CN leaders say Stilwell mortality figures flawed

03/12/2019 08:30 AM
Main Cherokee Phoenix
A Centers of Disease Control and Prevention study released in 2018 stated that Stilwell in Adair County has the lowest life expectancy in the country. Cherokee Nation officials have said that the study was inaccurate. CHAD HUNTER/CHEROKEE PHOENIX
STILWELL – Stilwell in Adair County made national headlines in 2018 for having the lowest life expectancy in America, but Cherokee Nation leaders question the accuracy of a study that led to that distinction.

“I think everyone in here would say their district can improve on lifestyle,” Tribal Councilor Shawn Crittenden said in a Feb. 28 Health Committee meeting. His Dist. 8 covers part of the county. “My district can. But the deadliest city in America?”

Dubbed the “Strawberry Capital of the World,” Stilwell serves as the county seat. Nearly half of its estimated 4,000 residents are Native American, according to the U.S. Census Bureau.

Residents are expected to live an average of 56.3 years, which is 22.5 years lower than the national average, according to a study released by the Centers of Disease Control and Prevention’s National Center for Health Statistics.

“The report, it did a great disservice to the community,” Tribal Councilor Keith Austin said. “The media grabs hold of it and splashes it all over the place.”

CN health leaders said they have been “digging into” the study’s specifics study since its release.
“The study covered six years, 2010 to 2015,” Public Health Medical Director Dr. David Gahn said. “There were 1,408 deaths in Adair County during that six-year period. So they took those deaths and asked the state, give us addresses of all these people and their age when they passed. Out of that 1,400, there were 196 that they couldn’t code.”

Nationally, Gahn said, the rate of unusable data was less than 1 percent.

“So for Adair County, it was over 10 percent,” he said. “Those were left out. There were also 85 deaths where they had zero records at all. Then, there were 91 deaths attributed to a single address in Stilwell that appears to be a nursing facility. The idea is that people live somewhere else, went to the nursing facility and passed, and that’s where the death certificate said they live.”

The study indicated southern Adair County’s average life expectancy was 70.9 years, Gahn said. But for Stilwell, “They couldn’t run the numbers by removing those 91 deaths from the nursing facility.”

“Ethically, you know, their methods wouldn’t allow them to do that,” Gahn said. “So I don’t know exactly what to do with that. But for Adair County, their method didn’t work. It’s not CDC’s fault. It’s just the accuracy of the data that they had, and they did the best they could with it.”

Lisa Pivec, CN Public Health senior director, said she did not expect an apology or retraction related to the study.

“These are scientists who took numbers they were given and crunched numbers,” she said. “In their minds, technically they crunched the right numbers they were given and came up with the right numbers. We’re not finished looking into Adair County, and I don’t want to cast a light that everything in all of our communities health-wise is just fine and there’s no work to be done. There’s tons of work to be done.”

Within the CN, heart disease is the “leading cause of death and disability,” according to CN health leaders who classify it as a “public health issue.”

“Overall, heart disease in the No. 1 killer in Cherokee Nation,” Gahn said. “It’s also the No. 1 cause of early death.”

CN health officials have undertaken a yearlong heart disease study with the Department of Biostatistics and Epidemiology at the University of Oklahoma Health Sciences Center.

“The majority, about 53 percent, of the people who die from heart disease are less than 75 years old,” Gahn said. “It kind of dispels the idea that it’s very old people. There are people in their 30s and 40s dying from heart disease. So why this is a public health issue is because heart disease is largely preventable.”

Major risk factors, Gahn said, include cigarette smoking, obesity, lack of physical activity and poor nutrition.
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