Troubling trends for homelessness, physical activity, food security, and drug-related deaths

Part I of our double blog on recent trends in King County focused on some of the good news from King County Hospitals for a Healthier Community’s new Community Health Needs Assessment.  Now we’ll look at some of the more challenging findings.

Part II.  ACROSS KING COUNTY OVERALL, WHAT’S FAILING TO IMPROVE OR GETTING WORSE?  While many indicators showed little or no improvement in the 3 years since the previous report, those with special relevance for healthcare providers were highlighted in the Community Health Needs Assessment.

Homelessness:  In the context of escalating housing prices, student homelessness in King County more than doubled since 2008, reaching 8,411 (2.9% of enrolled students) in the 2015-16 school year. In 2016-17, this increased further, to 9,407 (3.2% of enrollees).

  • In most school districts, more than 40% of homeless students were in elementary school or pre-kindergarten.
  • In addition to student homelessness, the 2017 Count Us In Report identified 11,643 individuals experiencing homelessness, 50% of whom had one or more disabling conditions.

Too little physical activity: Fewer than 1 in 4 King County adults and youth get the recommended amount of exercise. Insufficient physical activity is associated with obesity, which in turn is linked to diabetes and other chronic diseases (including 4 in 10 cancers diagnosed in the United States).

  • This represents no change for adults, and modest but inadequate improvement for 8th, 10th, and 12th graders, given the importance of physical activity to health.
  • The overall obesity rate for King County adults has been flat since 2009 (at more than 1 in 5 adults). Nationally, adult obesity levels rose for decades, stabilized between 2003 and 2012, then rose again slightly for women.
  • At 22%, the 2015 adult obesity rate in King County was significantly lower than the Washington state rate of 26%, and the national rate of 29% (although the 2011-2015 rate in South Region matches the national rate, at 29%).
  • For King County youth, obesity has held steady around 9% since 2004 except in South Region, where it has increased. In comparison, high school students nationally experienced a steady increase in obesity from 1999 to 2013, which appeared to level off at a higher rate -14% in 2015.

Food insecurity:  By 2016, King County participation in the Basic Food program (formerly food stamps) had not returned to pre-recession levels and was increasing for older adults, especially in South Region.

  • A similar pattern was found for visits to King County food banks.
  • Although survey data about food hardship (running out of food without money to buy more) have not been collected since 2013, use of food assistance is often associated with food insecurity.

Feeling depressed: On the mental health front, 30% of youth reported that, every day for 2 or more consecutive weeks, they felt so sad or hopeless that they stopped doing some of their usual activities.

  • This indicator of depressive feelings has gotten worse in King County since 2004, driven by increases among youth in South Region.
  • Among adults, reports of frequent mental distress (poor mental health in at least 14 of the past 30 days) have increased among Hispanics since 2005, but remained stable among other race/ethnicity groups.
  • While the percentage of heterosexual adults reporting serious psychological distress has been flat since 2009, feeling “nervous, hopeless, restless, depressed, worthless, or that everything was an effort” within the past 30 days has increased significantly among lesbian, gay, and bisexual adults.

Drug-related deaths, especially those related to heroin and methamphetamine, increased dramatically between 2010 and 2016.  New data released last week revealed a 10% increase (from 348 to 379) in King County drug-related deaths in 2017.

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