Many Ohioans suffer from chronic diseases, particularly heart disease, adult-onset diabetes and childhood asthma. But it doesn't have to be that way.
And not only do state and local officials say they're committed to solving the problem, but individuals can do several things in their daily lives to improve their personal health.
"We need to get active," said Dr. Teresa Long, a former Columbus health commissioner who now works at Ohio State University's College of Public Health.
Rates of adult diabetes, heart disease and children's asthma were higher in Ohio than the U.S. average, according to a 2016 state report, the most recent statewide health assessment.
Heart disease was the leading cause of death in Ohio from 2014 to 2016 and diabetes ranked seventh during that period, the report found.
Asthma, meanwhile, is one of the top reasons that children end up hospitalized, said Dr. Beth Allen, a pulmonologist at Nationwide Children’s Hospital.
Last year, the state health department made lowering the rates of these three chronic diseases a “priority outcome” in its three-year road map for creating a healthier Ohio.
A key tenant of the state plan is empowering local health departments and groups to develop the best policy solutions for their communities. But there are personal solutions, too, Long said.
The top three are eating healthy, regular exercise and not smoking, she said. All have the ability to play a role in reducing the rates of the three prioritized chronic diseases.
Controlling blood pressure and doing screenings illustrate the intersection of policy and personal action, Long said.
Increased access to blood-pressure screenings and programs designed to lower blood pressure would be policy-based solutions, because high blood pressure is linked to heart disease and Type 2 diabetes, she said. But eating healthy — fresh fruits and vegetables — and exercising are proactive ways to keep blood pressure down in the first place.
Exercise doesn't have to mean going to the gym every day. Recently updated federal guidelines say that all aerobic activity, even if in short stints, can be beneficial. Going for a walk around your neighborhood, for example, is a simple way to get exercise, Long said.
"What we eat, how much we eat, how much we salt, how much we’re physically active, all are contributors to our heart health," she said, adding that making fresh food more accessible to low-income individuals and families is imperative in creating a healthier state.
Long emphasized the importance of children establishing healthy lifestyles through school and community programs, and extending those good habits into adulthood to reduce the likelihood of their developing heart disease or Type 2 diabetes.
Prevention is its own kind of treatment, said Clint Koenig, medical director of the Ohio Department of Health.
Koening said screenings to detect early signs of Type 2 diabetes are particularly valuable — and their availability needs to be increased — because they give patients who have prediabetes an opportunity to seek out programs that can reverse the diagnosis.
YMCAs across central Ohio, for example, have diabetes-prevention programs, and Koening said the state health department wants to encourage more businesses to incorporate them into their health-care plans.
Ohio's child asthma rates rose from 12.2 percent in 2012 to 14.3 percent in 2013, the latest available data from the federal Centers for Disease Control and Prevention for which age and states are broken down. That's just above the then-national average of 14 percent, Allen said.
Airborne allergens are likely helping to drive those rates up, she said, because asthma can develop as a result of allergies.
But an increased emphasis on childhood asthma is necessary because the condition is at once highly manageable and highly problematic if left untreated, Allen said.
"Coughing all the time is a sign your asthma isn’t controlled. And if you stay like that, it could get you sick, like big-time sick," Allen said. "We’re trying to step in when symptoms are even more mild."
Untreated asthma can lead to an increased risk of infection, influenza and chronic lung disease, said Koening, who noted that asthma disproportionately affects low-income children and children of color.
The probability of developing asthma can be reduced outside the hospital and without medication, experts say. "Getting smoking out of the house” is paramount, Allen said.
Ohio’s smoking rate of 22.5 percent is significantly higher than the national average of 14 percent, and smoking is linked to certain types of heart disease and the development of diabetes. The takeaway: Quitting smoking will improve numerous aspects of health.
Medicine also can reduce asthma's effects.
Most asthma patients will have a rescue inhaler to use when they’re experiencing symptoms such as coughing and wheezing. But patients with severe asthma typically have preventive inhalers that they can use daily to lower the risks of such things as allergens, exercise and cold weather triggering their asthma.
The key is educating patients — and their parents — so they know if they should be using a preventive inhaler, Allen said. For example, if a child needs a rescue inhaler three times per week, preventive care would likely be beneficial.
“Emergency room visits for asthma are preventable. It’s something we should be able to spare kids that sensation of, ‘I can’t get enough air,’ if we manage them properly,” she said.