Crossing county lines in your state can mean a world of difference for your health, a new report reveals.
The County Health Rankings and Roadmaps Program, a study and website created by the University of Wisconsin Population Health Institute and funded by the Robert Wood Johnson Foundation, found major differences between state counties close to one another and even some that share borders.
The study uses a list of 30 health indicators, including smoking, alcohol consumption and obesity rates, as well as factors such as income, education attainment and insurance coverage to rank counties within each state from healthiest to least healthy.
Richer suburban counties where residents are better educated, have access to good health care and enjoy strong employment rates tended to rank highest. Frequently, an adjacent urban county with a high degree of poverty, unemployment and high school dropouts received the lowest ranking in the state.
Wisconsin is a good example of this trend. Ozaukee County, a wealthy commuter suburb just outside Milwaukee is ranked the healthiest in the state. The county boasts relatively low levels of alcohol abuse, smoking and obesity.
The county right next door — densely populated, metropolitan Milwaukee County — is rated dead last in the state. Rampant unemployment, plummeting high school graduation rates and crushing poverty seem to conspire against it. Nearly a third of Milwaukee residents don’t exercise. Binge drinking, tobacco use and teen pregnancy soar well above state averages.
“We see this pattern repeated again and again in nearly every state,” Dr. Pat Remington, the senior researcher and co-director of the program stated. “Places with better jobs, more education and higher income are where people live longer, healthier lives.”
One confounding factor in the rankings is physical environment, which takes into account environmental aspects such as air and water quality, mass transportation and density of fast food establishments. Remington said many high ranking counties actually scored quite low in this area due to poor street planning and nonexistent mass transportation systems.
For example, Livingston County just outside of Rochester is ranked the healthiest in the New York state overall, yet ranked 61st out of 62 counties on measures of physical environment. While smoking, drinking and obesity rates are lower than average, county residents have poor access to healthy food, clean water and recreational facilities.
The study intentionally does not compare state against state, Remington said, because the authors were concerned individual counties might get lost in the data and they really wanted to highlight what is going on at the local level.
However, Remington did note that the healthiest states are generally located in the West, Midwest and Northeast while the least healthy states are in the South and Southeast, a fact supported by other surveys and studies.
Vermont is the nation’s healthiest state, according to the United Health Group’s annual state-by-state health rankings. New Hampshire and Connecticut claim the second and third spots respectively, with Hawaii and Massachusetts rounding out the top five. At the other end of the spectrum, Mississippi ranks the least healthy, followed by Louisiana, Oklahoma, Arkansas and Alabama.
Remington said he hoped the rankings would inspire localities to make the necessary changes needed to rise in the rankings. He noted that some counties have already adopted healthier habits and policies in an effort to improve their scores but he added, the four years the group has published data probably isn’t enough time to register improvements.