County Health Rankings

Mobilizing Action Toward Community Health

The County Health Rankings—the first set of reports to rank the overall health of every county in all 50 states—are now available on The 50-state report, released by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation, 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.

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.

Poorly ranked counties often had multiple challenges to overcome, including: two- and three-fold higher rates of premature death, often from preventable conditions; and high smoking rates that lead to cancer, heart disease, bronchitis and emphysema.

The County Health 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.

“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 County Health 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.”

How healthy is your county? Find out at

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