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2012 County Health Rankings Highlight Income Gap

While a myriad of factors determine a community’s overall health, a strong correlation exists between median household income and health outcomes, according to Governing’s analysis of data from the 2012 County Health Rankings, conducted by the University of Wisconsin and sponsored by the Robert Wood Johnson Foundation.

While a myriad of factors determine a community’s overall health, a strong correlation exists between median household income and health outcomes, according to Governing’s analysis of data from the 2012 County Health Rankings, conducted by the University of Wisconsin and sponsored by the Robert Wood Johnson Foundation.

According to the data, the healthiest county (based on the rankings methodology) is also the county with the highest average income in 17 states. In another 19, the healthiest county ranks in the top three for income, the wealthiest county is in the top three for health, or both. Three states (Kentucky, New Jersey and Vermont) illustrated the trend perfectly: the healthiest county is the richest and the least healthy county is the poorest.

There are exceptions to every rule, and the correlation might be attributed to other factors as well (for example, communities with more retirees might have lower average incomes and more indicators of poor health). But the connection has been consistent since the national rankings began in 2010, said Pat Remington, associate dean for public health at the University of Wisconsin-Madison and one of the lead researchers on the project.

“The places that rank well tend to be affluent suburbs. They have fairly healthy behaviors, fairly good educational systems, relatively low unemployment,” Remington said. “Inner cities and small rural communities oftentimes have high rates of poverty, bad socio-economic factors and associated unhealthy behaviors.”

The rankings are divided into two main categories: health outcomes and health factors. Both rankings are based on a variety of statistics. For outcomes, researchers used data such as mortality rates, low birth weight, adult smoking, adult obesity, etc.; for factors, they used information such as number of uninsured, number of primary care doctors, unemployment, education levels, access to healthy foods, etc.

The rankings do not provide comprehensive national rankings. Instead, counties are ranked within their own state. The reason, Remington said, is that the authors are interested in stimulating conversations about how to improve public health, rather than focusing on the few counties at the top or bottom of a national list.

For a full description of the methodology, visit the rankings website. The online hub also includes a searchable map and idea centers for policymakers to confront the challenges presented by the findings. Insights on how to form community partnerships and links to funding opportunities are also available.

“The rankings show that where you live matters to your health,” said Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation. “They provide a better understanding of where communities are doing really well and areas in which they can improve. The information can become a power tool for local leaders to say: Here’s what we’re going to work on.”

Select your county from the menu below to see how it stacked up against others in your state.


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Dylan Scott is a GOVERNING staff writer.
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