Official expects surgery needs

When the University of Nevada School of Medicine's chief of bariatric surgery re-started the program in July at University Medical Center, he did not anticipate his first operation until sometime early next year.

But with two to three new clients coming to the program's clinic each week and a new report showing that one in four Nevadans is obese, it's clear the need is already there, said Dr. James Lau, a bariatric surgeon.

Lau's comments came Monday after performing a gastric lap band surgery, a procedure that makes the stomach smaller.

"We have a lot of people in the pipeline. ... This started a little faster than expected.''

According to the report, released Monday by the United Health Foundation and the American Public Health Association, 25 percent of Nevadans were found to be obese this year, an increase from last year's 21 percent.

The report, America's Health Rankings, ranks states based on 20 health-related measures.

Nevada's increase in its obesity population mirrors national trends.

Since 1990 obesity has steadily increased, from 11.6 percent then to 24 percent today, the report shows.

Lau will go before the Clark County Commission today to request a specialized bariatric surgery table. He thinks the number of obese Nevadans is higher than being reported. He said obesity is inherently under-reported because most behavioral health data are based on telephone surveys.

Lau also has put in a request for larger hospital beds, wheelchairs, blood pressure cuffs and scales to accommodate patients who weigh more than 500 pounds. Most equipment at UMC can accommodate patients up to 300 pounds.

He said the hospital might have to retrofit some of its patient rooms to include toilets that can accommodate obese patients.

"I'm sure these will appear on future agendas,'' he said Monday. "We have to think about accommodating people who are bigger.''

In addition to the waistlines of Americans, the report also analyzed smoking rates, binge drinking, violent crime and infectious disease as well as high school graduation rates, health status and several measures of mortality rates.

Nevada's overall ranking among states slipped one notch, to 39th this year.

Although the nation as a whole has seen reductions in cancer rates and cardiovascular mortality, the improvements are overshadowed by obesity, an increasing number of uninsured people and children living in poverty.

Violent crime is also on the rise nationally and in Nevada, the report showed.

Nevada has shown improvements in other areas, including the percentage of children living in poverty, infant mortality rates and preventable hospitalizations. Smoking continues to decline, the report showed.

"That's very encouraging, but we certainly don't want to let our guard down,'' said Martha Framsted, a spokeswoman for the state Health Division. "The good news is we are seeing decreases in areas that have taken us a long time to see progress.''

But Nevada continues to struggle with a high percentage of uninsured people and with getting children timely immunizations, the report showed.

Nevada ranks last among states for vaccination rates among children between 19 months and 35 months, at nearly 65 percent.

Doug Banghart, the state's immunization program manager, said immunizing children is a persistent problem. He said that the state's recent population boom and transient nature of residents are factors.

Health officials have said some parents are ignoring recommendations for childhood vaccinations, either for personal reasons or because they cannot afford them. Families of uninsured children, who often have minimal access to pediatricians or primary care, never even get the message, officials have said.

State and local health groups have worked with the state's Department of Health and Human Services to talk to insurance companies about re-evaluating reimbursement rates for vaccinations.

The groups also have lobbied for a statewide immunization registry. Such registries are secure sites that provide authorized health care providers with immediate access to a patient's immunization status.

Banghart said that the registry is up and running and that he hopes it will help reverse Nevada's low childhood immunization rates.

So far, 120 health care providers -- including pediatricians, primary care providers, public health agencies and some rural health agencies -- are enrolled in the registry.

Nevada's school districts have "read only" access to the computerized registry so that they can evaluate whether potential students have received their vaccines.

According to the report, Vermont surpassed Minnesota as the healthiest state in the nation this year. Mississippi ranks as the least healthy state, followed by Louisiana.

Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.