The 2017 County Health Rankings and Roadmaps released last week shows the City of Falls Church, as well as several Northern Virginia counties, once again near the top of the state in both health factors and outcomes.
The rankings, put together by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, have Falls Church City No. 1 in the state in terms of health factors and No. 6 in health outcomes (which incorporates length of life and quality of life).
Fairfax County ranked second in health outcomes and third in health factors.
While the data generally showed a population in excellent health, there were a few trends worth noting: Falls Church had the second highest percentage of adults that reported binge drinking (20 percent).
In addition, the number of cases of sexually transmitted infections (STI) in the City has seen spikes and falls over the last decade but remained higher in 2014 (the last year of reported data) than in 2007 (the first year of the report).
To make sense of the data, and explain how the local public health community tackles these issues, the News-Press spoke with Dr. Raja’a Satouri, Deputy Director for Medical Services at the Fairfax County Health Department.
News-Press: What stood out to you in this year’s report?
Dr. Satouri: The premature death number across the nation and the state is something that was a real focus of these rankings. That issue is something of note for anyone looking at them. The rankings’ report reveals that drug overdose deaths might be fueling this dramatic increase in premature death nationally because of an increase in death among 15-44 year olds. They’re looking at things like drug overdose, suicide, key things public health people would be interested in looking at.
In terms of Falls Church, it actually says Falls Church is getting better for this measure. We recognize that there are myriad issues that can contribute to those preventable outcomes. So if we use drug overdose epidemics for instance, it really does take a comprehensive approach to those issues. In fact, the governor has really put a focus on this and the public health commissioner, Dr. Marissa Levine, has declared a public health emergency around the opioid crisis in Virginia.
So they have developed a government leadership task force to look at setting regional coalitions to work with state resources better, and build communities of resilience and response capabilities. So this is something that the state is taking seriously and the counties and cities in the Fairfax community will also be participating to try to identify through data what these issues are and try to screen and treat for addiction and reduce any harm from addiction. Those are the goals we’re looking at.
NP: How are you looking at this premature death trend at the local level?
DS: In public health we’re always looking at trends, at general trends — not a fluctuation here and there. We want to be looking at it over time to make a judgment, but we do know that nationally we’re seeing the numbers increasing. The factors that are contributing to that nationally, we’re not immune to, so we do want to put some effort into, through the comprehensive approach to looking at preventable death, particularly the drug overdose issues. We want to look at that for our communities as well because we’re not immune to the effects that are making those numbers increase across the nation.
NP: One surprising measure that stood out in Falls Church was the high percentage of adults who reported “excessive drinking.” How would you explain that?
DS: The excessive drinking measure is a self-reporting measure into the behavioral risk factor surveillance system. And I think anything that’s a self report, in terms of data, we look a little bit differently. However, that being said, it is a risk factor that has been identified. And as with all risk factors, they can lead to adverse health outcomes, and that’s why we’re concerned and that’s why we look at risk factors more closely.
We look at those risk factors as a potential determinant of a negative health outcome, so what Fairfax County and Falls Church City communities do well is building these partnership coalitions to look at the risk factors in that community and build on policies or programs that can improve help.
Even the report says self-reported data has limitations because there may be recall bias or social desirability response bias — there are some things that can bias data. But regardless, it’s still a risk factor that we would incorporate in the work that we look at for root causes of health outcomes.
NP: The higher rates in Falls Church of sexually transmitted infections (STI) was one of the other notable measures in this report. How are you looking at this data and what can be done to address this issue?
DS: So when I looked at that data for Falls Church City, there were spikes in certain years and then down to more national baseline, and then up again with another spike. So that’s been seen in previous years.
It’s interesting, when you look at STIs, we actually want individuals to come in and get tested. Chlamydia is the number one sexually transmitted disease in North America. When they use the measure for STIs, they base it off chlamydia rates. Some individuals who may be in high-risk situations, we are encouraging them to come in get tested.
So the fact that the numbers go up actually, as a caveat, may be something that’s good because more people are getting screened, more people are getting identified and treated, and that’s the number one way we can decrease disease transmission.
So a high number, because they’re looking at rates of positive chlamydia tests, may be that we’re identifying more people and treating them and hopefully decreasing the transmissions, and that may be why we’re seeing peaks and valleys.
NP: What can be done to bring these rates down?
DS: I can tell you we’ve been busier in our STI clinics, so more people are coming in now for STI testing.
We do outreach into our communities to make greater awareness that the STI clinics are there, we discuss what STIs are, what the symptomology may be, so people are understanding when they should be getting tested.
We also do a lot of prevention work in terms of condom use and education around safe sex practices, so those are the kinds of things we’re trying to do with bring STI rate down.