When we talk about the health of America, we often talk in broad strokes. We focus on big trends—say, in obesity or diabetes—not what's happening at a more local level.
That's unfortunate for two reasons. One, we might miss some of the variety of health out there—for example, that one county in a state is appreciably less healthy than another. And, two, we might overlook local factors that affect our health as much as federal or state policy, or even our own personal responsibility.
The idea of the County Health Rankings is to shine a light on the local, and show how where we live matters.
"There are things we can do as individuals in terms of our behavior, but then there is a lot more that communities can do to provide support to individuals to make healthy choices," says Bridget Catlin, codirector of the rankings. "Our frame goes beyond things like smoking and not eating too much and looks at the characteristics of the community more upstream, like income, employment, education, community support, and safety."
The rankings deliver a detailed snapshot of more than 3,000 counties (plus the District of Columbia), including measures of health (like the premature death rate) and factorspertaining to health (like unemployment). You can look up the health of your area, then have data to begin to understand what might be driving certain outcomes.
"We really encourage communities to take a look at what is going on right where they are, and then to look at the whole set of factors," Catlin says. "Then folks begin to find out [things] and share stories with other places. The rankings are all about showing where we live matters to our health."
About 60% of counties are getting healthier, measured by their rates of premature death (i.e. how many years people die before life expectancy). For example, the District of Columbia saw a 31% improvement in 2010-12 compared to 2004-6. But 40% of counties are going backwards, as you can see from one of the charts. Many of the counties with higher premature deaths seem to be in the third quarter of the country, running south from the Great Plains.
Now in their sixth year, the rankings are produced at the University of Wisconsin and supported by the Robert Wood Johnson Foundation. The latest edition includes new data for income inequality on the factors side.
Catlin hopes to encourage a wider-ranging conversation about health—one that's focused not only on health care, but also on the community. "Social and economic factors contribute in a big way to determining health. We want to bring all kinds of people to the table to talk about what makes a place healthy and where there are opportunities for improvement," she says.