County Rankings Illustrate Population Health

Despite the commitment and valiant efforts of healthcare providers across the nation to improve health in their communities, they can't do it alone.

The benefits of a half-hour visit with a healthcare provider can quickly evaporate if the patient returns to his own reality and resumes the unhealthy behaviors that prompted his call for care in the first place.

It's increasingly clear that any attempt to improve population health will require a coordinated effort, not just tactically between healthcare providers, but also strategically and involving healthcare providers, educators, government, businesses and charities such as the United Way.

Fortunately, there's a handy tool out there to help providers and other community leaders identify the health needs of their areas. The 4th annual County Health Rankings assesses the health of almost every county in the United States and ranks the counties within their states. The rankings were compiled by the University of Wisconsin Population Health Institute in conjunction with the Robert Wood Johnson Foundation.

The data provide a status report on critical population health metrics such as morbidity, access to care, overweight and obesity, tobacco and alcohol use, sexual activity, educational attainment, pre-natal and infant health, and teen pregnancy.

Angela R. Russell, a researcher at the University of Wisconsin Population Health Institute, says the data provides an "annual snapshot" at a somewhat granular level that is detailed enough to allow local leaders to develop targeted remedies.

"It shows where they are doing well and where there are opportunities for improvement," Russell says. "On the national level and the local level a lot of the conversation has focused on healthcare and our data set and research shows that healthcare is important. But our research also tells us that much of what affects our health occurs outside of the doctor's office. In fact, where we live actually matters to our health."

Russell wants healthcare providers to use the rankings as a starting point and then to dig a little deeper to find out what their communities are up against. After all, it's hard to fight when you don't know your opponent.

"As a health administration, you get a better sense of your actual service area and know the challenges and opportunities you face," Russell says. "It would tell you a lot about your community health. It would tell you if folks in your service area are dying before they should. It will tell you if you have a high rate of low birth weight babies being born in your area. It can tell you a lot about health behaviors. Are people smoking more? Are they obese? Are they physically inactive?"

The data also show that there are a variety of factors that influence the health of the community that go beyond health behaviors and access to care. "It also includes socio-economic factors such as education, poverty, income, community safety, and the physical environment," Russell says. "The data also show that there are some counties that can be right next to each other and some can be very healthy and some are not."

And that's why improving population health cannot be left solely to providers.

"We want this to serve as a call to action for local leaders across the nation… by working together we can improve the health of the nation from the ground up. It really takes us all working together. If they are going to change the health of the county they have to work alongside educators and the United Way and maybe the local chamber of commerce."

Russell cautions that changing population health is not easy.

"One thing we recognized is that it takes a long time to make change," she says. "We have been putting out this data for four years, but we know things aren't going to change overnight. It's going to take persistent and consistent hard work of leaders across the nation to see change over time."

And finally, if your county is on the bottom or near the bottom of the list with some of the worst health issues in your state, don't despair.

"In fact, use it as a call to action," Russell says. "The rankings give us hope and tell us there are things we can do today to create cultures of health where we live, where we learn, and where we play."