How Healthy Is Your County?

New County Health Rankings give first county-by-county snapshot of health in each state.

    • February 16, 2010

The County Health Rankings—the first set of reports to rank the overall health of every county in all 50 states—were released today by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation at a briefing in Washington, D.C. and on www.countyhealthrankings.org. The 50 state reports 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.

Each county is ranked within the state on how healthy people are and how long they live. They also are ranked 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.

Other studies have ranked states on health factors, but this is the first time researchers have examined the multiple factors that affect health in each county in all 50 states.

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.
  • High numbers of liquor stores and fast-food outlets but few places to buy fresh fruits and vegetables.

“For the first time, people have a tool to help identify what is making people in every county unhealthy,” says Patrick Remington, M.D., M.P.H., associate dean for public health at the University of Wisconsin School of Medicine and Public Health. “We hope this kind of check-up will mobilize community leaders to take action and invest in programs and policy changes that make their counties healthier places to live.”

The online Rankings, available at www.countyhealthrankings.org, include snapshots of U.S. counties with a color-coded map that compares each county’s overall health with other counties in each of the 50 states. Researchers used the latest data available for each county, ranging from 2000 to 2008, to develop the Rankings.

Each county’s rank reveals a pattern of strengths and weaknesses. For example, Woods County, Oklahoma, ranked first in the state for overall health, but ranked 48th out of 77 on clinical care access and quality. Carbon County, Montana, 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.

Researchers used five measures to assess the level of overall health or “health outcomes” 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 show that people who live in healthier counties tend to have higher education levels, are more likely to be employed, have access to more health care providers, and have more access to healthier foods, parks and recreational facilities.

In addition, the Rankings show sharp health disparities even in counties located right next to each other. For example, someone living in Chester County, Pennsylvania, 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 higher numbers of children living in poverty.

“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,” says Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. “People, no matter where they live, should have the best possible opportunity to be healthy.”

The Rankings can be used to mobilize communities to improve health disparities. 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, which includes Kansas City, lacks access to stores selling healthy foods, a problem that’s exacerbated by poor bus service in the county. 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.

“All of us—health officials, government and business leaders, educators and media—must play a role in transforming our communities,” Lavizzo-Mourey says. “County by county, we need to pursue programs and policies that help all Americans live longer, healthier lives.”

For more information, visit www.countyhealthrankings.org.


About the Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.

About the University of Wisconsin Population Health Institute

The University of Wisconsin Population Health Institute is the focal point within the University of Wisconsin School of Medicine and Public Health for translating public health and health policy research into policy and practice. The Institute strives to:

  • Address a broad range of real world problems of topical importance to government, business, providers, and the public;
  • Promote partnerships of inquiry between researchers and users of research, breaking down barriers between the academic community and public and private sector policy-makers;
  • Advance the development of interdisciplinary research, along the spectrum from public health to health care;
  • Provide continuing education for practitioners and opportunities for applied learning for graduate and medical students; and
  • Make useful contributions to public health and health policy decisions that improve the health of the public.

For more information, visit, http://uwphi.pophealth.wisc.edu/.