Bill aims to address health disparities in tribe and county

Significantly lower than average life expectancy for Passamaquoddy tribal members and high cancer death and poor health rates for Washington County residents have prompted the introduction of legislation to address those issues.

Following the release of a report in April 2008 that showed that Washington County is the only county in the northeastern U.S. where women were dying at a younger age than in previous years, during the period from 1960 to 2000, three meetings of health professionals were held last summer to discuss the health disparities. Concern about those disparities has also resulted in the submission of a legislative resolve by Passamaquoddy Rep. Donald Soctomah that would direct the Department of Health and Human Services, Maine Center for Disease Control and Prevention, and a Washington County health organization to work with the Passamaquoddy health directors to help reduce the health disparities between the tribe, the state and the nation and the county, the state and the nation. An action plan and recommendation to address the health disparities would be developed, and a report would be submitted by next January so that legislation could be submitted during the next session of the legislature.

Soctomah observes, "Everybody agrees that health disparities exist in the tribal community. The most obvious is life expectancy in the tribal communities C 49 to 50 years old, which is about 20 years less than the average in the U.S." He says the life expectancy of Passamaquoddy tribal members is among the lowest 5% in the world, with only a few other countries with a lower average life expectancy. Diabetes and cancer rates for tribal members are high, and Soctomah says, "We want the state and federal governments and the tribe to look at what is causing this problem." He notes that economic disparities are related to the health of a community, and he has introduced another bill to seek to address economic issues.

According to the state's health data, the average age of death for Native Americans in Maine is 60 years old, versus 74 for all Mainers. Native people may die at higher rates from cancer, particularly lung cancer. Soctomah notes, though, that tribal health data from the tribe does not match the data from the state, and he observes that the tribe is the best source for the information. Barriers to health identified by tribal health directors in the state include: transportation, low income, prejudice and racism, shortages of qualified health personnel, inadequate state and federal funding, lack of accessible and/or culturally appropriate health care, especially for substance abuse treatment and nursing home care, and threats from environmental toxins such as dioxin, mercury, lead, arsenic and cadmium.

Concerning the health of Washington County residents, the health profile prepared by the Maine Center for Disease Control and Prevention found that the county has the highest rates in the state for: overall cancer incidence and cancer death rates; lung and colon cancer incidence and death rates; adult smoking rates; adult obesity rates; high blood pressure and high cholesterol rates; and number of people reporting fair or poor health status. Diabetes and asthma rates are also higher than the state average. The report states that both lung and colon cancer have significant causative factors in tobacco, poor nutrition, physical inactivity and obesity. It notes, "Therefore, perhaps related to these cancer statistics is the finding that tobacco, overweight/obesity and related indicators are worse in Washington County than the state average."

Also according to the county's health profile, substance abuse admissions have increased by almost 150% in the past 10 years and account for 7% of the statewide substance abuse admissions, although the county only accounts for 2.5% of the population. "Adolescents in Washington County are more likely to report that the cultural norms are more favorable to drug use, that there is a perceived easy availability of drugs and there is an early initiation of drug use." Prescription narcotics are the most common illegal drug seized in the county.