South Dakotans are hard working people but does that mean we are healthy working people? According to the United Health Foundation, the Rushmore State ranks just 27th for overall health.
In fact South Dakota is slipping. Just last year, the state ranked 19th but even that ranking would put us well behind most of our neighboring states. But why does South Dakota rank so low and what's being done to improve that rank?
It's a test South Dakota is failing.
"We're watching it all the time and it doesn't take a national ranking for us to say oh we got a problem we need to work on this." Said South Dakota Secretary of Health Doneen Hollingsworth.
While the secretary wasn't too surprised by the United Health Foundation's study, the stats speak for themselves. Obesity and diabetes numbers lie towards the bottom half of all states. The study also suggests you're more likely to light up a cigarette or binge drink if you call South Dakota home. But these health problems are not South Dakota specific, so then why are we struggling to get a good grade? the answer might have something to do with the landscape.
"Access to healthcare in rural South Dakota is an issue now, it was an issue 30 years ago, and it's going to be an issue 30 years from now." Said Secretary Hollingsworth.
The secretary says a person's health status shouldn't depend on where you live. But when some of the poorest counties in the nation can be found in our state, it can be a struggle to keep that promise.
"Our greatest health disparity in South Dakota is between or the differences between white South Dakotans and Native American South Dakotans, in so many measures." Said Secretary Hollingsworth.
Cases of diabetes, heart disease and tobacco use all tend to rise when you cross onto the state's reservation land.
"The level of health of the patient depends upon sometimes the socio-economic level. certainly if you're living in poverty and you see no prospects for jobs and economic advancement you're certainly not going to be as motivated about your health as you should be." Said Dr. Rodney Cuny, the Chief Medical Officer for the Aberdeen Area Indian Health Service.
Dr. Cuny says the biggest challenge on the reservation is not having that doctor-patient relationship to encourage healthy behaviors. That's caused large in part due to lack of doctors and care providers.
"It's more like episodic care, people come in for the problem at the moment and these other things kind of fall by the wayside." Said Dr. Cuny.
Health problems are significant on the reservations, but the issue encompasses the entire state. With the largest population, the city of Sioux Falls has a tremendous impact.
"The important piece is to know what's going on, to understand our health and understand how we compare to others and what communities are highly successful and why is that?" Asked Sioux Falls Health Director Jill Franken.
To answer that question, we decided to hit the road.
Our neighbors in Minnesota rank as the fifth healthiest state and have annually been among the top ten.
"We have a strong state health department but we also have strong local public health agencies throughout the state that play a huge role in keeping people healthy and getting people access to care." Said Minnesota Health Commissioner Dr. Edward Ehlinger.
Commissioner Ehlinger says the big reason why Minnesota has a better health ranking is obvious, they have a bigger population and economy but they've used those resources to make an investment and take care of their own.
"The health that Minnesota has right now as being the fifth healthiest state is not because of what we are doing right now it's because of the investment that was made 20 to 30 years ago. Investments in the public health system and in the healthcare system and in the school system and in social activities of housing and transportation. Those investments are paying off now." Said Ehlinger.
Minnesota's efforts have helped bolster healthy behaviors, essentially treating people so they don't need medical services. So the question is, how do we or can we improve South Dakota's 27th place finish?
Sioux Falls is already taking steps to be more like the land of ten thousand lakes. Live Well Sioux Falls is a multi-phase plan to change the health climate of the city. But like Minnesota has shown, behaviors take time to correct.
"What you don't understand you can't influence and so you really can't look at it as good or bad but something that you want to affect over time." Said Franken.
As for drinking and smoking? That may be something state governments can address. The upper Midwest states have some of the lowest beer and alcohol taxes and they haven't gone up since the 1980's.
"So alcohol is cheap! And we know that alcohol use like tobacco use is price-sensitive if you increase the price use will go down particularly among kids in adults and among people with lower incomes." Said Commissioner Ehlinger.
As for those who need care the most, the state is working with Indian Health Services on scholarship programs to attract new doctors out to critical areas. But just throwing out money doesn't cause change; change must also come from the individual.
"You have to hear the message over and over again and if at home it's not being modeled well for you, the message has to be louder." Said Secretary Hollingsworth.
No state wants to receive a failing grade, but studies like this help start the discussion that could ultimately spawn change.
"Oh I absolutely we can change and improve our ranking and I think we are well-positioned for that moving forward." Said Franken.
The United Health Foundation has given out health rankings since 1990. The best ranking South Dakota has ever received was 9th back in 1997. Our current ranking of 27th is the worst by far, beating out our rank of 20th back in 2009.
Click here to view the United Health Foundation's findings.
