Colorado’s Paradox: Healthy Adults, Unhealthy Children

Colorado advertises itself as a healthy state, attracting mountain climbers, skiers, and outdoorsy types. But new data finds that just because Colorado is lean, that doesn’t mean its entire population is healthy.

The Colorado Health Foundation‘s 2010 Report Card showed that the Rocky Mountain state is a health paradox — with a population of healthy adults, but unhealthy children.

Leanest Adults, Obese Children

Colorado adults are the leanest in the United States with, a 19 percent obesity rate, compared to the national average of 27 percent. But obesity among the state’s children is rising at an alarming rate. Colorado ranked 23rd in the nation for childhood obesity, according to the report card, a major slip from its third-place rank four years ago.

“We import a lot of healthy, educated people,” said Anne Warhover, CEO of the Colorado Health Foundation, “but we’re not growing our own.”

There are a number of reasons behind this paradox, said Michele Lueck, CEO of the Colorado Health Institute. Like the rest of the country, children’s lifestyles in Colorado are increasingly sedentary.

Experts cite a few reasons why the rates have risen so dramatically in the state, including the public school system. Colorado is one of only two states that do not require physical activity as part of the school curriculum. For many kids, a gym class may be their only exercise.

Another major contributing factor is poverty. Colorado’s childhood poverty rate is rising quickly, according to Shepard Nevel, vice president of policy for the Colorado Health Foundation. Fewer economic resources mean less access to healthy food and education.

“There’s a strong correlation between socioeconomic status and health,” he says. “We don’t think you can talk about improving the health of Colorado and reversing this unfortunate trend of childhood obesity without also addressing childhood poverty.”

Healthy and Educated — With High Premiums

Colorado adults take good care of themselves, beyond just keeping their weight down. They rank well in terms of physical activity and healthy diets. Smoking rates among adults have dropped, and Colorado adults rank second in the nation for low blood pressure and low rates of diabetes.

But despite these numbers, Colorado health insurance premiums are the seventh highest nationwide. Nearly 20 percent of adults are not insured, and according to the report, most uninsured adults are employed full-time.

Tom Clark, vice president of the Metro Denver Economic Development Corporation, said this is because 90 percent of Coloradans work for small businesses, which often can’t afford to provide insurance for their workers.

As to why the premiums remain so high despite such a healthy workforce? “We don’t know,” said Patty Silverstein, president of Development Research Partners.”That’s the Colorado paradox. We’re scratching our heads.”

Healthy Aging, Unhealthy Beginnings

Colorado also has one of the healthiest aging populations in the United States, the 2010 report card shows. The state attracts healthy retirees, and they rank high in physical activity, mental and physical health, compared to other senior populations.

But the state barely earns an average grade for the health of its youngest citizens, ranking 37th in babies with a low birth weight. Colorado children’s dental health is also in the bottom tier nationwide: Oral disease is five times more prevalent than asthma in the state, according to the report.

The state’s childhood immunization rates are also alarming, Lueck said. While the state ranks second for aging adults receiving flu and pneumonia vaccines, its childhood immunization rate is only 65 percent, a radical drop from 79 percent just four years prior.

These disparities are largely due to income, Lueck said. The growing poverty rate and lack of access to coverage means less care for pregnant women and children. The state also has one of the most conservative Medicaid plans, he added, meaning fewer people, including young children, have access to the program.

And with such high premiums and 19 percent of adults in Colorado uninsured, even full-time employed adults have a hard time getting their children health care.

Policy changes are expected to improve access to insurance coverage. Under the new federal health care reform law, about 500,000 Coloradans will be newly eligible for Medicaid or for a tax credit under the new state exchanges, a move that Nevel hopes will help families get their children’s health on track again.

However, access to coverage alone won’t do enough to reduce the childhood obesity rate. Colorado does have initiatives underway to reduce the problem of childhood obesity, from removing all soft drinks from schools to investing in nutritional education. But Lueck says they haven’t yet found an ultimate fix.

“We’re trying to figure out how you stop obesity like we were trying to figure out how to stop smoking thirty years ago,” she said, “But we’re trying to figure out what are all the different levers that we can apply to reverse the trend.”

Raising Colorado’s health grade is critical, not just for the health of Colorado, but for the state’s economic development, Nevel said. If the health of Colorado’s children doesn’t improve, neither will its economy.

“To state the obvious, children are our future,” he said. “The healthier a community is the more productive it is. It is a significant, even a primary factor in the economic development sphere.”