- Associated Press - Monday, January 30, 2017

SIOUX FALLS, S.D. (AP) - Paralyzed by a stroke, Trevor Jackson heard his doctor tell his ex-wife to plan for the worst.

That was the first time the 47-year-old Hartford resident faced his own mortality. It happened again years later when a heart stress test led to a five-bypass surgery.

He came in for the test on a Tuesday. By Thursday, he was on the table.

“Making money and having things and striving to climb the corporate ladder doesn’t really mean anything to me anymore,” Jackson said. “It’s mostly my family, my church, my kids and trying to live as long as I can.”

Health experts are taking steps to prolong the lifespan of South Dakotans like Jackson. That means going after the state’s deadliest killers.

Heart disease is the leading cause of death in South Dakota, according to a list kept by the state Health Department. Its terrifying reign as the deadliest force in the state goes back decades, except for a couple of years in 2010 and 2011 when it was replaced by the state’s number two killer: Cancer.

Cancer and heart disease are by far the deadliest, killing more than three times as many people than respiratory disease, the next leading cause of death, the Argus Leader (http://argusne.ws/2jrM6YW ) reports. Heart disease claimed the lives of 1,712 victims in 2015, as cancer killed 1,695.

The ability to prevent heart disease and its deadliness are a frustrating dichotomy for physicians, said Dr. Tom Stys, medical director of Sanford Heart Hospital.

“The scope of cardiovascular disease as a problem for our society in health care is huge,” Stys said.

One way to prevent premature death from heart disease is to get tested, like Jackson did before his 2014 bypass. He makes regular trips to the gym after work to stay healthy. He wants to be able to see his son get married, see his grandchildren.

“I have to do something to make a difference in my life so I can be around,” Jackson said.

The American Heart Association is hosting low-cost heart screenings Feb. 3 at the El Riad Shrine, 510 S. Phillips Ave. Education and increased screenings account for some of the drop in heart disease deaths in the past couple of decades, along with laws outlawing smoking in public spaces, said Dr. Tad Jacobs, Chief Medical Officer for Avera Medical Group.

“Patients are more educated,” Jacobs said. “We get these folks in for screenings earlier, we identify their risks factors earlier.”

Early detection and screenings are key to prevention, but so is access to healthy food and lifestyle. Health experts in Sioux Falls are shifting their focus to environment and what they call “social determinants of health” as they try to improve the quality and length of life of the city’s residents.

Different pockets of the same city can have different life expectancies, based on a number of varying factors. That means instead of worrying just about cholesterol numbers, the American Heart Association also pays attention to topics such as bike lanes or tobacco use in city parks.

“You would never expect the American Heart Association to get involved in affordable housing,” said Chrissy Meyer, spokeswoman for the association’s Midwest affiliate. “Now we see ourselves playing in that sphere.”

Sioux Falls city officials are trying to draw attention to the link between lifestyle and lifespan. They teamed up with health groups and both hospitals on the 2016 Community Health Report, with dozens of pages of local health indicators.

Among the findings are dangerously high blood pressure rates for young men, problems with access to fresh food, and near-obscene eating habits. The four-county metro area ranks last in the nation -compared to 180 metros - in the percentage of people who eat at least five fruits or vegetables.

“Health is not just the Health Department’s job,” said Mary Michaels, public health prevention coordinator for the city. “How do we do this as a community?”

Health experts are expanding the scope of their advocacy when it comes to the fight against South Dakota’s heart disease epidemic. Trying to get one person to improve their own cardiovascular health can be challenging, Meyer said.

“Now we’re talking about individual behavior, right?” Meyer said. “That’s really hard to impact, so that’s where as an organization, we kind of took a step back and said maybe this isn’t just about advocating for individual behavior change, maybe it’s about creating environments and cultures of health.”

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Information from: Argus Leader, http://www.argusleader.com

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