Tuesday, July 8, 2014

County by County Health

The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation recently released their annual County Health Rankings and Roadmap.  The annual County Health Rankings measures key factors related to health including:

1.) high school graduation rates
2.) obesity
3.) smoking
4.) unemployment
5.) access to healthy food
6.) income
7.) air and water quality
8.) teen births

Here is a graphic showing how the elements of the data collected work together to provide a complete picture of health in a given region of the United States:


The data is then compiled at the county-level and provides two rankings:

1.) Health outcomes - how healthy a county is now which is measured by how long people live (mortality) and by how healthy people feel while they are alive (morbidity).

2.) Health factors - how healthy a county will be in the future which is measured using health behaviours (i.e. diet, exercise, alcohol and drug use, sexual activity, tobacco use), access and quality of clinical care, the physical environment (i.e. water and air quality and housing and transit) and social and economic factors (i.e. community safety, employment, education, income and family and social support).

The healthiest counties have:

1.) better health behaviours including access to healthy foods, parks, gyms and people with enough to eat.

2.) more access to health care providers.

3.) higher high school graduation rates and college attendance.

4.) fewer overcrowded households.

The least healthy counties have:

1.) higher rates of unhealthy behaviours including smoking, obesity, physical inactivity, teen births and sexually transmitted diseases.

2.) less access to health care providers.

3.) lower rates of education, higher rates of poverty, higher rates of unemployment, higher rates of violent crime and more deaths due to injury.

4.) overcrowded homes with inadequate facilities for cooking and bathing.

Now let's look at the specific findings of the study.

Here is a map showing the most (dark orange) and least (light orange) healthy counties in the United States:


If you want to see how your county scored, the data can be found here.

The least and most healthy counties for each state in 2014 were:


Health outcomes vary quite widely when the least healthy ten percent of counties are compared to the most healthy ten percent of counties.  Premature deaths (i.e. before age 75) are twice as high in the least healthy states as they are in the most healthy states.  In the least healthy states, 22 percent of residents report poor or fair health compared to only 12 percent in the most healthy states.  In the least healthy states, 4.2 percent of residents report poor mental health days compared to only 2.8 percent in the most healthy states.  What I found quite interesting was comparing the rate of sexually transmitted diseases and teen births in both; in the least healthy states, there were 1.5 times as many cases of sexually transmitted diseases and 2.2 times as many teen births as there were in the most healthy states. 

As shown on this chart, between 1997 and 2010 there has been a substantial increase in the cost of hospital stays for many common health conditions that require hospitalization accompanied by an increase in the number of stays per population for the majority of conditions:



Looking at the data from the County Health Rankings makes one realize that the health of Americans varies widely and is largely dependent on factors including unhealthily lifestyles and  access to adequate health facilities.  Obviously, some parts of the United States have a great deal of work ahead of them if they expect both the quantity and quality of their lives to improve. 

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