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So, surprise: Las Vegas isn’t exactly renowned as a paragon of healthy living. Maybe we can’t be completely blamed for that distinction, given our mandate to peddle ourselves in the global marketplace as the nation’s test site where tourists are invited to suspend the rules of common sense and subject their vital organs to a marathon obstacle course of punishing fun. Like Nietzsche sort-of said, if you live in a party town, beware lest the party town live in you. No wonder Nevada’s state bird is a bacon cheeseburger smoking a Marlboro.

Okay, it’s not. But I always feel a hum of cognitive dissonance when we talk about health and medicine in the valley because lingering stereotypes seem to militate against it: We’re a bunch of wheezing butterballs shouting for another light beer, right? Don’t be so sure. I flipped through the University of Nevada School of Medicine’s most recent annual Health and Health Care report expecting the Four Horsemen of the Apocalypse to fly out in a pestilential torrent of diabetes and secondhand smoke. Instead, I found a detailed and nuanced portrait of our changing lifestyles and habits. And, actually, for all the challenges we face in the arena of health and medicine, there are some surprising glimmers of good news about the health of Southern Nevada.

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Of course, it would be naive to ignore the troubles ahead — and we address many of them in this issue. But we’d also be remiss to ignore some promising developments that leap from the pages of the report. I won’t tug you through an unrelenting parade of stats here — you can do that yourself by grabbing the report at medicine.nevada.edu/ohprp — but a few are worth pointing out. For example, according to the report, 23.6 percent of adults in Clark County are former smokers, vs. 22.2 percent identifying as current smokers. Nice. At least it certainly upends a long-held assumption of mine that chain-smoking was the most popular local sport after video poker. Also, about seventy-five percent of Clark County residents reported engaging in physical activity or exercise in the last 30 days. Again, assuming that “physical activity” doesn’t involve finger-workouts on the TV remote, it’s a promising figure. Additionally, Clark County’s teen pregnancy rate is down dramatically from 2000 to 2010, dropping by nearly 40 percent in that time. Again, glimmers and gleams, but let’s hope these small blips portend a sea change for the better, particularly with the rollout of the Affordable Care Act in 2014, when anywhere from 300,000 to 400,000 Nevadans will enter the insurance rolls. (Right now, about a quarter of the state population under 65 is uninsured, and 36 percent live in a “shortage area” that makes it tougher getting primary care.) In one upbeat scenario, the long-term picture suggests those newly insured taking advantage and taking charge of their health with wise, preventive care — instead of rolling into the emergency room because a minor condition has snowballed into a major crisis.

This isn’t an Rx for blind optimism. The immediate picture is not so rosy. Between waves of retiring Baby Boomers with changing health care needs and those newly insured shopping the valley for good doctors, the pressure on Southern Nevada’s health care infrastructure will be significant. The most pressing and immediate problem: a chronic lack of doctors to dispense care. Nevada continues to have one of the worst physician shortages in the U.S., a condition only aggravated by the fact that we produce more medical school graduates than we can actually train (p. 98). Add to that the fact that it’s hard enough to retain the medical talent we currently employ, and we have on our hands what one state health expert calls a “tsunami” that’s already looming. But I’m optimistic: Amid that, we’ve got a corps of passionate, dedicated physicians — among them, this year’s Best Doctors (p. 75) — up for the challenge. Let’s see what this next wave brings.

Next month in Desert Companion step out in style with our fall culture and fashion issue

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