Washington area counties reflect health disparities

March 30, 2011

The Washington area has some of the region’s healthiest counties, such as Fairfax and Montgomery, but also pockets of poor health in the District and Prince George’s County, according to a set of reports to be released Wednesday.

The reports, which rank U.S. counties and cities based on how long people live and how healthy they are, reflect disparities that are closely linked to factors outside the doctor’s office, including high school graduation rates, poverty rates and the number of single-parent households.

Fairfax, Arlington and Loudoun counties in Northern Virginia received the highest marks within the state for overall health. In Maryland, the top three counties are Howard, Montgomery and Frederick. Prince George’s County ranked 17th out of Maryland’s 23 counties and Baltimore City for overall health, in part because the rate of people dying before age 75 was higher than the state benchmark and more than double that of neighboring Montgomery.

The rankings, available at www.countyhealthrankings.org, are virtually identical to ones released last year by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation.

This year, in addition to ranking the overall health of almost every county in all 50 states, researchers included information for the District of Columbia, which compared unfavorably with its suburban counterparts in several areas, such as rates of high school graduation and teenage birth, but scored better in other areas, such as the ratio of primary-care providers per population and the number of uninsured adults.

Researchers rated overall health based on five measures that included the rate of people dying before age 75; the percentage of people who reported being in fair or poor health; and the rate of low-birthweight babies. They also gave a separate grade to factors that influence health. Those include: smoking, obesity, binge drinking, access to primary care providers, high school graduation rates, violent crime rates, air pollution levels and access to healthful foods. They relied on federal health, census and crime data, including the latest available figures from 2009.

Researchers said they expected little change in the rankings for those at the top and bottom of the list. That’s because it takes time to change underlying factors at the root of poor health, such as education, poverty rates and access to health care, said Patrick Remington, a University of Wisconsin professor who directs the county health rankings program.

The purpose of the rankings is to help a wide range of policymakers and community groups think about the issue, he said. The approach cannot be limited to “get your flu shot and quit smoking,” he said.

Even though Fairfax County has the highest overall health rating in Virginia, it still came in last — 132nd — this year, the same as last year, for poor air quality because of its traffic pollution.

“That affects children as they grow. It affects anybody with asthma,” Remington said. Changing that involves driving less and using less energy, he said, acknowledging that those are politically difficult issues.

Counties and cities were ranked within each state; there is no overall score for which county is the healthiest in the nation. But this year, researchers included a national benchmark for each category they measured, showing how 90 percent of all counties fared.

Since the rankings were released last year, some counties that scored near the bottom in their states have been motivated to take action. In West Virginia, the pastor at one church in Lincoln County, which ranked 50th overall among the state’s 55 counties, started a weight-loss program for some of his parishioners. In Wyandotte, Kan., which had an overall health ranking of 96 out of 99, the county expanded the use of an early childhood learning program, began a program where local minority residents go into neighbors’ homes to talk about preventing conditions such as obesity and heart disease, and helped use tax credits and incentives to bring in the first new grocery store in a lower-income neighborhood in 35 years, researchers said.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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