Hillsdale County has one of the highest smoking rates in Michigan.
A report released jointly by two national health institutes shows that from 2004 to 2010, 27 percent of adults in Hillsdale County reported currently smoking, compared with just 21 percent for all of Michigan. Of the 67 counties surveyed, just 12, including Hillsdale, had a rate of 27 percent or higher.
Dr. Ravi Yarid, a physician in Hillsdale, used to work in Oakland county, which has a 16 percent smoking rate according to this survey. Now that he practices in Hillsdale, he sees quite a difference.
“About three years ago [when I came to Hillsdale] I was overwhelmed with the number of smokers I saw in the hospital,” he said. “The higher rate is definitely seen in the patient population.”
The report, which includes smoking rates for most counties in the U.S. and compares them with statewide statistics, was published by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The data included in the report comes from a random digit dial survey, in which surveyors asked citizens if they smoke at least one cigarette most days and have smoked more than 100 cigarettes in their lifetime. The full report can be found at http://www.countyhealthrankings.org.
The county’s smoking statistics give reason to be concerned, but also show that there may be some improvement. A report published by the Branch-Hillsdale-St. Joseph Community Health Agency (which deals with health issues in all three counties) shows that in the three counties as a whole, smoking has significantly decreased over the last few years. Between 2005 and 2007, the rate was 25.4 percent for the jurisdiction; from 2008 to 2010, it was only 20.6 percent. Because these more recent statistics involve a larger area than Hillsdale County, there is no way to be completely sure how much of this change took place in Hillsdale. Nevertheless, the trend seems to indicate less smoking in all three counties.
These statistics are encouraging for Theresa Christner, the Health Education Director of this organization.
“We’re encouraged because the county health rankings are based on the premise that if you put appropriate policies in place, you will impact risk behaviors,” she said. “We’ve done a lot of work.”
Christner says the Health Agency has been very active in programs to prevent smoking as well as in pushing for policy change both at a legislative level and in schools or other institutions, such as senior housing.
According to Christner, “Hillsdale Housing Commission, which oversees low-income housing, instituted a smoking ban in January 2011.” She sees the decreased smoking rate as a reflection of changes such as this.
“We’ve had a lot of successes,” she said.
Karen Odegaard of the Population Health Institute said the smoking rate has been going down both nationally and in Michigan. Michigan’s rate in 2010, she said, was 23 percent, but now it is 21 percent. She also said that since the error margin is 21 – 35 percent for Hillsdale, it could be that Hillsdale’s actual rate is in line with the state average.
Yarid said that what he’s seen in Hillsdale County over the last three years is similar to what he saw while doing his residency in Branch County from 2003 to 2007. For those who are looking to see Hillsdale’s rate go down, this could be a good sign, since Branch County’s average smoking rate was only 20 percent from 2004 to 2010. Yarid, however, has not seen much change in Hillsdale over the last three years, and said the number of smoking-related cases he sees is still very disturbing.
Christner pointed out that while some data shows improvement, other facts are less encouraging. Smoking rates among high school-age children are higher than in Michigan as a whole. In an anonymous survey across the state conducted in 2011, 9.7 percent of ninth graders and 13.3 percent of 11th graders reported smoking cigarettes on one or more of the past 30 days. When a similar survey was conducted in Hillsdale County, however, the numbers were 12.8 percent for ninth graders and 23.9 percent for 11th graders.
According to Christner, one of the problems schools face is that tobacco products other than cigarettes are emerging, such as snuff, hookah, or e-cigarettes. Christner said one of her agency’s priorities in combating the effects of smoking has increasingly been to work through local schools to make sure they have policies to prohibit smoking on and off campus.
Another serious issue is smoking among pregnant women. Birth records between 2008 and 2010 show that 30.5 percent of mothers reported using tobacco either prior to or during their pregnancy. Also, 29.8 percent of mothers reported that others in their households smoked, as compared with 16.7 percent for Michigan.
Christner said because the statistic counts women who quit before becoming pregnant, it makes sense that it is higher than the average number of current smokers, but she still sees the number as too high.
Yarid sees statistics about smoking while pregnant as some of the most alarming.
“I think it’s a very unfortunate circumstance,” he said. “I think I see that more in the younger mothers. I’ve always heard the excuse as ‘well, I’ve cut down.’”
Yarid said he urges women to put their children first, because smoking while pregnant can have such detrimental long-term consequences for the children.
“It’s such a shame and it causes so many problems,” he said, citing risks such as asthma that can affect the child many years later.
While Yarid credited numerous factors with the prevalence of smoking in Hillsdale, he said one of the most notable is the standard of living.
“Unfortunately it’s seen more often in the lower socioeconomic class,” he said. “You learn that early on in med school and it has proven itself to be true.”
Another factor could be a lack of education. Yarid said people understand the risks of lung cancer associated with smoking, but are often not aware of other harms. But ultimately, for some children, it comes down to the parents.
“Often when I see smoking in kids, it’s the parents who get them cigarettes, believe it or not,” he said. “I’ve seen this time and time again.”
Overall, Christner is optimistic about the progress, but agrees that there is definitely work still to be done.
“Smoking is still a problem that we need to address because we know that it is the single most prevalent cause of disease, disability, and death in the United States,” she said.
