County’s largest health survey shows gains and challenges

The Allegheny County Health Department on Wednesday released the results of the largest health survey it has ever undertaken, and the results are a mixed bag.

There was much good in the results of the survey of 9,000 county residents: More of us have health insurance, more are seeing doctors regularly and getting screened for colon cancer, and fewer of us are smoking.

But there was a lot to concern health officials, including the fact that obesity continues to grow, fewer young people are getting tested for HIV, and there are still too many disparities between genders, racial groups and rich and poor regions of the county.

The fact that this survey was so large — nearly twice as many people were surveyed compared to the last one in 2010 — has allowed the county for the first time to present data for each of its 13 county council districts.

Previous surveys were too small to provide anything but countywide data, preventing the county from using the data to attack problems in specific areas.

“When we go out to talk to people, we always get asked: ‘How is my neighborhood doing?’” said Karen Hacker, director of the health department, who had pushed for a larger survey since coming to the county nearly four years ago. “I was adamant that we’ve got to be able to go as small [in presenting the data] as we can go.”

Getting enough surveys to present data on all of the county’s 130 municipalities would have

required tens of thousands of surveys and cost millions.

But Dr. Hacker said the survey results are large enough that the department will be able to do a “small area analysis.”

That will mean using the results to extrapolate down to municipal or even census track level data, to help make even better decisions about how to address health issues, although that data will not be available until later this year.

“To me this data becomes, hopefully, a road map to how do you focus your efforts,” she said.

County Executive Rich Fitzgerald said that was his hope when Dr. Hacker explained how large the survey was going to be.

“What we’ve tried to do in my administration is make data-driven decisions, whether it’s with public works or with the [regional nursing centers],” he said. “Without this [health] survey, we wouldn’t have the kind of information we need to make decisions.”

Both Mr. Fitzgerald and Dr. Hacker were most distressed by the survey results on obesity and overweight adults.

“The [high levels of] obesity was the one [result] that was most disappointing to me,” Dr. Hacker said. “But I’ve been in this field long enough to know that it is one of the areas that is hardest to make a dent in.”

Although a far higher percentage of men (70 percent) are overweight or obese compared to women (59 percent) in 2016, obesity for both genders has risen since the county’s first survey in 2002 and second in 2010.

But the gaps between groups — and regions — continue despite efforts to battle them.

For example, Dr. Hacker said, “if you look at the whole east side of the county, which includes the Mon Valley, everything just lights up” in the unhealthy data. “But that is an area where we are already putting a lot of energy now.”

The fact that the uninsured rate in the county dropped from 11 percent in 2010 to 7 percent in 2016 was a good sign and seemed to play out in many of the improving data, including that more people (70 percent) are being screened for colon cancer.

The reason so many more people have insurance was obvious, she said.

“It is because of the” Affordable Care Act, she said. “We’ve been tracking that very carefully.”

And now, she said, “We worry what happens if we reduce that” ACA coverage. “Will we start to see upticks in things we’re now seeing downward trends?”