While premature death rates have fallen in a majority of U.S. counties, significant disparities persist between the healthiest and least healthy counties, a study by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute finds.
The 2015 edition of County Health Rankings provides in-state rankings based on the length and quality of life, as well as thirty factors that affect those health outcomes, including insurance coverage, access to primary care physicians and mental health providers, educational attainment, housing, and pollution. According to the 2015 County Health Rankings Key Findings Report (12 pages, PDF), premature death rates fell between 2004-05 and 2010-12 in 60 percent of the counties in the U.S. and were down by a third in the District of Columbia.
At the same time, the study found large disparities in socioeconomic and environmental factors that shape health such as poverty and income inequality, with nearly a quarter of all children in the U.S still living in poverty, and child poverty rates in the least healthy counties in each state more than twice the rates in the healthiest counties. Using a new measure of income inequality — which is particularly harmful to the health of poorer individuals — the report also found the worst inequality ratios are in counties that have large metropolitan areas and in the Southeast and Southwest, as well as parts of Appalachia and the Plains region.
The study also found that unemployment rates are 1.5 times higher in the least healthy counties in each state compared to the healthiest counties, and that violent crime rates, which affect health, well-being, and stress levels, are highest in the Southwest, Southeast, and Mississippi Delta regions.
"The County Health Rankings have helped galvanize communities across the nation to improve health," said RWJF president and CEO Risa Lavizzo-Mourey. "Solutions and innovation are coming from places as diverse as rural Williamson, West Virginia, in the heart of Appalachia to urban New Orleans; they are engaging business, public health, education, parents, and young people to build a culture of health."