the fourth-highest infant mortality rate in the country. Mississippi comes in last, followed by Delaware and Tennessee.
According to the CDC report, North Carolina has made steady progress since 1989 in reducing its infant mortality rate. However, a closer look at the rate by race and ethnicity points to disparities. Black infants in North Carolina have the highest mortality rate of all races and ethnicities with 13.9 deaths per 1,000 live births, a higher rate than that of Mississippi. In comparison, white infants have a mortality rate of 5.7 deaths per 1,000 live births.
No coverage, no money, no care
Data from the CDC report also show that many North Carolinians are unable to access health care due to a lack of insurance coverage, low availability of physicians and dentists and financial constraints.
In 2003, 15.5 percent of the population was uninsured. The most recent data show that 16.9 percent of North Carolinians did not have health insurance in 2012, slightly higher than the national average of 15.8 percent.
Last year, the N.C. General Assembly opted out of Medicaid expansion as allowed for under the Affordable Care Act, which would have covered an additional 318,710 North Carolinians.
The percentage of North Carolinians who had to delay or couldn’t receive necessary medical care due to cost increased from 1997 to 2012, according to the CDC. Nearly 10 percent of North Carolinians reported postponing or not making visits to the doctor and dentist due to cost.