How Utahns’ health changed this decade

The Salt Lake Tribune is examining the trends that have fundamentally changed the state in the 2010s. It is hard to ignore the seemingly ubiquitous vaping or the enduring tragedy of overdose deaths. Here are five major health trends from the the past 10 years:

Vape smoke surrounds Utah high school students

Sarcastic high schoolers often call school restrooms “vape rooms," and they hung out there more and more so as the decade went on.

Back in 2011, when Utah officials began asking teens about vaping, 1.9% self-reported they used e-cigarettes. By 2019, that number had jumped to 12.4%.

The same teens were asked about alcohol and tobacco use in the state’s Student Health and Risk Prevention survey, which is conducted in Utah public schools in the spring of odd-numbered years. The survey also asks questions about students’ mental and physical health, substance abuse and anti-social behaviors.

In the latest survey, Utah students were significantly more likely to report trying alcohol and e-cigarettes than conventional cigarettes. Teen use of cigarettes was highest in Uintah, Duchesne and Daggett counties, while e-cigarette use was highest in Weber and Morgan counties.

The Utah Department of Health has urged people to stop vaping THC — which is the psychoactive substance in marijuana — amid a recent outbreak of vaping-related lung injuries.

As of Dec. 9, there were 115 lung injury reports connected to vaping in Utah. There’s been one death. Most of those who became ill are in their 20s and 30s, with just over 15% of cases involving teens age 19 and younger.

Nationwide, the Centers for Disease Control and Prevention reported 2,409 cases of vaping-related lung injury and 52 deaths.

Utah’s suicide rate continued to rise, but there’s hope it will improve

The number of Utahns who have died by suicide has steadily increased over the past decade.

There were 466 Utahns age 10 or older who died in 2010 — a rate of 20.6 deaths per 100,000 people. That number increased year by year, and, in 2018, there were 666 suicide deaths, a rate of 25.14.

That means Utah has the sixth highest suicide rate in the nation, according to the most recent data (2017) from the CDC.

But could this trend reverse in the next decade? State officials said in November that the year-to-year rate of suicide in Utah decreased this year — the first time in more than a decade. But they warned that the reduction isn’t statistically significant, and public health experts typically look for consistent reductions over three years before confirming a trend.

Kimberly Myers, the state’s suicide prevention and crisis services administrator, said the recent decrease is in line with statewide changes that began around 2013 to improve coordination among health care workers, schools and state agencies on mental health interventions. The Legislature provided funding for officials to develop this unified strategy.

“We, for the first time in many, many, many years, pulled together a group of stakeholders and wrote a state suicide prevention plan,” Myers said. “If you look at the science of prevention, it suggests once you start reducing risk factors, having a strategic plan and implementing it ... it’s usually about a three- to five-year process to when you start seeing reductions.”

Meth makes a deadly comeback as opioids remain a persistent killer

Prescription opioids hit Utah, and much of the nation, hard this decade but pill-related deaths have been declining in recent years. Heroin deaths are down, too, according to Meghan Balough, a state epidemiologist.

There has, however, been a huge spike in meth-related overdose deaths, more than doubling in the past five years. Drug overdose deaths involving meth rose from a low of 31 in 2010 to 217 in 2018, according to records from the Utah Department of Health.

In fact, meth-related deaths surpassed street heroin death for the first time last year. In many overdose deaths, multiple drugs are involved.

Brian Redd, the chief of the State Bureau of Investigation, said market factors could explain meth’s rapid rise. It’s about a tenth of the cost now that it was in the early 2000s, according to Redd — a pound costing between $1,000 to $1,500, with a single hit going for about $20.

In some cases, meth dealers are making their way into markets where opioid use is declining, Redd said. In others, it’s replacing costlier drugs like cocaine, which is now 10 times as expensive as meth.

Meth use has been rising nationwide but especially in the West, according to federal health data. Utah had the ninth-highest rate of deaths involving psychostimulants with the potential for abuse — chiefly meth, but that also includes ecstasy and some drugs for attention deficit disorder.

Sexually transmitted diseases became far more common

The state has seen a spike in sexually transmitted diseases, particularly chlamydia and gonorrhea, according to the state Health Department.

The rate for chlamydia infections was 240 cases per 100,000 people in 2010. The rate rose to 333 by 2018. Gonorrhea was less prevalent, but the rates for that STD skyrocketed — an 834.7% increase — from 2010 to 2018, rising from 11.2 cases per 100,000 people to 91.6 cases.

Chlamydia and gonorrhea are two of the more than 70 diseases that doctors, clinics and other providers are required to report to public health officials.

The Utah Department of Health said the increase in chlamydia rates could be attributed to increasingly sensitive diagnostic testing, efforts to boost reporting by providers and labs and improved information systems for reporting.

But the rise in gonorrhea and chlamydia cases in recent years — especially among teenagers — is alarming to Salt Lake County Health Department Director Gary Edwards. In August, he released a statement that said Utah’s approach to STD education isn’t working.

“Teens need accurate, realistic and comprehensive STD education,” he said, “whether that’s at home, at school, at church or in another venue appropriate for the discussion.”

More Utahns have at least some type of health insurance

In the past decade, few issues were as politicized as health insurance. First, the Affordable Care Act required people to buy insurance or face a fine and offered hefty subsidies for those who had a hard time affording private coverage and did not qualify for government programs like Medicaid.

That led to a decline in the number of Utahns who went without insurance, but Utah didn’t immediately expand Medicaid as the law pushed by former President Barack Obama allowed. Instead the issue became entangled in lengthy and arduous legislative debates, killed by conservatives who despised the new health care law and warned that Medicaid expansion could eventually bankrupt the government. Ultimately, voters approved a ballot measure to fully expand Medicaid — a move that was estimated to allow coverage for an additional 150,000 Utahns.

But lawmakers repealed and replaced the voter-backed law with one that allowed more modest expansion of Medicaid, enough to cover an estimated 90,000 more residents. Subsequently, the federal government rejected Utah’s requested waiver for the new partial program, but after some wrangling, signed off on a full Medicaid expansion with some work requirements. That starts Jan. 1.

All of this fighting over insurance and how much it costs took place while more people signed up. The number of Utahns without health insurance shrunk over the past decade, according to the U.S. Census Bureau.

The Census’ American Community Survey found that 8.7% of Utahns reported that they did not have health insurance in 2017, the latest available data.

That was down significantly from 2010, when 15.5% of survey respondents in the Beehive State said they didn’t have coverage.

With full Medicaid expansion, the uninsured rate is expected to dip even further.