Study: Health habits reveal two Maines

Even after becoming sick with lung cancer, heart trouble or other chronic conditions, Mainers in the northern and eastern parts of the state are more likely than counterparts in southern Maine to keep smoking, drinking and eating to excess, a new study funded by Eastern Maine Healthcare has concluded.

Thirty percent of those with three or more chronic diseases are smokers. Compared to their counterparts, they are almost twice as likely to be chronic drinkers and 30 to 80 percent more likely to be obese.

Some areas exhibited worse habits than others. Of those aged 45 to 64 with lung disease in the Waterville-Skowhegan-Pittsfield area (called central Maine in the study), 46 percent continue to smoke compared to 42 percent in the Washington County region and 37 percent in Aroostook County region.

The behavior patterns surprised veteran health investigator Ronald DePrez, president of the Portland-based research firm PHRG, which conducted the study of nine counties divided into seven regions for purposes of analysis. The perplexingly high cost of medical care is attributable to the poor health of people in the region, he said.

The findings clearly point to the need for more emphasis on prevention, DePrez said.

EMH commissioned the study because the state hasn’t done enough to provide data on which to base planning decisions, said Norman Ledwin, EMH CEO. The cost was $200,000.

“If you don’t understand the epidemiology of the region how can you institute a program [to deal with the problems]?” Ledwin asked.

He said the findings would be distributed to anyone interested when published, and would serve as a foundation for guiding the EMH system in developing its health care services. EMH owns a network of hospitals, including Eastern Maine Medical Center, and other services from Waterville north.

The thick draft report is chock full of findings from a phone survey of 2,500 people and from data collected from other sources.

It found:

. Mental health problems are high in northern, eastern and central Maine with particular problems in the Bangor and Aroostook regions.

. Cardiovascular disease is high, with more deaths than average per capita in northern, eastern and central Maine.

. Respiratory disease rates are elevated across the region.

. Oral health is poor in northern, eastern and central Maine, particularly among the elderly.

. Maternal and infant health were favorable, with a few areas having inadequate prenatal care.

. Cancer risks from smoking and obesity were elevated across most of the area.

. Cancer diagnoses were deemed inadequate.

. Outcomes from cancer treatment were unfavorable in the Aroostook region.

The report has many recommendations on improving health care in the region. Some of the ideas include standardizing hospital and doctor operating procedures, promoting clear procedures for doctors to use in educating patients about prevention and other available services, and developing a statewide behavioral health services plan.

The study also recommends increasing insurance coverage for people in the region through Medicaid and other programs..

Another idea is to create a regional “Institute for Medical Improvement” to spur improvement in services.

Ledwin said health care services in the region have been developed using a shotgun approach. Now, providers and community leaders should focus on developing targeted solutions.

The study will be available online by Dec. 1 at emh.org or sooner by calling (800) 789-6050.