Startling differences in the health of residents living just a few miles apart are highlighted in a new health rankings report that assesses wellness in nearly all the nation's 3,000-plus counties.
A typical example is in Illinois, where the healthiest of its 102 counties, Kendall, is right next door to the one ranked 65th, LaSalle. Twice as many LaSalle County residents are in poor or fair health and smoking rates are double the national average.
Suburban versus rural and proximity to big cities and high-paying jobs partly explain the disparities. Kendall County is on the edge of Chicago's metropolitan area, while LaSalle County is more farming-based.
"Affluent suburbs tend to have higher paying jobs, often in the cities, whereas rural communities often are dealing with loss of businesses" and declining populations of young people, who tend to be healthier, said Dr. Patrick Remington, a researcher at the University of Wisconsin's Population Health Institute. The institute produced the rankings with the Robert Wood Johnson Foundation and their second annual rankings report was being released online Wednesday.
Residents of rural communities also tend to have less education, less access to health care, and higher rates of substance abuse and smoking — all factors that contribute to the rankings.
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Still, counties encompassing big cities aren't immune. Wyandotte County, Kansas learned that when the researchers released their widely publicized first county health rankings report last year.
The county includes Kansas City and boasts two major medical centers, which officials figured would mean a top ranking. But Joe Reardon, mayor and CEO of Kansas City and county government, said the county's listing — 96th out of 98 in Kansas — was a wake-up call. It prompted several meetings with county authorities, local institutions and citizens, resulting in plans for more urban grocery stores and public works projects that aim to make sidewalks and roadways safer and more usable for pedestrians and bicyclists.
The rankings compare counties within each state. They're based on data from vital statistics and government health surveys. In many cases, several years of data are used to calculate rankings, Remington said. For that reason, many rankings this year are similar to those from the 2010 report.
Premature deaths — people dying before age 75 of preventable diseases; self-reported health status; and the percent of low birth-weight babies contribute to the rankings. Other measures include obesity rates, unemployment, high school graduation rates and pollution.
Richard Sewell, a health policy specialist at the University of Illinois at Chicago, praised the report for including a wide array of important measures that affect health.
"It's a call to action" that leaders beyond the medical realm pay attention to, Sewell said.
James Marks, director of the Robert Wood Johnson Foundation's health group, said last year's report resulted in an impressive amount of action in many counties that fared poorly. With annual rankings planned in the future, he said the reports likely will spur real improvement in Americans' health.
Already, prompted by last year's report:
- Jason Cook, an outreach pastor at Center Point United Baptist Church in Lincoln County, W. Va., started a wellness program to encourage parishioners to become more active, eat more healthy foods and lose weight. Overall, 18 people signed up and have lost nearly 250 pounds since January, Cook said.
- The chamber of commerce in Jackson, Tenn., in Madison County, is using health scores to help attract businesses to relocate in the area. Companies are asking about the region's health, said Kyle Spurgeon, chamber president. The county fared better than the statewide average on some measures including the number of college graduates and primary-care doctors, in both reports. It slipped in other areas on this year's report.
- LaSalle County, Ill., authorities are continuing with recent programs to distribute nicotine patches to smokers and increase awareness to school officials about diabetes and obesity, said county health department spokeswoman Jenny Barrie. The report emphasized the need to do so, she said.
- Authorities in central Michigan, where the lowest-ranked counties are located, created a "We Can" initiative to improve health measures including obesity, inactivity and poor nutrition. Monthly brainstorming sessions have been held involving officials from local health departments, mental health agencies, colleges and elsewhere, and a working plan is expected to be developed in April, said Mary Kushion, health officer for the Central Michigan District Health Department.
"We really do have a common theme and a common mission," Kushion said. "We know that we are much better prepared and able to address the issues than we were" last year.