The first national ranking of its kind has found a link between counties with good health factors, such as low unemployment and cleaner air, and counties with low early mortality and disease.
The report suggests that perhaps wellbeing depends on factors such as the environment, education, jobs, income, and access to healthy food.
That's according to the county-by-county health comparison maps released by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
The clickable maps allow anyone to see how any of 3,000 counties in the country measures up with other counties within that state on the basis of two ways of measuring health.
The first, called health outcomes, measures years of life lost before age 75 (premature death) in that county, and the percentage reporting poor health, the percentage of days one felt physically or mentally unhealthy.
The second, called health factors, measures lifestyle issues such as diet and exercise levels, alcohol use, percentage of respondents who reported engaging in unsafe sex, and smoking. Also measured in health factors are social and economic indicators such as education, employment and income, levels of particulates and ozone in the air, and access to healthy food and recreational activities.
"While you won’t always see the same county as the healthiest (or unhealthiest) in both health outcomes and health factors, there is usually a high level of correlation if you look within quadrants," notes Julie Willems Van Dijk, Associate Scientist, University of Wisconsin Population Health Institute.
There are several reasons why differences may be seen in health outcomes and health factors, she explained. However, "since health factors drive health outcomes, today's health outcomes are a reflection of past health factors. Therefore if health factors are worse than health outcomes, it could be a predictor that (these counties) will not fare so well in the future," she said. "Likewise, if health factors are better than health outcomes, it could provide hope to a community that it is on the right path and that future health outcomes will improve."
Sure enough there are amazing similarities. For example, in California, Marin County is the healthiest in both categories.
In Mississippi, of the 10 counties that are lowest in health outcomes, seven are also low in health factor scores.
In Texas, seven of the top 10 counties in health outcomes are also in the top 10 in health factors.
In Illinois, seven of the top 10 counties in health outcomes are also in the top 10 in health factors. And seven of the poorest 10 counties in health outcomes are also among the 10 poorest scoring counties.
"The rankings really show us with solid data that there is a lot more to health than healthcare," said Patrick Remington, MD, director of the project and associate dean for Public Health at the University of Wisconsin School of Medicine and Public Health. "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."
Scores can also be compared based on how the county does in areas like diabetes screening or number of uninsured, or on the basis of rates of obesity and teen births or high school graduation rates.
The maps also show that the unhealthiest counties,
- Have populations that are nearly twice as likely to be in fair or poor health
- Significantly lower high school graduation rates.
- Have more than twice as many children in poverty.
- Have far fewer grocery stores or farmer's markets.
- Have much higher rates of unemployment.
The project has previously published a similar sets of rankings, this year, expanded it so that people can compare the overall health of their county against other counties in their state, and also compare their performance against national benchmarks in top-performing counties.