Examining health and illness

Editor’s note: This is the second in a series of articles highlighting some of the components of the recently-released survey of the health status of residents in Baraga, Gogebic, Houghton, Keweenaw and Ontonagon counties. This article focuses on how behavior affects health.

HANCOCK – There are many illnesses and diseases which people can do little to prevent, but there are also many health problems directly related to behavior, which can be prevented or lessened by changing behavior, according to Guy St. Germain.

“There are many risk factors that lead to poor health outcomes,” said St. Germain, who is health officer/executive officer for the Western Upper Peninsula Health Department in Hancock. “Some of the risk factors are within our control.”

One of the sections of a health survey of residents in the health department’s five-county coverage area released in late April concerns respondents who don’t use available leisure time to get physical activity not related to their work.

“It relates to people voluntarily going out of their way to do some sort of physical activity for their health,” he said.

According to the health survey, about 15 percent of respondents to the survey indicated they did not get some level of physical activity.

“They don’t even walk the dog,” he said. “They don’t even garden.”

That level of respondents who say they don’t get some sort of physical activity is too high, St. Germain said. Lack of activity can lead to cardiovascular disease, diabetes and osteoporosis. Some new research is finding a connection between lack of exercise and some colon and breast cancers.

“Studies are still fluid on that topic,” he said.

St. Germain said “adequate physical activity” as defined by the American College of Sports Medicine and accepted by the National Institutes of Health and the federal Center for Disease Control and Prevention, includes at least 150 minutes of moderate activity per week or 60 minutes of rigorous activity per week.

For the western U.P., St. Germain said about 22 percent of survey respondents get enough physical activity per week, which is too low.

“It’s only about a fifth of the population who get the recommended levels of activity,” he said.

St. Germain said he was impressed by the fact levels of education were a factor affecting whether people got exercise or not. Only about 16 percent of survey respondents with less than a high school education stated they got adequate physical activity, while about 31 percent of those with a four-year college degree stated they got adequate physical activity.

“That is a bit of an interesting finding,” he said.

St. Germain said he was especially troubled by the finding of the survey that so many children in the five-county are aren’t getting enough physical activity.

“Just barely half our kids in our counties get at least 60 minutes of physical activity per day,” he said.

By contrast, St. Germain said a high percentage of children in the survey area spend three or more hours per day watching television.

The lack of physical activity has led to high rates of obesity and overweight for both adults and children in the five-county area.

Although there are other behavioral-related illnesses, St. Germain said if people would simply increase the amount of physical activity they get, it would significantly reduce the incidences of those illnesses.

“Living a sedentary lifestyle is a major risk factor for many chronic diseases,” he said. “Apart from (quitting) smoking, being physically active is the most powerful lifestyle choice.”

One of the other behavioral issues examined in the survey is nutrition, particularly the consumption of fruit and vegetables, which St. Germain said is too low.

According to the survey, in the western U.P., 11.5 percent of respondents are eating fruits and vegetables five or more times per day. In Michigan, the rate is 17.8 percent.

Knowledge of the effects of poor diet is not new, St. Germain said.

“Nutrition is an important issue,” he said. “Research has shown good nutrition is coordinated to health.”

St. Germain said the findings of the survey for cigarette smoking are particularly dramatic, particularly for education and income levels.

The survey shows almost 41 percent of respondents with less than a high school education smoke, while of those with at least a four-year college degree, only about 9 percent smoke.

Regarding household income and cigarette smoking, the survey shows about 36 percent of those with an annual income of $24,999 or less smoke, while about 13 percent of those with an annual income of $50,000 or more smoke.

The negative effects of tobacco use have also been known for decades, and St. Germain said they include lung and other cancers, emphysema, high blood pressure, and cardiovascular disease, which can include stroke.

Heavy alcohol consumption in the survey coverage area is similar in all categories. In the western U.P., about 12 percent of survey respondents report heavy drinking, which is more than two alcoholic drinks per day for men and more than one per day for women.

The effects of heavy alcohol consumption include liver and heart disease, but St. Germain said there are safety issues involved, also, particularly drinking and driving.

Although 12 percent of respondents reporting heavy drinking may seem like a low number, St. Germain said it should be 0 percent.

“There’s no acceptable level for heavy drinking,” he said.

Also involved in the regional assessment were Aspirus Grand View, Aspirus Keweenaw, Aspirus Ontonagon, Baraga County Memorial, and Portage Health hospitals. Other agencies involved in the assessment were Copper Country Community Mental Health Services, Gogebic County Community Mental Health Authority, and the Western Upper Peninsula Substance Abuse Services Coordinating Agency.

The next article in this series will involve mortality statistics for diseases such as cancer and diabetes. The full health survey can be seen online at