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Audit of health issues suggests changing behaviors

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Dr. David Wippermann talks with patient Wayne Clark prior to performing a procedure Wednesday at Johnson Memorial Surgical Specialists. Scott Roberson / Daily Journal
Dr. David Wippermann talks with patient Wayne Clark prior to performing a procedure Wednesday at Johnson Memorial Surgical Specialists. Scott Roberson / Daily Journal

Unhealthy behaviors, such as tobacco use, poor nutrition and a sedentary lifestyle, are leading to heart disease and cancer, the two top causes of death in Johnson County, a local study showed.

Levels of obesity and smoking are high in Johnson County and are causing health problems for residents, including diabetes, cancer and coronary heart disease, according to a health needs assessment by Johnson Memorial Hospital. The assessment, which is required for all hospitals nationwide as part of the Affordable Care Act, analyzed hospital discharge data, patient comments and data gathered by the Partnership for a Healthier Johnson County to determine the most significant health risk behaviors and outcomes in Johnson County.

None of the results was surprising, Johnson Memorial Hospital spokesman Bill Oakes said. Partnership for a Healthier Johnson County keeps track of data on health risks, such as how many people smoke or have diabetes, so the hospital already knew the main health issues in the county, he said.

The prominent health issues in the county are not ones the government can regulate, but ones that residents must improve for themselves, county health officer Craig Moorman said. So education and outreach are key, he said. The county and hospital will continue to support Partnership for a Healthier Johnson County, which puts on classes, workshops and counseling sessions to help people struggling with their weight and tobacco use, officials said. The program is funded by the hospital, and the county provides staff, such as nurses from the health department, to serve on different teams and boards.

Expanding those programs and creating new ones will be a priority for both the county and Johnson Memorial Hospital. Lack of accessible and affordable care causes many patients to leave health concerns unattended, Oakes said. By continuing to improve education throughout the county, care workers can help people who may not be able to get to the doctor, he said.

Some of the main areas for concern in the county are:

Tobacco use. Twenty-six percent of county residents smoke, and 20 percent of pregnant women smoke.


A health assessment for Johnson County showed the biggest health issues in the county and the behaviors that lead to them.

Most common behaviors:

  • Sedentary lifestyle
  • Poor nutrition
  • Tobacco use
  • Lack of early prenatal care

Health outcomes:

  • Obesity and overweight.
  • Diabetes, which is the fourth-leading cause of death in the county.
  • Heart disease, which is the top cause of death in the county.
  • Infant mortality. Twenty percent of expectant mothers in the county smoke during their pregnancy. The infant immunization rate is 42 percent, seven percentage points lower that the state average.

Sedentary lifestyle and poor nutrition, which can lead to residents being overweight and obesity. Heart disease is the leading cause of death in the county, and diabetes is fourth. Forty percent of deaths are caused by cardiovascular disease.

Chronic high blood pressure and cholesterol.

Infant mortality. A high number of pregnant women in the county do not go the doctor during their first trimester, Oakes said. And 42 percent of infants are immunized in the county, compared to the state average of 49 percent.

Issues like a lack of prenatal care, obesity and diabetes awareness, are linked first and foremost to a lack of access to care for many residents in the county, Oakes said. When people can’t get to a doctor because they can’t afford it or don’t have time, their health problems are allowed to get worse and worse.

For pregnant mothers especially, lack of care is a problem in the county. When women don’t get to the doctor until their third trimester, it’s too late to warn them of risks such as smoking, he said.

Partnership for a Healthier Johnson County works with expecting mothers and fathers on prenatal care education. Pregnant women who smoke are encouraged to call the Tobacco Quitline, which provides coaching and counseling to help people quit smoking.

The Quitline is available for all residents as young as 13. People can now receive counseling sessions by phone, text or online, tobacco coordinator Nancy Voris said. Since July, 85 residents have used the call line to try to quit smoking.

Starting out early with tobacco education is a staple of Partnership for a Healthier Johnson County’s education program, Voris said. Educators put on puppet shows and skits such as “Smoke Busters” and “Tar Wars” at elementary school to teach kids about the dangers of smoking.

Schools have become one of the most important places to start educating students on healthy choices.

In the past three years, Franklin College has made more healthy food options available to students and spread awareness about nutrition, food service director Les Petroff said. Sodexo, the company that provides food to the college, started a campaign to provide healthy options to schools, and the college worked with Partnership for a Healthier Johnson County on improving their services.

The school has installed televisions at each food station where the nutritional information for each item is listed. Two years ago, a healthy food section was added where each plate is under 500 calories and has become popular, especially among students watching how much they eat in the buffet-style cafeteria, he said.

But getting students and residents to choose these healthier options and follow them is impossible unless they make the decision for themselves, Moorman said.

Moorman, a pediatrician, said that he sees lots of patients who have preventable health issues, like being overweight, and he tells parents they need to make changes. But unless they decide to take his advice and educate themselves about how to live well, there’s nothing more he can do, he said.

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