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February 17, 2010

CDHD Looks at County Health Rankings

A new report released today indicates that Ada County, in the Central District Health Department area of jurisdiction, is one of the healthiest counties in the state. However, the district’s other three counties each present challenges to healthy living. The report entitled “County Health Rankings, Mobilizing Action Toward Community Health” is a full list of county health rankings, developed by the University of Wisconsin Population Health Institute, scored Idaho and other states’ counties on 28 different criteria to rank overall health at the community level.

Ada County ranks among the healthiest counties in the state, while the report indicates Boise, Elmore and Valley counties have room for improvement.

“The health of counties depends on many different factors, including quality of health care, individual behavior, education and jobs, and the environment,” says Central District Health Department Director Russ Duke. “We look at this data as a snapshot of where our counties stand relative to other counties in Idaho. It should provide public health and our partners an opportunity to identify areas for improvement.”

This report, funded by the Robert Wood Johnson Foundation, is the first to rank the overall health of counties in all 50 states by using a standard formula to measure how healthy people are and how long they live. The Wisconsin Population Health Institute has been conducting a similar survey in Wisconsin since 2003.

The online report, available at www.countyhealthrankings.org, includes a snapshot of 42 of the Idaho’s 44 counties, with a color-coded map comparing each county’s overall health ranking. In Idaho, Camas and Clark counties are not included in the report because there was insufficient data for reliable comparisons.

High ranking counties include areas where people live longer than 75 years, their health is generally good and their quality of life is high. The report shows there are significant differences in the overall health across Idaho counties, which are due to many factors ranging from individual behaviors to the availability of quality healthcare, access to healthy foods and the quality of air.

Ada County achieved high ranking in nearly every category except physical environment, which is linked to air quality and access to healthy foods.

Boise County’s low ranking is tied to several factors:

• Higher mortality – 30th out of 42. People don’t live as long in comparison to residents of other counties.
• Higher morbidity – 39th. On the whole, Boise County residents have poorer physical and mental health than the average for Idaho.
• Clinical care – 31st. Access to all levels of medical care is limited, at least in part because of geographic isolation and a small population. One in four Boise County residents is uninsured.
• Socioeconomic – 29th. Boise County generally has higher unemployment, lower incomes, fewer support services and lower levels of education than the citizens of other Idaho counties.

Elmore County’s ranking presents challenges, but several factors stand out from the report:

• Mortality – Elmore County ranks 16th in mortality, meaning people generally live longer than residents of most other Idaho counties.
• Morbidity – Elmore County ranks 32nd. Residents may live longer but their quality of life isn’t as good as it could be, as measured by physical and mental health and the incidence of low birthweight babies.
• Health Behaviors – Elmore County is 41st out of the 42 ranked counties, which clearly identifies an area for improvement. This area is measured by rates of tobacco use, adult obesity, alcohol use, and indicators of high risk sexual behavior, as indicated by very high rates of Chlamydia and teen births.
• Social and Economic factors – Elmore County is 24th. The primary indicator here the low rate of high school graduation (56%).
• Physical Environment – Elmore County is 19th. Residents have poor access to healthy foods.

Valley County’s ranking is related, in part, to its low population base and relative geographic isolation. Beyond that several factors stand out from the report:

• Mortality – Valley County ranks 9th in mortality, meaning people generally live longer than the residents of most other Idaho counties.
• Morbidity – Though Valley County residents may generally live longer, their quality of life isn’t as good as it could be, as measured by physical and mental health and the incidence of low birthweight babies.
• Health Behaviors – Valley County is 27th out of the 42 ranked counties as measured by rates of tobacco use, adult obesity, alcohol use and high risk sexual behavior, as identified by substantially higher rates of Chlamydia and teen births.
• Physical Environment – Surprisingly, Valley County ranks 35th for physical environment. The largest single factor in this rating is access to healthy foods, but the report also identifies access to alcohol as being well above the state’s average.
• On the plus side, Valley County is ranked 2nd behind only Ada County in Clinical Care.

It should be noted that some of the data used to rank the counties is as old as eight years. The authors chose to use existing studies to develop a standardized method of evaluating the relative health of counties within a state. There is no state-to-state comparison.

“Our vision for the citizens of this health district is healthy people in healthy communities,’ Duke says. “Since the health of our counties is measured in so many different ways the challenge is building partnerships with all who have a stake in the health of our communities. That means bringing together local government, business, community, faith-based, and education groups to work together to identify strategies that can improve the health of our citizens.”

To some extent the building of partnerships to address health issues is already underway. For example, CDHD is participating in a program entitled Start Strong Idaho; Building Healthy Teen Relationships (www.startstrongidaho.com). The program is designed to promote healthy teen relationships and prevent teen violence by targeting 11- 14 year olds with knowledge and skills of health relationships. The program has, or will be, presented to students at schools in all four of the CDHD counties.

CDHD provides oral health care services and education to pre-school and elementary students in most of its counties. WIC services are provided in all four counties to help at-risk low income mothers and children access better nutrition.

CDHD and Elmore Medical Center have partnered to present a new evidence-based Reducing the Risk curriculum to the Mountain Home School District Board. The stated purpose of the new material is to build teen skills to prevent pregnancy, STD and HIV.

In Valley County the University of Idaho Horizons facilitates partnerships to reduce poverty and achieve sustainable prosperity in small rural communities, such as Cascade, which is working to increase recreation opportunities, low income housing, transportation access, and improve sidewalks and cycling trails to increase opportunities to bike and walk safely. CDHD is an active Horizons member.