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South Carolina moves up a notch in health rankings

By Joey Holleman, The State (Columbia, S.C.)
McClatchy-Tribune Information Services

Dec. 12--South Carolina's status improved slightly in the 2013 edition of America's Health Rankings, moving from 44th to 43rd in part because of the state's effort to ensure poor children get Medicaid coverage.

The annual rankings, released Wednesday by United Health Foundation, tend to reinforce rather than surprise. South Carolina's overall ranking has ranged from 41 to 48 through the years, weighed down by high rates of diabetes (44th in 2013), obesity (44th) and infectious disease (49th) and low rates of high school graduation (47th).

But this year the report gave a shoutout to South Carolina for the best one-year improvement in percentage of insured population. The drop from 19.7 percent of the population uninsured to 16.6 percent amounted to about 140,000 more people insured in 2013 than in 2012.

Most of that improvement is related to the S.C. Department of Health and Human Services recruiting children from low-income families into the state Medicaid program. The effort, called Express Lane Eligibility, has added 103,000 children in families earning less than about $15,000 to the Medicaid rolls in the past two years.

HHS director Tony Keck said those children met eligibility guidelines set by the state legislature and should have been covered by Medicaid all along. Other programs also helped register disabled adults and pregnant women who were eligible but not signed up for Medicaid.

"Those are the people the state has said are most in need of our help," Keck said. "If we made that promise to help them, we've got to meet it."

And especially in the case of the children, the extra expenditure is cost-effective. Most of the payout for youngsters is for preventive care, which has a high return when those children are healthier adults, Keck said.

The state had a long way to go when it came to uninsured statistics. Even with the remarkable drop last year, the percentage of South Carolinians without health insurance increased by 4.7 percent in the past decade as residents lost jobs in the recession. That ranks as the second worst drop over the past decade among states, according to the report.

Keck said the most troubling statistic for the state is the continuing uptick in obesity, up to 31.6 of the adult population, ranking 44th among states. "That's our single biggest problem because obesity is a precursor of even worse health outcomes to come," Keck said.

Obesity leads to higher rates of diabetes, cardiovascular disease and some forms of cancer. South Carolina already rates poorly in those areas -- 44th in diabetes rates and 38th in cancer deaths. South Carolina has gone from 373.5 cardiovascular deaths per 100,000 residents in 2003 to 277.6 in 2013, the best improvement of any state in that period. But every state has improved remarkably in that category with the advent of statin drugs, and South Carolina still ranks only 38th overall.

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The report for the first time broke out youth immunization rates into two categories -- children ages 19-35 months and adolescents ages 13-17. South Carolina did a good job on the younger ages (17th among states) but poorly on the adolescents (47th).

Keck said his agency had noticed similar problems in other statistical analyses, and a fix is in the works. The state's Medicaid payment formula only paid half of the cost for adolescent immunizations. The agency is working to pay doctors a higher rate for those shots, thus encouraging more adolescent immunizations.

The full report is available at www.americashealthrankings.org.

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(c)2013 The State (Columbia, S.C.)

Visit The State (Columbia, S.C.) at www.thestate.com

Distributed by MCT Information Services

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