A big study looking at health in practically every county in the U.S. was just released this week, and the picture of how we’re doing as a nation has some good news—if you’re in the right Zip code. If you’re not, the news can be very bad.
The County Health Rankings report, created by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, looked at 25 factors related to health, including poverty, smoking, obesity, teen pregnancy, access to doctors, education, physical activity, insurance coverage, and access to healthy foods, clean drinking water, and recreational facilities, among other things.
Let’s start with the good news: Rates of premature death are at their lowest level in 20 years. “This is something that’s happening across the world—people are starting to live longer,” explains Angela Russell, Community Engagement Lead, at the University of Wisconsin Population Health Institute, in Madison. “There’s lots of good public heath stuff going on in terms of vaccination and people not smoking as much as they used to. More people are embracing living a healthy lifestyle.” Another piece of very good news: Violent crime has dropped by nearly half over the past two decades.
But that’s far from the full picture for many Americans: A lot depends on where you live, the County Health Rankings report finds. If you have the misfortune to live in one of the unhealthiest counties you have twice the chance to die too soon, for example.
“You’ll see in the County Health Rankings that there are a number of things that contribute to a community’s health—or its poor health —and it’s not just a single factor,” says Russell. For example, access to good-quality healthcare is important, but there are factors that are typically even more important, Russell adds, since “the rankings also tell us that health happens outside of the doctor’s office.” So things like how easy (or hard) it is to exercise or find healthy food matter, too. Although what constitutes a low health ranking varies from state to state, higher rates of smoking; a lower high-school graduation rate; and more children living in poverty correlate significantly to a county having a low health ranking.
The County Health Rankings report is designed to provide county-to-county comparisons within a state (but not across states), and a quick dive into the data makes it easy to see how much variation there can be from place to place. For example, a look at Quitman County, in Mississippi—which ranked lowest in the state—has an adult obesity rate of 40 percent; a premature death rate of nearly 18,000 people (per 100,000 residents); a car crash death rate of 44 people (per 100,000); an STD transmission rate of 1,143 (per 100,00); and a doctor-to-patient ratio of 8,196 citizens for each physician.
Compare that with affluent Marin County, California—ranked the healthiest county among the state’s 57, according to the new report—which has an adult obesity rate of just 15 percent; a premature death rate of under 4,000; a car crash death rate of 5 people; an STD transmission rate of 235; and a ratio of one doctor to every 712 residents.
There is, though, one health problem that affects nearly every community: “I think one area that probably needs to be addressed in every county is the obesity rate—there aren’t many counties that are doing well on this,” Russell says.
And even if your county got a poor health ranking, it definitely doesn't mean it can’t make big improvements. Russell points to Genesee County. “That’s where Flint, Michigan is,” she notes. “After years of economic downturn and turmoil they used their County Health Ranking as a call to action to create healthier communities.” In 2012, the county decided to prioritize community safety. “It’s much easier for people to go outside to bike, walk and run if they’re in a safe community,” adds Russell.
The Robert Wood Johnson Foundation recently recognized six communities doing innovative work in getting healthier with its Roadmaps to Health Prize. “There are a couple [of example communities] that resonate with me, especially the ones where there’s youth involvement,” Russell says. “In Fall River, Massachusetts, the youth there saw that pharmacies were selling tobacco products and cigarettes and worked with the city council to prohibit selling” these products.
Ultimately, it’ll take a combined effort to improve the health of more Americans, regardless of where they live (and it’s worth noting that even very healthy communities have room for improvement, and even the least healthy usually have a few measures on which they do all right). “The purpose of the County Health Rankings is that we know that it’s easier to lead a healthy lifestyle if you live in a healthy community, so this serves as a call to action to improve the health of the community from the ground up,” Russell explains. “Public health or the healthcare industry thought they were leading the way, but these rankings say we’re all working together—it’s all hands on deck.”
To find examples of what other communities are doing to improve their community’s health—and how your county ranks on all 25 measures—go to CountyHealthRankings.org.
How does your county rank? What do you think would do the most to improve a community’s or county’s health?