Conversations about health tend to revolve around national statistics. People talk about the childhood obesity rate, the smoking rate, the diabetes rate, and so on. This is fine, but national numbers tend to minimize local differences, which can be quite dramatic. For example, the least healthy counties have twice the premature death rate—measured by years lost before the age of 75—as the healthiest counties, according to a new ranking. If you just cite the overall rate, you miss what's happening in, say, Menominee County, Wisconsin.
The state you live in matters, and the county you live in matters more. Which is why the latest County Health Rankings, developed by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, are so valuable. They provide a detailed picture of health for 3,000-plus counties, measuring both outcomes (like premature death) and factors that cause these outcomes. They allow communities to understand how they're performing health-wise, and what's driving that performance.
"All of the factors that we include in the ranking are there because they are actionable. They're things communities can do something about," says Bridget Catlin, who leads the project. "They can see where they're improving and where they need to put in a few more resources."
The team behind the rankings, now in their fifth edition, takes a broad view of what drives health. In addition to predictable measures, like smoking and physical inactivity, there are also factors like employment and pollution. The data is deeper than ever this year, with six new sets of statistics included (you can see them mapped in the slide show above). You can now look at how housing (which includes affordability and access to kitchen facilities), public transit, access to mental health providers, and exercise opportunities all affect outcomes, for instance.
"With the debate about health care coverage, we recognize that that is important. But it's also important that there are sufficient providers for people to go to locally," Catlin says, referring to mental health provision.
The research shows that the healthiest counties in each state have 1.3 more mental health providers than the least healthy counties. Likewise, exercise opportunities. The healthiest counties have access to 1.4 as many parks and recreational facilities as the least healthy.
Where you live really does matter to your health.