By Tim Bonfield
The Cincinnati Enquirer

More Tristate residents say they are living healthy lives compared with three years ago, but a health care report card released Thursday also shows that we need to do more.

We still smoke too much, drink too much and eat too much.

We're growing frustrated with rising health care bills and a bit more skeptical about the quality of service we get.

And in tough economic times, many lower income people struggle to get care for substance abuse, mental health and dental problems that can wreck families and ruin job prospects.

"A lot of the chronic illnesses we're seeing in the community are lifestyle related. So we have an opportunity to help change our own health," said Ann McCracken, director of evaluation at the Health Foundation of Greater Cincinnati.

The 2002 Greater Cincinnati Community Health Status Survey posed about 100 health-related questions to more than 2,000 Tristate residents. The survey - conducted every three years since 1996 - offers the region's most detailed snapshot of public health trends.

Lawmakers and lobbyists, public health departments and medical researchers, and a wide array of nonprofit and for-profit service providers are expected to spend the next several months studying the 119-page report.

For most of its findings, the margin of error was plus or minus 2.2 percentage points. But margins ranged more widely for findings involving subgroups of those surveyed.

"This is truly a very important project. We can all have our impressions about what's going on. But there is no substitute for going out and doing a survey like this to actually get the data," said Malcolm Adcock, Cincinnati's health commissioner and chairman of a committee that co-sponsored the survey.

About 54 percent said their overall health was excellent or very good; 16 percent said their health was fair or poor. That's a slight improvement from 18 percent in 1999 who said their health was fair or poor.

But the good news stops there.

Unhealthy living

More local people have unhealthy lifestyle habits than the national average.

About 32 percent smoke, far higher than the 23 percent national average.

More people are drinking alcohol more frequently in Greater Cincinnati than national averages, including higher rates of binge drinking and self-reported drunken driving.

Nearly 61 percent of Tristate residents are overweight and nearly 22 percent are obese. That compares with 59 percent overweight nationally and 22 percent who are obese nationally.

A troubled system

Most Tristate residents say they are satisfied with the quality they get from the health care system, but not as happy about the costs.

Those who say health care costs are reasonable dropped from 56 percent in 1999 to 49 percent in 2002.

The people who are satisfied with the quality of health care services dipped from 87 percent to 85 percent, which survey sponsors did not consider statistically significant.

"The economy was a little better in 1999. Unemployment was a little lower. And state governments weren't in the crisis they are today," said Donald Hoffman, president of the Health Foundation.

Be it high smoking rates or observing that the poor suffer more health care problems, many of the survey's findings come as no surprise. The survey's value is having local numbers to track the impact of various health improvement initiatives, Dr. Adcock said.

The survey data also help guide millions of dollars a year in grants issued by the Health Foundation of Greater Cincinnati.

`Optional' care at risk

Study sponsors say oral health, substance abuse and mental health are significant local problems that are likely to get worse as employers cut health benefits to fight rising costs and state officials are looking to cut the Medicaid budget.

About 17 percent of Tristate residents say they haven't been to a dentist at all in the past five years. That's nearly twice the national rate of 9 percent.

Meanwhile, about 70 percent of those who said they had a substance abuse problem did not seek treatment in 2002, down sharply from 42 percent who did not seek treatment in 1999.

"Unfortunately, a lot of people view physical health as a core service and all the rest as optional," Dr. Adcock said.

E-mail tbonfield@enquirer.com