Lucas County health data questioned

1/23/2004

Some results of a $70,000 study about the health of Lucas County residents released yesterday could be skewed because the Toledo firm that conducted the polling admittedly may have surveyed too many low-income residents.

The true percentage of Lucas County adults who smoke and the number of county residents who do not have health-care benefits are two of the findings called into question from a survey by Great Lakes Marketing of 2,000 county residents age 19 or older conducted in July, 2003.

The “Healthy Lucas County” survey - about half of which was funded by taxpayers - reported that 37 percent of county adults smoke compared to 27 percent in 1999. The number of adults without health insurance in Lucas County also was reported to have increased from 11 percent in 1999 to 24 percent in 2003.

But Dr. Robert Indian, an Ohio Department of Health expert who oversees federal health surveys in the state, said he was skeptical of the results because they conflict with previously released data collected by the federal Centers for Disease Control.

When the CDC surveyed Lucas County in 2000, it found 30 percent of adults smoke. In 2002, the CDC found 28 percent of adults smoke, Dr. Indian said.

“I honestly believe that s the best estimate [of smokers] for Lucas County,” he said.

Fewer people might be smoking or, just as likely, there probably was no change at all from 2000 to 2002 or even much change in 2003 because the two CDC percentages are so close, he said.

The CDC did not survey residents about health insurance status, but Dr. Indian said if Great Lakes had too many low-income people in its survey, it could skew the findings both for health insurance status and for smoking prevalence. He said lower-income adults smoke more and are more likely to lack health insurance.

Asked about the possibility of discrepancies, Dr. Lori Dixon, owner of Great Lakes, acknowledged in an interview with The Blade that it appears her firm included too many low-income people in its survey, but she can t say for certain.

While those two findings may very well be inaccurate, she said the rest of Great Lakes findings are accurate and overall the findings from the survey conducted in person at libraries, grocery stores, and other locations around the county are still useful.

Dr. Dixon pointed out that most of her firm s findings mirror the CDC s survey. For example, the CDC and her firm both found that 29 percent of Lucas County adults are obese and were almost the same on diabetes prevalence (8 percent according to the CDC, and 10 percent according to Great Lakes). In addition, Great Lakes found that 19 percent of adults in Lucas County binge-drink, compared to an 18 percent finding by CDC.

John Zogby, president of the national polling firm Zogby International, said that based on a description of Great Lakes survey methodology, he doubts the results are scientifically valid.

“You can t claim that s representative of the entire community as a whole,” he said. “It s useful information and it s certainly valuable, but it can t be claimed to be scientific.”

By contrast, he said his company - like the CDC - relies on telephone surveys for its polling. A computer randomly generates a list of people to call. By approaching people in person at a shopping mall, or some other location, one can t ensure randomness, he said.

Dr. Dixon defended her firm s methodology, and said telephone surveys have room for error because they miss people without phones. Mr. Zogby said almost 98 percent of the American public has a phone, so he believes phone surveys are the best method. “I make my living doing phone surveys and we can call an election to a tenth of a percent,” he said.

Kathy Silvestri, director of health planning for the Hospital Council of Northwest Ohio and a coordinator for the Lucas County survey, said she, too, is concerned about the discrepancies. But she added that the local data are invaluable for planning purposes because the results allow local agencies to target programs to areas that need attention.

Unlike the CDC survey, for example, the Great Lakes survey also examined minority health issues.

David Kontur, president of the Lucas County Family Council, which helped fund the study, said he s a little concerned that the potential errors will make it difficult to make generalizations about the overall health status of Lucas County.

He added, however, that he still finds the survey useful, especially given that the findings appear to confirm or bolster some of the CDC findings. In addition, Great Lakes asked more questions than the CDC did and broke down smoking rates by race and other factors - unlike the CDC.

The discrepancies, especially in the area s smoking rate, could cause some headaches for local politicians, public health officials, nonprofit and private health-related organizations, and a confused general public when it comes to evaluating just how healthy - or unhealthy - Lucas County really is.

The smoking rate and the number of uninsured in Lucas County are two numbers closely followed by local elected leaders. Toledo City Council has passed a ban on smoking inside public places, including bars and restaurants. Mayor Jack Ford has been a strong supporter of the smoking ban and has spoken out about the uninsured and pushed local health providers to form CareNet, an organization partly funded by tax money, that provides free health care to some uninsured Lucas County residents.