New rankings provide county-to-county health snapshots

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People who live in healthier counties tend to have higher education levels, are more likely to be employed, have access to more healthcare providers and have more access to healthier foods, parks and recreational facilities, according to a report on the rank of overall health of every county in the U.S. from the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation (RWJF).

"These rankings demonstrate that health happens where we live, learn, work and play, and much of what influences how healthy we are and how long we live happens outside the doctor's office," said Risa Lavizzo-Mourey, MD, MBA., president and CEO of RWJF. "People, no matter where they live, should have the best possible opportunity to be healthy," Lavizzo-Mourey said.

The 50 state reports include snapshots of U.S. counties with a color-coded map comparing each county’s overall health with other counties in each of the 50 states. This information will help public health and community leaders, policy-makers, consumers and others to see how healthy their county is, compare it with others within their state and find ways to improve the health of their community, according to the foundation.

Each county is ranked within the state on how healthy people are, how long they live and on key factors that affect health such as smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty.

Researchers used the latest data available for each county, ranging from 2000 to 2008, to develop the rankings, RWJF stated.

According to the report, poorly ranked counties often had multiple challenges to overcome, including:

  • Two- and three-fold higher rates of premature death, often from preventable conditions;
  • High smoking rates that lead to cancer, heart disease, bronchitis and emphysema;
  • High rates of obesity which can put people at risk for diabetes, disability and heart disease;
  • High unemployment and poverty rates; and
  • High numbers of liquor stores and fast-food outlets but few places to buy fresh fruits and vegetables.
According to RWJF, each county's rank reveals a pattern of strengths and weaknesses. For example, Woods County, Okla., ranked first in the state for overall health, but ranked 48th out of 77 on clinical care access and quality. Carbon County, Mont., ranked second in the state for overall health, but ranked low (39th out of 44) on factors related to the physical environment, such as air pollution, access to healthy foods and liquor store density.

The reports also show sharp health disparities even in counties located right next to each other, RWJF stated. For example, someone living in Chester County, Pa., which ranked highest in the state for overall health, has a better shot at staying healthy than a resident of nearby Delaware County, which ranked 36th out of 67 and has higher rates of smoking, adult obesity and violent crime, and a higher number of children living in poverty.

According to RWJF, researchers used five measures to assess the level of overall health by county: the rate of people dying before age 75, the percentage of people who reported being in fair or poor health, the number of days people reported being in poor physical health, number of days in poor mental health and the rate of low-birth weight infants. Researchers then looked at factors that affect people's health within four categories: health behaviors, clinical care, social and economic factors and physical environment.

The rankings can be used to mobilize communities to improve health disparities, RWJF stated. For example, Wyandotte County ranked last in a similar study last year ranking all counties in Kansas on health factors. That study found that Wyandotte County, which includes Kansas City, lacks access to stores selling healthy foods and suffers from poor bus service. Since then, political leaders, local officials, policy analysts and residents have been working together to improve bus routes and create incentives for grocery stores and farmers' markets to set up shop in disadvantaged Kansas City neighborhoods, according to RWJF.

"Health officials, government and business leaders, educators and media must play a role in transforming our communities," Lavizzo-Mourey said. "County by county, we need to pursue programs and policies that help all Americans live longer, healthier lives."