OPINION
4A
THE DAILY ASTORIAN • THURSDAY, APRIL 13, 2017
Founded in 1873
DAVID F. PERO, Publisher & Editor
LAURA SELLERS, Managing Editor
BETTY SMITH, Advertising Manager
CARL EARL, Systems Manager
JOHN D. BRUIJN, Production Manager
DEBRA BLOOM, Business Manager
OUR VIEW
We are dying
much too young
in Clatsop County
T
he new 2017 “County Health Rankings & Roadmaps”
by the Population Health Institute places Clatsop County
11th out of Oregon’s 36 counties in terms of factors that
affect individual health, and 24th for how long residents live and
what kind of health we have.
The institute is part of the University of Wisconsin funded by
the Robert Wood Johnson Foundation, and has been doing this
analysis since 2010. The report has flaws, but provides an inter-
esting starting point for discussions about local health. It’s worth
thinking about what deliberate steps we can take to improve, as
individuals and as a society.
Dying too young
Our weakest attribute, according to the report, is length of life
— 28th, in the bottom quartile in Oregon.
The institute assumes 75 years is a full life, and counts up the
number of years lost when residents die before that age. We cur-
rently lose an estimated 8,200 years of pre-75 life per 100,000
people — compared to about 6,000 in the state as a whole. The
best-ranking counties in the U.S. are losing around 5,200 years.
Cancer is the county’s leading cause of premature death, fol-
lowed by heart disease, chronic lung ailments, accidents and
suicide.
Toward the end of the last decade, county residents were liv-
ing a little longer than the overall U.S. population. Our “Years
Lost of Potential Life,” as the measurement is officially known,
then got considerably worse, and remains much higher than the
U.S. and Oregon averages.
About 15 percent of county residents are in poor or only
fair health, slightly better than the state figure of 18 percent.
Clatsop is a fairly good — 10th in the state on this quality of life
measurement.
Nationwide, the more rural the place, the worse people’s
health tends to be. Younger people often gravitate to larger pop-
ulation centers, leaving an older rural citizenry that suffers worse
health. Highly damaging behaviors like smoking are concen-
trated among older people, along with other problems like diabe-
tes, obesity and alcoholism.
Sure enough, our adult obesity rate is 31 percent — higher
than the state figure of 26 percent — and trending worse in the
past decade. Our excess alcohol-drinking rate matches the state
at 19 percent — nothing to brag about.
What’s going right?
Overall, “Health factors” have generally been improving in
the county. Our 2017 11th place is our highest rating ever, an
improvement from 15th in 2016.
Though we have too few primary care physicians — a peren-
nial complaint of hospital administrators nationwide — our rate
is far better than that of many rural counties. Across the river
in Pacific County, Washington, the proportion of these front-
line doctors to the population is nearly 3,000-to-one; here it is
1,250-to-one.
The 2017 report indicates the county’s educational attainment
level is improving, with a high school graduation rate nearly on
par with the state average. Oregon as a whole seriously trails the
nation in this measurement, however. Why is this important to
health? Study after study shows that more education translates
into better quality of life, with better-educated people enjoy-
ing better nutrition and access to other factors contributing to
wellness.
Things to work on
There are a number of factors in which we must endeavor
to begin beating state averages. Smoking, for example, is one
of the single biggest controllable causes of premature death.
Individually and as a society, we must do more to help smokers
break the addiction and add years to their lives.
Disturbingly, Clatsop County’s rate of child poverty — which
dramatically rose during the recession — still has not returned to
what is was in the years before 2008. More than a fifth of local
kids live in poverty. The best-performing counties in the U.S.
have managed to get this down to around 12 percent. Beating
poverty is notoriously difficult. But individual communities
like ours can make a dent in it by supporting vocational educa-
tion, college scholarships and volunteer mentoring programs.
And we must make sure the health needs of growing children are
addressed.
For much more detail, see tinyurl.com/Clatsop-Rankings.
Any report like this is bound to have weaknesses. For one
thing, statistical information is often seriously lacking for
low-population counties. But enough of this report rings true for
it to warrant our attention. Deliberate actions can make things
even better, if we’re willing to try. We should make the effort.
Why is Trump fighting ISIS in Syria?
By THOMAS L. FRIEDMAN
New York Times News Service
T
he Trump foreign policy
team has been all over the
map on what to do next
in Syria — topple the regime,
intensify aid to
rebels, respond to
any new attacks on
innocent civilians.
But when pressed,
there is one idea
everyone on the
team seems to agree on: “The
defeat of ISIS,” as Secretary of
State Rex Tillerson put it.
Well, let me add to their confu-
sion by asking just one question:
Why?
Why should our goal right now
be to defeat the Islamic State in
Syria? Of course, ISIS is detestable
and needs to be eradicated. But is it
really in our interest to be focusing
solely on defeating ISIS in Syria
right now?
Let’s go through the logic:
There are actually two ISIS
manifestations.
One is “virtual ISIS.” It is
satanic, cruel and amorphous; it
disseminates its ideology through
the internet. It has adherents across
Europe and the Muslim world.
In my opinion, that ISIS is the
primary threat to us, because it
has found ways to deftly pump
out Sunni jihadi ideology that
inspires and gives permission to
those Muslims on the fringes of
society who feel humiliated —
from London to Paris to Cairo
— to recover their dignity via
headline-grabbing murders of
innocents.
The other incarnation is
“territorial ISIS.” It still controls
pockets in western Iraq and larger
sectors of Syria. Its goal is to
defeat Bashar Assad’s regime in
Syria — plus its Russian, Iranian
and Hezbollah allies — and to
defeat the pro-Iranian Shiite regime
in Iraq, replacing both with a
caliphate.
Challenge No. 1: Not only will
virtual ISIS, which has nodes all
over the world, not go away even
if territorial ISIS is defeated, I
believe virtual ISIS will become
yet more virulent to disguise the
fact that it has lost the territorial
caliphate to its archenemies: Shiite
Iran, Hezbollah, pro-Shiite militias
in Iraq, the pro-Shiite Assad regime
in Damascus and Russia, not to
mention America.
Challenge No. 2: America’s
goal in Syria is to create enough
pressure on Assad, Russia, Iran and
Hezbollah so they will negotiate a
power-sharing accord with mod-
erate Sunni Muslims that would
also ease Assad out of power. One
way to do that would be for NATO
to create a no-fly safe zone around
Idlib province, where many of the
anti-Assad rebels have gathered
SANA
Pro-government protesters hold a portrait of President Bashar As-
sad and a placard that reads, “Down with everyone who cooperated
and supported the American aggression,” during a protest against
the U.S. attack on a military airbase last week, in front the United
Nations building in Damascus, Syria, on Tuesday.
and where Assad recently dropped
his poison gas on civilians. But
Congress and the U.S. public are
clearly wary of that.
So what else could we do? We
could dramatically increase our
military aid to anti-Assad rebels,
giving them sufficient anti-tank and
anti-aircraft missiles to threaten
Russian, Iranian, Hezbollah and
Syrian helicopters and fighter
jets and make them bleed, maybe
enough to want to open negotia-
tions. Fine with me.
This is a time
for Trump
to be Trump
— utterly
cynical and
unpredictable.
What else? We could simply
back off fighting territorial ISIS in
Syria and make it entirely a prob-
lem for Iran, Russia, Hezbollah
and Assad. After all, they’re the
ones overextended in Syria, not
us. Make them fight a two-front
war — the moderate rebels on one
side and ISIS on the other. If we
defeat territorial ISIS in Syria now,
we will only reduce the pressure on
Assad, Iran, Russia and Hezbollah
and enable them to devote all their
resources to crushing the last mod-
erate rebels in Idlib, not sharing
power with them.
I don’t get it. President Donald
Trump is offering to defeat ISIS
in Syria for free — and then pivot
to strengthening the moderate
anti-Assad rebels. Why? When was
the last time Trump did anything
for free? When was the last real
estate deal Trump did where he
volunteered to clean up a toxic
waste dump — for free — before
he negotiated with the owner on
the price of the golf course next
door?
This is a time for Trump to
be Trump — utterly cynical and
unpredictable. ISIS right now is the
biggest threat to Iran, Hezbollah,
Russia and pro-Shiite Iranian
militias — because ISIS is a Sunni
terrorist group that plays as dirty as
Iran and Russia.
Trump should want to defeat
ISIS in Iraq. But in Syria? Not
for free, not now. In Syria, Trump
should let ISIS be Assad’s, Iran’s,
Hezbollah’s and Russia’s headache
— the same way we encouraged
the mujahedeen fighters to bleed
Russia in Afghanistan.
Yes, in the long run we want
to crush ISIS everywhere, but the
only way to crush ISIS and keep
it crushed on the ground is if we
have moderate Sunnis in Syria and
Iraq able and willing to replace it.
And those will only emerge if there
are real power-sharing deals in
Syria and Iraq — and that will only
happen if Assad, Russia, Iran and
Hezbollah feel pressured to share
power.
And while I am at it, where is
Trump’s Twitter feed when we
need it? He should be tweeting
every day this message: “Russia,
Iran and Hezbollah have become
the protectors of a Syrian regime
that uses poison gas on babies!
Babies! Russia, Iran, Hezbollah,
Assad — poison gas enablers.
Sad.”
Do not let them off the hook!
We need to make them own what
they’ve become — enablers of a
Syria that uses poison gas on chil-
dren. Believe it or not, they won’t
like being labeled that way. Trump
needs to use his global Twitter feed
strategically. Barack Obama never
played this card. Trump needs to
slam it down every day. It creates
leverage.
Syria is not a knitting circle.
Everyone there plays dirty, devi-
ously and without mercy. Where’s
that Trump when we need him?
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