County health ratings for the 50 states have been released, showing how income influences public health.
The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute developed their sixth annual report. However, this is the first time that income inequality has been factored into the rankings of public health.
Premature deaths were found to be declining in 60 percent of counties around the nation, while no change was recorded in 40 percent of the regions examined. The largest change was seen in Washington, D.C., where premature deaths dropped 30 percent in the time period of 2010 to 2012, compared with 2004 to 2006.
The report studied several factors that affect public health, including insurance coverage, premature death rates, and commute times to health care centers. A pair of scores were calculated for each county, measuring both current health and how well the county is likely to be able to care for its residents in the future. The first of these factors examined immediate data, such as birth weights and death rates, while insurance coverage and other socioeconomic influences were calculated for the second category.
"For those counties with lower rankings, they often are surprised to see their relative rank, and it stimulates some introspection and collective action to make improvements," Donald Schwarz from the Robert Wood Johnson Foundation said.
Income inequality was measured by examining the difference between the richest and poorest 20 percent of households in each county. On average, there is a fivefold difference in these incomes nationwide.
Additional income differences may exist between neighborhoods within counties, and some county-level organizations are pushing for a more detailed study to examine the effect of this local financial disparity. To explore county rankings by state, see this map.
Health care was once thought to be isolated from other factors of life, including income. However, a new understanding of health takes into account socioeconomic features as part of judging the effectiveness of public health programs. Health care choices are often shaped by household budgets, and those people in lower- and middle-income brackets are often forced to choose between health care and other necessities of life.
"The County Health Rankings have helped galvanize communities across the nation to improve health. Solutions and innovation are coming from places as diverse as rural Williamson, West Virginia, in the heart of Appalachia to urban New Orleans; they are engaging business, public health, education, parents and young people to build a Culture of Health," Risa Lavizzo-Mourey, CEO and president of the Robert Wood Johnson Foundation, said.
The least healthy states in the country were found to have more smokers, alcohol-related automobile accidents and teen births than healthier counties.
The new study was developed to assist counties in assessing the health of their residents as well as to see how the success of their programs compared with those in neighboring areas so it might possibly spur better public health programs nationwide.
Photo: Robert Couse-Baker | Flickr
