Friday, August 31, 2012

Illinois - Death and Health

In 2000, infant mortality was 8.5 per 1,000 live births. Nationally, Illinois ranked 8th in infant mortality in 2000; the national rate was 6.9. Although the infant mortality rate fell from 21.5 in 1970 to 13.9 in 1981 to 10.7 in 1991, it did not decline as rapidly as elsewhere. Since the late 1960s, Illinois has had a slightly higher infant mortality rate than the rest of the country; the 1993–94 rate was the 5th highest among the states while the 1996 rate ranked 9th highest. The number of legal abortions performed in 1999 was 45,924, down from 72,000 in 1977.

Illinois's death rate, 875.1 per 100,000 residents, was slightly higher than the national rate of 873.1 in 2000. At that time Illinois also ranked above the national averages in deaths due to heart disease and cerebrovascular disease, but below the averages in accidents and adverse effects and suicide. Major public health problems in the 1980s included rapidly increasing rates of venereal disease and drug abuse. Alcoholism has always been a major problem in Illinois. The state also has a high proportion of residents receiving psychiatric care. In 1995, there were 35.3 breast cancer deaths per 100,000 women, 4th-highest among the states. In 2000, 22.3% of the adults 18 years of age and older in Illinois were smokers. The rate of HIV-related deaths stood at 3.9 per 100,000 population, slightly below the national average of 5.3 in 2000. There were 26,319 AIDS cases reported through 2001.

Hospitals abound in Illinois, with Chicago serving as a diagnostic and treatment center for patients throughout the Midwest. With 192 community facilities (many quite large) and 36,834 beds, Illinois hospitals recorded 1,559,357 admissions in 2001. In the same year, total full-time personnel numbered 190,746, including 44,900 full-time registered nurses and 3,339 full-time licensed practical nurses. In 2000, the state had 285 physicians per 100,000 population. The average expense to hospitals for care provided in 2001 was $1,446.50 per inpatient day.

Federal government grants to cover the Medicare and Medicaid services in 2001 totaled $4.4 billion; 1,639,986 enrollees received Medicare benefits that year. At least 13.6% of adult residents had no insurance in 2002.

Death Rates in Illinois: Top 10 Causes

Heart disease and cancer kill half of the 100,000 people (give or take a few thousand) who die in Illinois every year. But the state lags in dealing with these medical conditions.

We’re No. 31 in the nation when it comes to the rate at which people perish from the two blockbuster illnesses, according to data published recently by National Center for Health Statistics.

A bunch of Southern states, a few on the East Coast, and several Midwestern neighbors bring up the bottom.

The gap between below- and above-average performers isn’t trivial; it affects whether people live or die . In No. 1 ranked Minnesota, age-adjusted fatalities from heart disease were 141.5 per 100,000 people, compared with 214.3 in Illinois. For cancer, No. 1 ranked Utah’s death rate was 139.4; ours was 190.1.

Of course, how many people succumb to illness in any area depends on many factors, including consumers’ lifestyles and health habits, access to medical care, genetics, poverty, the environment, demographic trends, and more. Some of the spread between Illinois and top-rated states can be explained by these variables.

But there’s plenty of room for action. The things that make us vulnerable to illness—known as “risk factors”—can be mitigated if doctors focus on prevention, if people eat well and exercise, if public health programs are effective, and if good medical services are readily available, research shows.

To save lives, Illinois needs to make a concerted push to do better in all those areas, experts suggest.

Asked for a response, the Illinois Department of Public Health sent along a long list of programs.  With a few exceptions, there’s no information on what impact these programs have had  (is this being measured?) or where they’re available (what was the department thinking?).  You’ll find an abridged list at the end of this posting.

Back to the government’s “cause of death” data, I spotted a question that deserves some scrutiny: Why do Illinois patients die of septicemia, a frequently fatal blood infection, five times more often than those in California? (Illinois’ rate is 11th worst in the nation.)  Does anyone have an answer?

Looking at state-by-state rankings, Illinois would also do well to focus on kidney disease, which my colleague Deborah L. Shelton spotlighted recently in a front-page report. The state’s death rate is 13th highest in the country.

For those of you who like the raw numbers, here’s the top 10 causes of the 103,654 deaths in Illinois in 2005, the most recent year for which comprehensive data is available:

1. Heart disease: 28,226.
2. Cancer: 24,250.
3. Stroke: 6,252.
4. Chronic lower respiratory diseases: 5,067.
5. Accidents/unintentional injuries: 4,182.
6. Diabetes: 3,034.
7. Alzheimer’s disease: 2,827.
8. Influenza/pneumonia: 2,949.
9. Kidney disease: 2,402.
10. Septicemia: 1,943.

Wednesday, August 1, 2012

Grief - A Perspective


Grief is a bereaved person’s internal emotional response to the loss event. It has several components: physical, behavioral, emotional, mental, social, and spiritual. It is often described by those that have gone through it as a heaviness that isn’t easily lifted. It can sometimes be so pronounced that it affects a person’s physical self and can even mimic illnesses. While grief is an expected and normal response to loss, severe or prolonged grief can cause problems. So what's normal and what's not?

Normal Grief

Normal grief is found in the majority of survivors. It describes grief that is eventually lessened as a person readjusts to their loss. This is done with support as one moves through the four phases and the four tasks of the grief process. Grief is usually not something one “recovers” from because the loss is never regained or replaced. A grieving individual doesn’t return to the person they were before the loss; rather they usually describe their lives after loss as “different”. For some, it changes their entire identity and they will divide their lives into “before” the loss and “after” the loss.

The Four Phases of Grief


The stages of grief can be divided into four distinct phases:

  1. Numbness – This is the phase immediately following a loss. The grieving person feels numb, which is a defense mechanism that allows them to survive emotionally.
  2. Searching and Yearning – This can also be referred to as pining and is characterized by the grieving person longing or yearning for the deceased to return. Many emotions are expressed during this time and may include weeping, anger, anxiety, and confusion.
  3. Disorganization and Despair – The grieving person now desired to withdraw and disengage from others and activities they regularly enjoyed. Feelings of pining and yearning become less intense while periods of apathy, meaning an absence of emotion, and despair increase.
  4.  Reorganization and Recovery – In this final phase, the grieving person begins to return to a new state of “normal”. Weight loss experienced during intense grieving may be regained, energy levels increase, and an interest to return to activities of enjoyment returns. Grief never ends but thoughts of sadness and despair are diminished while positive memories of the deceased take over.

Because everyone grieves in their own way at their own pace, there is no timeline that these phases are supposed to be completed in. Receiving bereavement counseling and joining bereavement support groups can help the grieving individual move through the phases fluidly.