Las Vegans pay for bad habits in more ways than one

Failing to kick the worst habits — smoking, excessive drinking and overeating — absolutely can.

According to the Centers for Disease Control and Prevention, cigarette smoking causes about one in every five deaths in the United States each year, while excessive drinking causes about one in every 10 deaths among working-age adults. Obesity contributes to one in five deaths, according to a study funded by the Robert Wood Johnson Foundation.

Life expectancy is at least 10 years shorter for smokers, according to the CDC, and 14 years shorter for the extremely obese, according to the National Institutes of Health. A recent study showed alcoholism reduced lifespans by an average of 7.6 years.

So what do the numbers show for a destination city anchored on excess, where people practically dare each other to throw caution to the smoke-filled wind?

We’re actually in better shape than you might think. Clark County residents are close to — and in some cases below — the U.S. average for obesity, smoking and heavy drinking, according to findings by the University of Washington’s Institute of Health Metrics and Population.

Specifically:

• Clark County’s obesity rate — 32.4 percent of women and 33.2 percent of men — was slightly below the national rate of 36.1 percent for women and 33.8 percent for men in 2011.

• The county had about the same percentage of heavy drinkers as the nation did in 2012 — 7.2 percent of women and 9.8 percent of men in Clark compared with 6.7 percent of women and 9.9 percent of men nationwide.

• But the county did outpace the nation in smoking in 2012, with a rate of 22.1 percent of women and 24.2 percent of men versus the national rate of 17.9 percent of women and 22.2 percent of men.

Income and Health

Some Southern Nevada residents are at greater risk than others.

A bevy of federal- and university-funded studies have shown low-income and blue-collar workers are at greater risk to develop bad habits earlier and keep them longer, in part because they simply don’t have access to the time, cash or social incentives that help their better-off peers to quit drinking, smoking or eating too much.

Worse still, many of those at-risk populations tend to live in so-called “food deserts,” typically poor, low-mobility areas with a high concentration of fast-food restaurants and little or no convenient access to more nutritious calories stocked at grocery stores.

Earlier this year, a life expectancy map of Clark County by the Robert Wood Johnson Foundation showed that residents in the 89106 ZIP code, west of the Spaghetti Bowl, can expect to live 16 fewer years than their counterparts in 89183, nestled between Silverado Ranch and St. Rose Parkway at the valley’s southern edge.

In 2013, the average household income in the 89106 ZIP code was $28,506, compared with $53,284 in 89183, according to the American Community Survey.

Dr. Cassius Lockett, the Southern Nevada Health District’s community health director, said low-income neighborhoods often have higher concentrations of liquor and tobacco stores, giving residents ample access to the troika of bad habits with almost nothing in the way of healthier alternatives.

Clark County is no exception. Here food deserts dot the actual desert, and whole city blocks offer little more than convenience stores, smoke shops and payday loan centers.

Lockett said he thinks every day about ways to help steer residents away from potentially fatal bad habits. He said the district is trying to dig up data that can help improve outcomes for those most at risk for chronic health problems, with the focus on controlling infectious diseases — about 80 percent sexually-transmitted diseases.

“We really haven’t built up the capacity to focus on chronic diseases,” Lockett said. “We probably don’t have as much data available to the public as we should for an organization of this size.”

“I like mapping. I want to map out the hot spots and do more testing in those hot spots, do more interventions in those hot spots,” he said. “That’s the direction we’re headed here at the health district.”

Spending on Sin

One way governments have tried to cure us of our bad habits is by levying hefty “sin taxes” on cigarettes, alcohol and, in some jurisdictions, sugary sodas. Trouble is, those who pay most of such taxes tend to be least able to afford them, prompting criticism that government is relying on taxing the poor and minority groups to balance budgets.

On paper, bad habits look prohibitively costly. Yet in Clark County, people find a way to pay.

Statewide, tobacco taxes have risen by more than 400 percent since 2003, including a $1 levy that went into effect in July. Nevada’s sin taxes — a $1.80 per-pack cigarette tax and three separate per-gallon levies on beer, wine and liquor — together netted the state more than $238 million over the past two years.

These dollars, along with the state’s fuel, cellphone and Department of Motor Vehicles taxes, form the backbone of just about every city and county budget across the state.

Given the nationwide statistical patterns, it’s also not much of a surprise that the county’s 14 poorest ZIP codes — representing a quarter of the population generally tracked by the health district — account for more than a third of the county’s age- and population-adjusted hospitalizations for high blood pressure and nearly half of all hospitalizations for diabetes, alcohol abuse and chronic pulmonary obstructive disease — a malady heavily linked to cigarette smoking.

But perhaps the county’s most telling health-related statistic is zero. That’s the number of health district-sponsored chronic disease prevention programs geared directly toward Southern Nevada’s poorest areas.

Officials say the district’s largely grant-funded budget for preventive programs doesn’t allow leeway to focus on places where statistics show residents need them most. In fact, they say the district lacks resources to tackle alcohol abuse anywhere.

“The grant funders dictate what our priorities are,” said Deborah Williams, manager of the chronic disease prevention and health promotion office. “The good news is we believe the things we’re doing are helping. “Every one of our programs has the potential to benefit low-income neighborhoods, but it is dependent on those neighborhoods demanding that some of these issues be addressed.”

‘Minor Declines’

Williams, who heads the health district’s chronic disease prevention programs, said her office cannot directly change local policies and lacks authority to do much besides partner with municipal and educational agencies to promote healthy habits and discourage bad ones. Much of her group’s most recent $4 million annual budget went toward continuing work on a health education website and mobile apps to help users pick a healthy snack or guide them to walking trails.

Williams’ office has backed plans to encourage physical fitness by bringing UNLV coaches and Crossfit workout regimens to the Clark County School District. It has also supported moves to pull sodas out of school lunchrooms, put cafeteria food in single-serving containers to limit portion sizes, and include electronic cigarettes as part of campuswide no-smoking policies.

Williams said those efforts contributed to a nearly 5-percentage-point drop in countywide adolescent smoking rates from 2010 to 2013, as well as a comparable decline in daily soda consumption. She said similar initiatives helped achieve “minor declines” in adolescent body mass index.

Efforts to get junk food out of workplace vending machines and rid apartment complexes of secondhand smoke are about as close as Williams said she could get to taking direct action on behalf of the county’s poor families.

“Maybe it’s not totally definitive that what we’re doing works, but we are seeing the decreases we want to see,” Williams said.

Staff writer Henry Brean contributed to this report. Contact James DeHaven at jdehaven@reviewjournal.com or 702-477-3839. Find him on Twitter: @JamesDeHaven