Health report has high, low marksIt’s the starting point for Grandma’s Marathon, home to inline skating races, trails, state parks, clinics, a hospital. So what makes Lake County so unhealthy, as a report released Wednesday shows?
It’s the starting point for Grandma’s Marathon, home to inline skating races, trails, state parks, clinics, a hospital. So what makes Lake County so unhealthy, as a report released Wednesday shows?
It’s death rates, surveys on how people are feeling, and low birth rates.
According to those factors, that makes Lake County 85th in a report on health statistics in 85 of Minnesota’s 87 counties. The report, conducted by the University of Wisconsin Population Health Institute and funded by the Robert Wood Johnson Foundation, used data from organizations such as Centers for Disease Control and Prevention, the U.S. Census and the FBI to measure what was labeled “Health Outcomes,” including early death, how people are feeling and how many babies are born at a low birth weight, said Julie Willems Van Dijk, one of the authors of the study.
Those factors had media outlets across the state calling Lake County the least healthy in the state. Most didn’t state that in a compilation of 13 more data sets, or “Health Factors” in the report, Lake County was a respectable 16th in the state, the highest ranking of any county north of the Twin Cities metro area.
That part of the study looked at factors such as obesity, alcohol and tobacco use, and exercise and diet habits.
“The data we have is a snapshot of a community,” Willems Van Dijk said.
The healthiest county in Minnesota under “Health Outcomes” was Jackson in the south-central part of the state. Olmsted County, where Rochester is located, was ranked No. 1 for “Health Factors.” Lake County’s neighbor to the north, Cook, wasn’t included in the report because of its low population. Traverse county also wasn’t ranked.
Researchers compiled data on nearly all of the 3,100-plus counties in the U.S. and it was unusual for a county to rank poorly in current health and highly in indicators of future health — as Lake County did.
“It’s pretty unusual,” Willems Van Dijk said. “If you find health factors as low, you get low outcomes.” She said there could simply be a time delay between the measures the county now has in place and the results. She said it would be much worse to be in a situation like Yuma County in Arizona, which scored well in “Health Outcomes” but is doing poorly in health factors.
She also said the small sampling pool in lake County, which has just 10,600 residents, is also a problem. Often, she said, statewide averages are used to describe the county.
“You’re not getting as clear a snapshot as you get in larger populations,” Willems Van Dijk said.
County Commissioner Paul Bergman said he was shocked to hear about the bottom ranking but took comfort in the fact that Lake County finished much higher in the second part of the rankings.
Lake County Health and Human Services Director Dennis Henkel said he was surprised by the bottom ranking in “Health Outcomes.” But given an aging population in the county, he said, he was expecting a “bottom half” ranking.
While the mortality ranking within the “Health Outcomes” category is fairly straightforward — years are counted for every death under the age of 75 — there is room for interpretation in the morbidity numbers, Henkel said. Morbidity includes statistics for low birth rates and phone polling data asking people how they are feeling.
Henkel said Lake County has had a “number of multiple births,” meaning each twin or triplet is naturally lower in birth weight.
He also said the polling for the questions on how people were feeling physically or mentally was done in the afternoon on landline phones. “Younger people have cell phones,” Henkel said. “I think they ended up with a lot of reports from the elderly.”
The median age in Lake County at the time of the 2000 Census was 42.9, compared to 34.4 statewide.
Even on the good news side, Henkel said there are statistics that might not give the “whole picture.”
Under “Health Factors,” the tally for the number of liquor stores per capita included resorts and other places with alcohol sales. “This is a tourism area,” Henkel said, meaning there is a higher proportion of such places to serve non-residents.
Access to healthful food is also a factor, and counties like Lake, with its geographic area stretching from near Ely to Two Harbors, can get skewed numbers when it comes to access.
“But there are a lot of good things to say,” Henkel said of the rankings. He said it’s a good way to get a discussion going on health care in the county.
One of the priorities in Henkel’s department is to continue doing work with the Statewide Health Improvement Program, which includes finding ways to make cities in the county more friendly to people seeking exercise and offering healthful food options in schools. Henkel said he is also finding a good response to the county program that brings nurses to homes of those who are expecting a baby or have a newborn at home.
He said the rankings could spur residents to seek more information on becoming healthier. “We have the resources,” he said. “We just need to make more people aware of them.”
Willems Van Dijk would agree, saying Wednesday that residents can take a “high resolution” view by coming together and discussing what’s working and what isn’t in the community. “This isn’t a blaming exercise of beating up on counties,” she said. “Minnesota has strong local health department and we want to help,” she said. This report can help create a sense of urgency.”
The County Health rankings released Wednesday ranks Minnesota counties according to their summary measures of Health Outcomes and Health Factors, as well as the components used to create each summary measure. Counties receive a rank for each population health component; those having high ranks are estimated to be the “healthiest.”
Health Outcomes Rankings
The summary health outcomes ranking is based on measures of mortality and morbidity. Each county’s ranks for mortality and morbidity are displayed here. The mortality rank, representing length of life, is based on a measure of premature death: the years of potential life lost prior to age 75. The morbidity rank is based on measures that represent health-related quality of life and birth outcomes. We combine four morbidity measures: self-reported fair or poor health, poor physical health days, poor mental health days, and the percent of low birth weights.
Lake County was No. 80 in Mortality and 81 in Morbidity, putting it last in the state for Health Outcomes among the 85 Minnesota counties that were part of the rankings.
Health Factors Rankings
The summary health factors ranking is based on four factors: health behaviors, clinical care, social and economic, and physical environment factors. In turn, each of these factors is based on several measures. Health behaviors include measures of smoking, diet and exercise, alcohol use, and risky sex behavior. Clinical care includes measures of access to care and quality of care. Social and economic factors include measures of education, employment, income, family and social support, and community safety. The physical environment includes measures of environmental quality and the built environment.
Lake County was 30th in Health Behaviors, 28th in Clinical Care, 23rd in Social and Economic Factors, and 26th in Physical Environment. Combined, that put the county at a rank of 16th among the 85 Minnesota counties.
Look it up
- An interactive presentation of the County Health Rankings for the state and nation can be found at www.countyhealth