The County Health Rankings — the first set of reports to rank the overall health of every county in all 50 states — were released recently by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation. The 50 state reports, available on www.countyhealthrankings.org, enables consumers, public health and community leaders, policy-makers and others to see how healthy their county is, compare it with others within their state and find ways to improve the health of their community.

The County Health Rankings

The County Health Rankings identify the healthiest and least healthy counties within every state in the nation. Health outcomes in the County Health Rankings represent how healthy a county is. Two types of health outcomes are measured: how long people live (mortality) and how healthy people feel while alive (morbidity).

Counties are ranked on four key factors that affect health: health behaviors, clinical care, social and economic, and physical environment factors. Each of these factors is based on several measures, including the percentage of adults that smoke, the percentage of adults that are obese, the percentage of a county’s population that binge drinks, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty. A fifth set of factors that influence health (genetics and biology) is not included in the Rankings. Although other studies have ranked states based on health factors, this is the first study where researchers have examined multiple factors that affect health in each county in all 50 states.

Each state snapshot includes color-coded maps for health outcomes and health factors, comparing each county’s overall health with other counties. In addition, a detailed list of rankings for health outcomes and health factors is also provided. A summary report (PDF) for each state is available for download.

Researchers used the latest data available for each county, ranging from 2000 to 2008, to develop the Rankings. The data collection process gathered information from thirteen national data sources.

National comparisons and trends

When the 50 healthiest counties (one from every state) are compared with the 50 least healthy counties, several striking trends emerge:

• Healthier counties are urban/suburban, whereas least healthy counties are mostly rural. While 48% of the healthiest counties are urban or suburban counties, 84% of the least health counties are rural.
• The least healthy counties have significantly higher rates of premature death — 2.5 times higher than the healthiest counties.
• People living in the least healthy counties reporting being in significantly poorer health — the rate of people who report being in fair or poor health is 2.1 times higher than people in the healthiest counties.
• People living in the least healthy counties are much more likely to smoke; over 26%, compared to only 16% in the healthiest counties.
• People living in the least healthy counties are 60% more likely to be admitted to the hospital for preventable conditions — a sign of poor outpatient and primary care.
• The least healthy counties have higher rates of poverty, with 30% of children living in poverty — over three times higher than the rate in the healthiest counties (9%).
• The 50 least healthy counties have fewer places where people can find healthy food. Only 33% of zip codes in the least healthy counties have at least one grocery store, compared to almost half (47%) of zip codes in the healthiest counties.

Patrick Remington, M.D., M.P.H., Associate Dean for Public Health at the University of Wisconsin School of Medicine and Public Health said [1]:

For the first time, people have a tool to help identify what is making people in every county unhealthy. We hope this kind of check-up will mobilize community leaders to take action and invest in programs and policy changes that make their counties healthier places to live.

The Rankings demonstrate that much of what influences an individual’s health happens outside the doctor’s office. To see how the county you live in ranks, visit www.countyhealthrankings.org.

References

1. How Healthy Is Your County? New County Health Rankings Give First County-by-County Snapshot of Health in Each State. County Health Rankings press release. 2010 Feb 17.

The St. Vincent de Paul (SVDP) Charitable Pharmacy in Cincinnati, Ohio, announced last week that it surpassed $5.1 million dollars worth of medication dispensed to help people in need since it opened in September 2006 [1]. The Charitable Pharmacy is the only pharmacy in southwest Ohio that provides free, professional pharmaceutical care to people in need.

The Charitable Pharmacy was established in 2005 in partnership with the Academy of Medicine of Cincinnati as a pilot project designed to provide free, professional pharmaceutical care to those unable to pay for discounted medication, those who don’t qualify for other programs, and those who simply need help navigating the options available for prescription medication. According to Liz Carter, Executive Director, Society of St. Vincent de Paul [1]:

There are more than 270,000 people in Greater Cincinnati without health insurance. One out of every 10 households locally has a family member who forgoes prescription medication in order to afford food, clothing or housing. We see individuals from every corner of our community who are suffering from illnesses but have no way to afford medication. Our pharmacy is a last resort for them.

The Charitable Pharmacy carefully screens people that need help, including the homeless, people who have lost their jobs, the working poor who cannot afford prescription insurance or pharmacy co-pays, and people that need temporary assistance as they try to get coverage, qualify for other assistance programs or reach a gap in Medicare coverage.

The Society of St. Vincent de Paul in Cincinnati is a non-profit organization that works personally with those in need, regardless of race or creed, to bridge the spiritual, emotional and material gaps in their lives through home visits provided by neighborhood-based volunteer groups, as well as groundbreaking initiatives like the Charitable Pharmacy.

Almost all of the medication at the Charitable Pharmacy is donated by twenty private physician’s practices, Skilled Care, KeySource Medical, the Ohio Drug Repository Program, and drugmakers Astra Zeneca and Novartis.

In 2010, the St. Vincent de Paul Charitable Pharmacy in Cincinnati anticipates providing more than 25,000 prescriptions valued at over $2 million dollars, and is is in need of financial donations, donations of sample medication form physician offices and pharmaceuticals from long-term care pharmacies. For more information, see http://www.SVDPcincinnati.org.

References

1. St. Vincent de Paul Charitable Pharmacy Announces Major Milestone: $5.1 Million in Prescription Medication Dispensed. Saint Vincent de Paul, Cincinnati. 2010 Feb 17.

As you or perhaps your parents get older, would you want to be at home when recovering from an illness? Would the choice between home rehabilitation or visits to a day hospital make a difference to your recovery and health? Which is cheaper for the healthcare services? A recent study published in the journal Health Technology Assessment (HTA) shows that home-based care in the United Kingdom is no worse than attendance at a day hospital for older adults [1].
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In May, we wrote about the Spectrum Health Value Study, an ongoing national online survey where Americans are asked what they value when it comes to healthcare products and services. The survey evaluates 27 programs, products and services categories used by the U.S. government for measuring economic activity in various sectors of the economy. Every three months, Spectrum, a public relations and public affairs firm based in Washington DC, interviews 1,000 people and asks them to identify from the 27 healthcare products, programs and services those ever used and how satisfied they were with each. The ongoing study can be used to identify the relative value Americans place in healthcare programs, products and services, and how the value changes over time.

Insured and uninsured

The most recent Spectrum Health Value Study data was used to compare answers from insured and uninsured respondents. As Congress recesses for the month of August to talk with their constituents about the current healthcare legislation under consideration in the U.S. House and Senate, these data offer a glimpse into what insured and uninsured Americans value in healthcare.
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