County Health Rankings Show There is More to Health Than Health Care

    • March 30, 2011

A new set of reports rank the overall health of nearly every county in the nation. In its second year, the County Health Rankings continue to confirm the critical role that factors such as education, jobs, income, environment and access to health care play in how healthy people are and how long they live.

Published online at by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, the Rankings allow people to see how their county compares with others in their state on multiple health factors and against national benchmarks. It is the only tool of its kind that measures the overall health of counties in all 50 states.

“It’s hard to lead a healthy life if you don’t live in a healthy community,” said Risa Lavizzo-Mourey, M.D., M.B.A. president and CEO of the Robert Wood Johnson Foundation. “The County Health Rankings are an annual check-up for communities to know how healthy they are and where they can improve. We hope that policymakers, businesses, educators, public health departments and community residents will use the Rankings to develop solutions to help people live healthier lives.”

Each county’s rank reveals a pattern of strengths and weaknesses. And, the Rankings reveal that all counties have areas where they can improve, even those that are the healthiest. Some highlights of what counties look like nationally:


  • People are nearly twice as likely to be in fair or poor health in the unhealthiest counties;
  • Unhealthy counties have significantly lower high school graduation rates;
  • Unhealthy counties have more than twice as many children in poverty;
  • Unhealthy counties have much fewer grocery stores or farmer’s markets; and
  • Unhealthy counties have much higher rates of unemployment


“The Rankings really show us with solid data that there is a lot more to health than health care. Where we live, learn, work and play affect our health, and we need to use the information from the Rankings to shine a spotlight on where we need to improve so we can take action to address our problems,” said Patrick Remington, M.D., M.P.H., director of the County Health Rankings project and associate dean for Public Health at the University of Wisconsin School of Medicine and Public Health.

As a result of the Rankings, several communities already have begun to take action, such as passing smoke-free laws, boosting educational opportunities for young children, or pushing for healthier grocery stores and farmer’s markets.


  • In Wyandotte County, Kan., Mayor Joe Reardon, after seeing his state’s low rank in a County Health Rankings report, worked with other local stakeholders to create a Healthy Communities initiative. The county has already expanded access to healthier foods; provided more health education to at-risk residents; and increased education support for low-income kids.
  • In Columbus County, North Carolina, the county recently banned smoking in county buildings to help curb high rates of tobacco use and county employees participated in a local weight-loss competition to raise awareness about the importance of a healthy diet and exercise.
  • In Clare County, Michigan, the Central Michigan District Health Department hosted a public health summit which resulted in the creation of the Together We Can Health Improvement Council. The Council is gearing up for a second Public Health Summit in April, has conducted community health assessments, distributed stakeholder surveys to evaluate community health challenges and has established Health Improvement Working Groups in four surrounding counties.


In conjunction with the release of the Rankings, the University of Wisconsin and the Foundation will launch a new program that includes funding up to 14 communities across the country to use the Rankings to improve the health of their residents.

In addition, to further illustrate the connection between social factors and health, the Foundation along with the Virginia Commonwealth University’s Center on Human Needs today unveiled the County Health Calculator. The County Health Calculator is a new interactive online app that shows people how much higher levels of education and income influence premature death rates in a county.

For more information, visit