by Scott Richter and Dr. Patrick Jones
Part of the shared human experience is we all have times of joy and pleasure and at other times sickness and pain. But unique to each individual is how often, to what degree (positive or negative), and more importantly, the effect they might have.
For example, nearly everyone has experienced times they could say they were very sick. Yet not everyone goes to a doctor’s office because of the illness and even fewer are hospitalized.
The same could probably be said about most injuries or illnesses because to be hospitalized for any reason indicates very serious, if not dire, circumstances. We are seeing this with COVID-19 too where data, data collection, and data dissemination varies by jurisdiction, but the number of hospitalizations is definitive. Because the number of hospitalizations is not an estimate, it can be used to create projections of the actual infection rate in a community.
Outside of COVID-19, it might seem little can be gained from this information because these are the most critical situations. If a relatively few number of people experience a condition bad enough to require hospitalization, what can it say about the community as a whole? Well, a lot.
Looking at the Share of Hospitalizations by the Top-4 Causes indicator on Walla Walla Trends, immediately we see an overall larger share of hospitalizations caused by one of the top-4 conditions occurred in Walla Walla County compared to the state. How much higher? In 2016, 4.5 percentage points higher, in 2017 3.6 points, and in 2018, 3.3 points.
It does not require much digging to then see what ailments Walla Walla County residents face a higher or lower chance of being hospitalized for compared to residents of the state. Differences to a benchmark or significant changes from one year to the next might indicate a public health problem unique to Walla Walla. Just like going to the doctor for treatment, understanding the condition inevitably helps lead to a treatment, or even better, a cure.
More specifically in Walla Walla County, from 2016 to 2018 hospitalizations for:
- Digestive System Disease decreased from 9.3% to 8.7%.
- Heart Disease decreased from 9.6% to 7.7%.
- Respiratory Disease decreased from 7.5% to 6.7%.
- Unintentional Injuries increased from 9.3% to 8.7%.
Similarities to a benchmark can be just as informative as differences. From 2016 to 2018, digestive disease, heart disease, and respiratory disease hospitalizations in both the county and state witnessed a decrease in shares.
More specifically in Washington State, from 2016 to 2018 hospitalizations for:
- Digestive System Disease decreased from 8.4% to 7.2%.
- Heart Disease decreased from 8.4% to 6.8%.
- Respiratory Disease decreased slightly from 6.5% to 6.3%.
- Unintentional Injuries increased from 5.3% to 7.6%.
Looking at another indicator, the Share of Population by Age Groups, every age group had a decreased share of the total population from 1998 to 2019 except for those ages 65+ increasing from a 15.0% share to 20.2%. Therefore, the slightly higher shares of the top-4 causes for hospitalizations in the county might be at least partially explained by the higher share of senior citizens compared to the state.
On the other hand, hospitalizations from unintentional injuries in both the county and state increased. The likely reason for the increase is the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) placement of self-harm and suicide into unintentional injuries category. While it remains a top-4 cause, the definition of unintentional injury expanded capturing more hospitalizations in this category than before the DSM-V.
While hospitals use this information to identify any specialized services needed in a community, public health officials can use this information to devise strategies, create healthcare standards, improve evaluation techniques and treatments, strategies to expand healthcare access, and to determine areas that may require additional or expanded research. In others, pursue preventive measures based on this information.
While this indicator might only have three-years of data, it is still a critical snapshot into the health of Walla Walla County. Since COVID-19 is respiratory, this category will certainly increase. However, medical researchers are learning more about the cardiovascular and neurological impact.
COVID-19 aside, one would both hope and assume the shares for 3 of the top-4 causes of hospitalizations would continue to decrease ever so slightly as more annual data becomes available.
Unintentional injuries, now that the expanded definition includes physical conditions resulting from mental disorders (self-harm and unsuccessful suicide attempts, for example) as well as from accidents, is the least predictable / most volatile category. But if true, suicide is considered preventable and a targeted community approach can make a difference.