Nebraska has fallen in the most recent America’s Health Rankings survey.

According to the report:

* Ranking:
Nebraska is 16th this year; it was 9th in 2008.

* Strengths:
Strengths include a high rate of high school graduation with 87.0 percent of incoming ninth graders who graduate in four years, few poor mental and physical health days per month at 2.5 days and 2.7 days in the previous 30 days, respectively, low levels of air pollution at 8.0 micrograms of fine particulate per cubic meter and a low infant mortality rate at 5.6 deaths per 1,000 live births.

* Challenges:
Challenges include a high prevalence of binge drinking at 18.6 percent of the population and low immunization coverage with 74.8 percent of children ages 19 to 35 months receiving complete immunizations. Nebraska ranks lower for determinants than for health outcomes, indicating that overall healthiness may decline over time.

*Significant Changes:

In the past year, immunization coverage decreased from 85.2 percent to 74.8 percent of children ages 19 to 35 months receiving complete immunizations.  In the past five years, the percentage of children in poverty increased from 11.0 percent to 16.2 percent of persons under age 18.  In the past ten years, the prevalence of smoking declined from 22.0 percent to 18.3 percent of the population.  Since 1990, the prevalence of obesity increased from 11.6 percent to 27.2 percent of the population.

* Health Disparities:
In Nebraska, obesity is more prevalent among non-Hispanic blacks at 37.0 percent than non-Hispanic whites at 26.6 percent. The prevalence of diabetes also varies by race and ethnicity in the state; 10.4 percent of non-Hispanic blacks have diabetes compared to 7.4 percent of non-Hispanic whites. In addition, mortality rates vary in Nebraska, with 1,016.2 deaths per 100,000 population among blacks compared to whites, who experience 752.1 deaths per 100,000 population.

By Robert Pore

Americans are not only struggling with coming up with a national health care policy, but they are also struggling with quiting smoking, according to a new study by the Center for Disease Control.

The new survey was released in advance of the Great American Smoke Out on Thursday, Nov. 19.

According to the CDC study, despite progress in some areas, smoking rates among U.S. adults remained stalled in 2008, halting the nation’s progress in ending the tobacco epidemic.

The study found that 46 million Americans (20.6 percent) were current cigarette smokers in 2008, which is virtually unchanged since 2004 when 20.9 percent of adults reported being smokers. The study’s findings indicate an alarming trend, because smoking is the leading preventable cause of death, killing more than 443,000 people every year and costing the nation $96 billion in health care costs annually.

This new data, based on the 2008 National Health Interview Survey, shows little to no change over the past five years and hints that smoking rates may be moving in the wrong direction, according to CDC.

“Today tobacco will kill more than 1,000 people, but we can reduce smoking rates,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “We must protect people from second-hand smoke, increase the price of tobacco, and support aggressive anti-tobacco campaigns that will reduce smoking and save lives. If every State had smoking rates similar to places which have implemented effective programs, there would be at least 10 million fewer smokers in the U.S., and millions of heart attacks, cancers, strokes, and deaths would be prevented.”

According to America’s Health Rankings, smoking stands out as the greatest public health battle of the past 20 years. Despite focused efforts, America’s Health Rankings found that nearly one in five Americans still smoke, which is only 8 million people fewer than 20 years ago.

AHR said smoking remains the leading preventable cause of disease and death in the country, leading to approximately 440,000 deaths annually. Over the past year, AHR reports that more than 3 million people have quit smoking, proving that smoke-free laws, smoking bans, increased cigarette taxes, access to smoking cessation programs and other interventions are beginning to make an impact.

According to the CDC study, the people hardest hit by the tobacco epidemic are those among vulnerable populations, including people with lower levels of educational attainment. In 2008, 41.3 percent of persons with a General Education Development certificate smoked cigarettes, compared to 5.7 percent of persons with a graduate degree.

In another study in this week’s CDC Morbidity and Mortality Weekly Report, the 2008 Behavioral Risk Factor Surveillance System reports that current adult smoking prevalence varied substantially across 50 states, the District of Columbia, and the three U.S. territories. Among states, smoking prevalence was highest in West Virginia (26.6 percent), Indiana (26.1 percent), and Kentucky (25.3 percent) and lowest in Utah (9.2 percent), California (14 percent), and New Jersey (14.8 percent).

In the same study, CDC also reported significant variation among 11 states in the proportion of adults protected by smoke-free workplace policies and the proportion of adults who protect themselves and their families from secondhand smoke in their homes.

Among the 11 states which asked questions about exposure to second-hand smoke, CDC said there was a large variation in indoor workplace exposure – from a high of 16 percent in Mississippi to a low of 6 percent in Connecticut and Tennessee. Second-hand smoke is known to cause cancer, heart disease, and many other health problems, and smoke-free laws have many benefits, including protecting non-smokers, reducing heart attacks in non-smokers, and encouraging smokers to quit.

According to CDC, past experience shows that smoke-free laws covering public places encourage people to adopt smoke-free policies in their homes. In these states, CDC saud home exposure varied widely from 3 percent of adults exposed in their homes in Arizona to 10.1 percent and 10.6 percent, respectively, in Mississippi and West Virginia.

This finding, CDC reports, correlates with household policies about not allowing smoking in households with a smoker present – for example, two thirds of smokers in Arizona live in households where smoking is not allowed in the home, compared to 41 percent and 36 percent in Mississippi and West Virginia.

Nationwide, 21 states and D.C. have implemented comprehensive smoke-free laws covering workplaces, restaurants, and bars, but more than half of the country still lives in areas where they are not protected by comprehensive smoke-free laws.

“Despite states having received more than $200 billion in tobacco-generated funds over the past 10 years, many Americans—particularly those with low educational attainment levels, and those who work in the hospitality, service, and other industries are exposed to smoke in their workplaces, and they do not have equal access to the support needed to help them quit,” said Matthew McKenna, M.D., M.P.H., director, CDC’s Office on Smoking and Health. “We need to make the investments so all people receive the same protections and adequate information to help them quit successfully.”

CDC also noted that smoking rates among low-income adults enrolled in Medicaid programs are much higher than the general population (33 percent vs. 19 percent), and that only 6 Medicaid programs provided full access to all proven means to help smokers quit. Because access to tobacco cessation treatments (FDA-approved medications and counseling) has been shown to help smokers quit, providing coverage to all smokers, including the Medicaid population, would help reduce smoking rates.

The American Cancer Society’s annual Great American Smokeout, slated for Nov. 19, 2009, encourages smokers to quit smoking. People who smoke can call 1-800-QUIT-NOW (1-800-784-8669) or visit http://www.smokefree.gov for quitting assistance. For more information on CDC’s tobacco control programs, visit http://www.cdc.gov/tobacco.

America’s Health Rankings is celebrating its 20th anniversary in efforts to track America’s health trends. While increasing health care costs are increasing, AHR said Americans are still struggling to change unhealthy behaviors such as smoking and obesity, which cause these diseases in the first place. 

The AHR’s 2009 rankings shows the nation`s health care system has become extremely adept at treating certain illnesses and disease, such as cancer and cardiovascular disease.

“However, Americans are struggling in the battle to modify risk factors, such as smoking, poor eating habits and lack of exercise, which may contribute to chronic diseases in the first place,” AHR reports. 

According AHR, the United States currently spends more per capita than any other nation on health care, including $1.8 trillion in medical costs associated with chronic diseases, such as diabetes, heart disease and cancer.

“These chronic, preventable conditions all have a direct link to smoking and obesity, the nation`s two largest national risk factors,” according to the AHR study.

Along with smoking, AHR rerports that:

*Obesity is growing faster than any previous public health issue our nation has faced. Today, more than one in four Americans are considered obese (31 percent). If current trends continue, 103 million American adults – or 43 percent of the population – will be considered obese by 2018, making obesity the nation`s next health battle. Included as supplemental data to this year`s rankings are estimates around the growth of health care costs over the next 10 years if obesity continues to rise at unprecedented levels.

Left unchecked, obesity will add nearly $344 billion to the nation`s annual health care costs by 2018 and account for more than 21 percent of health care spending. millions, AHR reports.

While all the nation’s major corn producing states are behind harvest, Nebraska, Minnesota and South Dakota are further behind than most states, according to the USDA. Minnesota was 43 percent completed and South Dakota at 27 percent completed. Other major corn producing state were rate completed:  Illinois, 52 percent; Iowa, 59 percent; Kansas, 80 percent; Ohio, 58 percent; and Missouri, 72 percent.

While more than half of the state’s estimated 1.5 billion corn harvest has yet to be picked, corn conditions were rated 79 percent good or excellent, near last year’s good and excellent rating. Irrigated and dry land corn conditions were rated 83 percent and 74 percent good or excellent.

State soybean harvest was 97 percent completed, and sorghum was lagging behind at 44 percent completed 20 days behind the five year average of 87 percent completed. Winter wheat conditions were rated 70 percent good or excellent compared to last year’s 82 percent.

The state’s pasture and range conditions were rated 75 percent good or excellent, above last year’s rating.

According to the USDA, this year’s corn harvest in Nebraska is comparable to the 1972 harvest in days behind. What’s delaying harvest progress was contined high grain moisture levels. Corn that has been harvested has been in the upper teens or low 20s in moisture and needs to be artifically dried though area drying capacity is unable to keep up with the demand. A number of area grain drying fires have been reported in the last couple weeks as a result of that heavy demand.

Statewide, the USDA reported for the week ending Nov. 15, temperatures were raining six degrees above normal November temperatures.

One of the reasons for the lack of natural drying across Nebraska and the country was that the October 2009 average temperature for the contiguous United States was the third coolest on record for that month according to NOAA’s State of the Climate report, which was issued last week.

The average October temperature of 50.8 degrees F was 4.0 degrees F below the 20th Century average. Preliminary data also reveals this was the wettest October on record with average precipitation across the contiguous United States reaching 4.15 inches, 2.04 inches above the 1901-2000 average.

October weather highlights include:

* October 2009 was marked by an active weather pattern that reinforced unseasonably cold air behind a series of cold fronts. Temperatures were below normal in all regions with the exception of the Southeast which had near normal temperatures for the month.

* Oklahoma recorded its coldest October on record while the month ranked in the top five for Arkansas, Colorado, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, South Dakota, and Wyoming.

* Florida was the only state to record an above normal temperature average in October. It was the sixth consecutive month that Florida’s temperature was above normal.

* The nationwide average precipitation of 4.15 inches nearly doubled the long-term average. This was the first month since December 2007 that no region in the United States recorded below normal precipitation.

* Iowa, Arkansas, and Louisiana recorded their wettest October while only Florida, Utah, and Arizona had below normal precipitation.

* Moderate-to-exceptional drought covered 12 percent of the contiguous United States, the second-smallest drought footprint of the decade, based on the U.S. Drought Monitor. Major drought episodes in California and South Texas improved significantly. Drought conditions, however, emerged across much of Arizona.

* About 45 percent of the contiguous United States had moderately-to-extremely wet conditions at the end of October, according to the Palmer Index. This is the largest such footprint since February 2005.

* Two major snow storms hit the Upper Midwest and the western Plains states. By month’s end, 13.6 percent of the nation was under snow cover, according to NOAA’s National Operational Hydrologic Remote Sensing Center.

* Cheyenne, Wyo., tallied 28 inches of snow in October, making this the city’s snowiest October on record. North Platte, Neb., recorded 30.3 inches of snow, making October 2009 the snowiest month ever for the city.

* October saw below-normal fire activity, with a total of 3,207 fires that burned about 158,000 acres, according to the National Interagency Coordination Center.

By Robert Pore

With the Senate likely to postpone debate on a climate change bill until next year, studies continue to point to possible problems facing agriculture if the atmoshpere continues to warm.

For example, Kansas State University’s Joseph Craine, research assistant professor in the Division of Biology, and KC Olson, associate professor in animal sciences and industry, have teamed up with some other scientists from across the United States to look into the possible effects of climate change on cattle nutrition.

Nebraska’s cattle industry is the biggest segement of the state’s ag industry at nearly $7 billion annually.

“Owing to the complex interactions among climate, plants, cattle grazing and land management practices, the impacts of climate change on cattle have been hard to predict,” said Craine, principal investigator for the project.

The lab measured the amount of crude protein and digestible organic matter retained by cattle in the different regions, according to the research.  The pattern of forage quality observed across regions suggests that a warmer climate would limit protein availability to grazing animals, Craine said.

“This study assumes nothing about patterns of future climate change; it’s just a what if,” Olson said. “What if there was significant atmosphere enrichment of carbon dioxide? What would it likely do to plant phenology? If there is atmospheric carbon dioxide enrichment, the length of time between when a plant begins to grow and when it reaches physiological maturity may be condensed.”

Currently, cattle obtain more than 80 percent of their energy from rangeland, pastureland and other sources of roughage, according to the study. With projected scenarios of climate warming, plant protein concentrations will diminish in the future, the study found. If weight gain isn’t to drop, ranchers are likely going to have to manage their herds differently or provide supplemental protein, Craine said.

Any future increases in precipitation would be unlikely to compensate for the declines in forage quality that accompany projected temperature increases, the research found. 

As a result, cattle are likely to experience greater nutritional stress in the future if these geographic patterns hold as a actual example of future climates, Craine said.

“The trickle-down to the average person is essentially thinking ahead of time of what the consequences are going to be for the climate change scenarios that we are looking at and how ranchers are going to change management practices,” Craine said.

“In my opinion these are fully manageable changes,” Olson said. “They are small, and being prepared just in case it does happen will allow us to adapt our management to what will essentially be a shorter window of high-quality grazing.”

In related news, new research found that spurred by a warming climate, daily record high temperatures occurred twice as often as record lows over the last decade across the continental United States.

The ratio of record highs to lows is likely to increase dramatically in coming decades if emissions of greenhouse gases continue to climb, the research found.

“Climate change is making itself felt in terms of day-to-day weather in the United States,” said National Center for Atmospheric Research (NCAR) scientist Gerald Meehl, the lead author. “The ways these records are being broken show how our climate is already shifting.”

The research was funded by the National Science Foundation (NSF), NCAR’s sponsor, the U.S. Department of Energy, and Climate Central.

“This intriguing study provides new evidence of climate change,” says Steve Nelson, NSF program director for NCAR. “And it’s change that’s affecting our daily lives.”

If temperatures were not warming, according to the research, the number of record daily highs and lows being set each year would be approximately even.

Instead, the research found that for the period from January 1, 2000, to September 30, 2009, the continental United States set 291,237 record highs and 142,420 record lows, as the country experienced unusually mild winter weather and intense summer heat waves.

A record daily high means that temperatures were warmer on a given day than on that same date throughout a weather station’s history.

The authors used a quality control process to ensure the reliability of data from thousands of weather stations across the country, while looking at data over the past six decades to capture longer-term trends.

This decade’s warming was more pronounced in the western United States, where the ratio was more than two to one, than in the eastern United States, where the ratio was about one-and-a-half to one, according to the study.

The study also found that the two-to-one ratio across the country as a whole could be attributed more to a comparatively small number of record lows than to a large number of record highs.

According to the study, much of the nation’s warming is occurring at night, when temperatures are dipping less often to record lows.

This finding, according to the research, is consistent with years of climate model research showing that higher overnight lows should be expected with climate change.

According to the study, if nations continue to increase their emissions of greenhouse gases in a “business as usual” scenario, the U.S. ratio of daily record high to record low temperatures would increase to about 20-to-1 by mid-century and 50-to-1 by 2100.

The mid-century ratio could be much higher if emissions rose at an even greater pace, or it could be about 8-to-1 if emissions were reduced significantly, the model showed.

The authors caution that such predictions are, by their nature, inexact.

Researchers said that climate models are not designed to capture record daily highs and lows with precision, and it remains impossible to know future human actions that will determine the level of future greenhouse gas emissions.

Researchers said the model used for the study, the NCAR-based Community Climate System Model, correctly captured the trend toward warmer average temperatures and the greater warming in the West, but overstated the ratio of record highs to record lows in recent years.

However, researchers said the model results are important because they show that, in all likely scenarios of future greenhouse gas emissions, record daily highs should increasingly outpace record lows over time.

“If the climate weren’t changing, you would expect the number of temperature records to diminish significantly over time,” says Claudia Tebaldi, a statistician with Climate Central who is one of the paper’s co-authors.

“As you measure the high and low daily temperatures each year, it normally becomes more difficult to break a record after a number of years. But as the average temperatures continue to rise this century, we will keep setting more record highs.”

The study team focused on weather stations that have been operating since 1950. They found that the ratio of record daily high to record daily low temperatures slightly exceeded one to one in the 1950s, dipped below that level in the 1960s and 1970s, and has risen since the 1980s.

The results reflect changes in U.S. average temperatures, which rose in the 1950s, stabilized in the 1960s, and then began a warming trend in the late 1970s, according to the study.

Even in the first nine months of this year, when the United States cooled somewhat after a string of unusually warm years, the ratio of record daily high to record daily low temperatures was more than three to two, the study found.

Despite the increasing number of record highs, there will still be occasional periods of record cold, Meehl said.

“One of the messages of this study is, you still get cold days,” Meehl says. “Winter still comes. Even in a much warmer climate, we’re setting record low minimum temperatures on a few days each year. But the odds are shifting so there’s a much better chance of daily record highs instead of lows.”

The study team analyzed several million daily high and low temperature readings taken over the span of six decades at about 1,800 weather stations across the country, thereby ensuring ample data for statistically significant results.

The readings, collected at the National Oceanic and Atmospheric Administration’s National Climatic Data Center, undergo a quality control process at the data center that looks for such potential problems as missing data as well as inconsistent readings caused by changes in thermometers, station locations, or other factors.

Meehl and his colleagues then used temperature simulations from the Community Climate System Model to compute daily record highs and lows under current and future atmospheric concentrations of greenhouse gases.