Missouri's public health crisis Annual report relays biggest issues facing seniors

Heart disease? Definitely. Senior abuse? Sure. Diabetes? Yes. But this year' Missouri Senior Report names falling as the leading cause of injuries among the elderly. In fact, falls are such a threat that the report dubs them a public health crisis.

Each year, the Missouri Senior Report gathers information on a variety of issues related to seniors, including finances, housing, and the biggest health threats.

This year's report says than 1/3 of adults 65 and over fall each year in the U.S., and the rate increases to 40 percent for those over age 80. Twenty to 30 percent of seniors who fall suffer bruises, hip fractures and head trauma, and many never fully recover -- some even die. Falls are the leading cause of injury death for older adults, and in Missouri, the rate of seniors who die due to a fall is more than 30 percent higher than the national rate.

Viviane Rains, administrator at the Missouri Veterans Home in Cape Girardeau, says falls have always been a "hard issue" to address in nursing homes, where workers struggle with encouraging residents to be as independent as possible, while also being safe. Intervention and independence often contradict one another in long-term care, explains Rains. To help combat the problem, the state has launched the Show Me Falls Free Missouri State Coalition to increase awareness and prevent falls among seniors. This is part of a wider effort called the National Falls Free Coalition.

WORKPLACE WOES

The report also found 11.5 percent of Missouri seniors still in the workforce in 2006, up from 9.8 percent in 2001. In Cape Girardeau County, those numbers are slightly higher, with 13.9 percent of seniors working for pay in 2006, an increase from 11.1 percent in 2001. It's likely that more seniors are working instead of retiring because of increased health care and housing costs, not to mention the economic recession.

Long-term Medicaid care costs have risen about 25 percent in recent years, from $122 per capita in 2002 to $136 per capita in 2007. In Cape Girardeau County, those numbers stood at $137 in 2002 and $174 in 2007, making local health care costs significantly higher than the state average.

Seniors are said to be "cost burdened" if they must spend 30 percent or more of their monthly income on housing, which includes mortgage or rent, taxes, insurance and utilities. These families may have trouble affording food, clothing, transportation and medical care. In Missouri, 28.5 percent of seniors were in that position in 2007, up from 23.8 percent in 2000. In Cape Girardeau County, those numbers are slightly better, with 25.4 percent of seniors "cost burdened" in 2000 and down to 24.3 in 2007.

Sherry James of Comfort Keepers says she's doing everything she can to keep services affordable for seniors, especially those who need transportation and medical assistance. Because the economy is awful and most seniors are already on a fixed income, James has seen many clients cut back on the hours they use Comfort Keepers; some are even trying to cut back on food and prescriptions. James is also working to find funding for survivors of veterans so that they can also receive benefits to use the services.

OTHER HEALTH ISSUES

Both the city and state are struggling when it comes to specific health issues, especially diabetes. Statewide, 7.3 percent of seniors were living with diabetes in 2005, and that number jumped to 19.3 percent by 2007. In Cape Girardeau, seniors with diabetes were 15.8 percent in 2005 and 19.3 percent in 2007. On the upside, more seniors are taking preventive health measures with the flu shot. In Missouri, 38.3 percent of seniors did not get the flu shot in 2005, and by 2006, only 28.2 percent were missing out. In Cape Girardeau County, the numbers were at 35.2 percent in 2005 and 32.5 in 2006.

Overall, the growing senior population is a concern. The report estimates that seniors make up 13.4 percent of the population today, will increase to 15 percent by 2015, and to 19 percent by 2025. Baby Boomers are moving into their senior years and life expectancy is higher than in the past, and the state of Missouri has begun to more closely evaluate its long-term health care system.

Rains worries most about the rising costs of prescriptions and long-term and preventive medical care, especially when stacked against the number of seniors financially able to pay for these needs. "It's leading us to a less healthy population," she says.

LONGTERM CARE

Rains also sees how long-term care facilities -- many of them already short-staffed -- will struggle to meet the needs of aging seniors. However, Rains, who previously worked in private sector and rural health care systems, says that the Veterans Home has been fortunate to maintain a full staff and steady rates. "Amazingly enough, we have very little turnover, and we have enough applicants that we can keep all our positions full," she says.

Ruth Dockins, public information director at the Southeast Missouri Area Agency on Aging, points out that in 2006, Cape Girardeau County's composite rank was 14 out of 115 Missouri counties, and for the past two years it has ranked at 13.

"I'm pleased that we didn't lose our status," says Dockins. "The rural counties have a hard time because the services are not available as much for seniors there." Other Southeast Missouri composite rankings include Ste. Genevieve, 16; Perry, 46; Bollinger, 64; Madison, 69; Stoddard, 84; Scott, 96; Reynolds, 98; Shannon, 103; Wayne, 104; Mississippi, 107; Butler, 109; New Madrid, 111; Dunklin, 112; Ripley, 113; and Pemiscot, 114. While St. Louis County came in at No. 6 this year, the city of St. Louis has been ranked 115 for at least the past two years.

The information most meaningful to the Agency on Aging, says to Dockins, is the county's health status and crime rates. Dockins says that while the Agency on Aging doesn't sit down with the report and plan programming around its results, it's still a useful tool for self-assessment.

"It's a very good indicator. It's like a report card to tell us how we're doing," she says. "If we begin to slip, the report will draw our attention to it, but that hasn't happened so far."

The Missouri Senior Report is developed by the Department of Health and Senior Services, the University of Missouri Office of Social and Economic Data Analysis, and the University of Missouri Extension, in conjunction with Lt. Gov. Peter Kinder, the official senior advocate for Missouri. For more information or to read the complete report, visit www.missouriseniorreport.org or call the DHSS Office of Public Information at (573) 751-6062.