Cancer, heart disease, respiratory disease, stroke and Alzheimer’s.

These are the primary killers of Arizonans.

Arizona is ranked No. 28 overall in the nation for health, while Hawaii, Vermont, Minnesota, Massachusetts, and New Hampshire currently take the top five spots, according to America’s Health Rankings.

Arizona’s retirement-age population grew by nearly 11 percent from 2010 to 2013, according to Census Bureau estimates, making it one of top 10 states for fast-growing senior populations.

Mindy Wakefield, program manager for the Alzheimer’s Association in Phoenix, said Arizona has the third largest population of those aged 65 years and older, behind Alaska and Nevada.

The state Department of Health Services reports that by 2050 the number of Arizonans age 65 and older is expected to increase 174 percent. Those who are 65 and older make up 15.4 percent of the population, and 120,000 suffer from Alzheimer’s disease in the state which is projected to reach 200,000 by the year 2025. One in nine people aged 65 years or older nationally have Alzheimer’s disease.

“There’s no treatment, there is no cure, but they are doing a lot of research, and a lot of it is being done in Arizona, trying to find something that will slow down or stop the disease,” said Wakefield.

The national population for Alzheimer’s is expected to triple by 2050, from 5.2 million, and could go up to between 11 and 16 million, she said.

Approximately 600,000 people die of heart disease in the United States every year, making it the leading cause of death, according to the CDC. The most common type of heart disease is coronary heart disease and it costs the United States $108.9 billion each year.

Dr. Raj Janardhanan, a cardiologist at University Medical Center in Tucson, said the typical consequences of heart disease are heart failure or heart attack.

He said patients should watch their diet by reducing saturated fats and carbohydrates. “We are definitely seeing changes in population habits from all of the consistent efforts at least from the university perspective,” he said.

The problem areas are the large Native American population because many of the educational efforts do not reach them and doctors see increased obesity and smoking, and lack of physical activity.

According to the Department of Health Services, smoking, lack of physical activity, and poor nutrition increase risk for heart disease. In Arizona, 16 percent of adults smoke, 48 percent do not get the recommended level of physical activity, and 72 percent do not consume the recommended five or more fruits and vegetables each day.

“A lot of advances have happened in the treatment of heart attacks, and the people who have had heart attacks tend to live longer,” Janardhanan said. “Unfortunately once they have a heart of attack there is some permanent damage and these patients unfortunately continue to not adopt healthy living [practices] and those patients end up having heart failure.”

Over the last 30 years cardiologists have focused on better treatment of heart attacks but they still have to a lot of work to do on their approach to secondary prevention after someone has had a heart attack, and how to prevent another one from happening. Janardhanan also said compliance with medications and patients missing follow up appointments are major problems. Constant educational efforts are the only way in which they can improve compliance.

“It’s not a case of people not having the money to buy,” he said. “They still have money to buy cigarettes, they still have money to have their cable TV, they still find the money for smoking and doing other unhealthy activities.”

According to the American Cancer Society, skin cancer is the most common form of cancer in the United States. It is estimated that more than 3.5 million new cases are diagnosed each year.

Community outreach coordinator Denise Spartonos for the Skin Cancer Institute in Tucson said Arizona has 1,400 new cases of melanoma every year. Spartonos said a lot of research being centers around peoples behaviors regarding the sun. She said more than 90 percent of skin cancers are caused from over exposure to the sun.

“Over at the skin cancer institute our message to get out is ACE: avoid, cover up, and examine,” said Spartonos. She said it’s hard to get people to implement these changes.

She runs a program called Project SASS (Students are Sun Safe), that offers a class on skin cancer prevention in the community through the College of Public Health.

“We know those steps that people can take to protect themselves, but its actually getting the people to do the steps and follow through,” said Spartonos. She said melanoma is increasing among women in their 20s and the increase in tanning booths contributes to this.

Although the United Health Foundation reports lower rates of cancer and cardiovascular deaths in Arizona, the state is doing worse in cardiovascular disease, diabetes, physical activity, and asthma in comparison to national rates. Arizona is seeing improvements in cigarette smoking, obesity, and self-reported health status compared to national rates. The State of Obesity ranks Arizona 34^th in adult obesity. More than a quarter of the population are obese. The national average is 34.9 percent.

When is comes to improving health in Arizona, William Humble, director for the Department of Health Services, said the most important tools include “working to ensure that the healthy choice is the easy choice, tracking illness and injury to look for patterns and then implementing best practices to reduce those, and looking at the global issue of community health and making ourselves available to policy makers and the community to help them make informed decisions.”

Madeline Ruth is a reporter for Arizona Sonora News, a service provided by the School of Journalism at the University of Arizona. Reach her at [email protected]