By Ivan Raconteur
McLEOD, CARVER, AND WRIGHT COUNTIES Local counties fared well in a report released Wednesday ranking the health of every county in the state.
McLeod County was ranked second-healthiest in the state, and Carver County was fifth. Wright County came in at number 23 of the 85 Minnesota coutnies that were ranked for this report (Cook County in extreme northeastern Minnesota, and Traverse County along the states’s western border were not ranked).
The Minnesota report was among reports for all 50 states published by the University of Wisconsin Public Health Institute and the Robert Wood Johnson Foundation.
The reports illustrate how factors such as individual health behaviors, in addition to education, jobs, income, and the environment, affect how healthy people are and how long they live.
Counties are ranked in two categories: health outcomes and health factors (also known as health determinants).
In the health outcomes category, McLeod County was significantly below the state average of 5,272, with 4,566 people per 100,000 dying before age 75.
Carver County was even lower in the premature death category with 3,784, and Wright County was higher with 4,922.
For comparison, the number jumped to 8,636 in Cass County, which was ranked the least-healthiest in the state.
The state average for adults reporting poor or fair health is 11 percent.
In McLeod County, the figure is 7 percent. Carver and Wright counties were also below the state average, with 8 percent and 10 percent, respectively.
Another healthy outcomes category is low birth weight, which tracks the percentage of live births with a birth weight of less than 2,500 grams.
The state average is 6.5 percent. McLeod came in at 4.9 percent, while both Carver and Wright were at 5.6 percent.
Among the health outcomes categories, the state average for adult smokers is 19 percent. McLeod and Carver were below the state average, and equal to the national average, of 15 percent. Wright County came in above the state average, at 21 percent.
Cass County reported 22 percent.
The state average for excessive drinking is 20 percent (compared to the national benchmark of 8 percent).
McLeod is at 16 percent, Carver is at 20 percent, and Wright is at 23 percent.
Another category is adult obesity, which was defined as adults having a body mass index greater than 30.
The state average is 26 percent. McLeod County was slightly higher at 28 percent. The average for Carver County is 27 percent, and the average for Wright County is 26 percent.
McLeod and Wright counties were both higher than the state average for motor vehicle crash deaths of 13 per 100,000 population, at 16. Carver County had fewer motor vehicle deaths, with 10 per 100,000 population.
Cass County had significantly more vehicle deaths at 29 per 100,000 population.
McLeod and Wright counties tied the state average of 11 percent of adults under age 65 who do not have health insurance.
Carver County has 9 percent uninsured, while 15 percent of Cass County adults are uninsured.
The report also considered unemployment rates. The state average was 8 percent. McLeod was 9.8 percent, Wright was 9.2 percent, Carver was 7.5 percent, and Cass had an unemployment rate of 10.8 percent.
A category that showed a wide gap between the healthiest and least-healthy counties was children in poverty.
The state average is 11 percent.
McLeod, Wright, and Carver counties were all below that at 8 percent, 6 percent, and 5 percent, respectively, but Cass County had more than double the state average, at 23 percent.
The state average for the teen birth rate (defined as the birth rate per 1,000 female population ages 15-19) was 28.
McLeod County was higher, at 35; Carver County was half the state average at 14; and Wright County was at 23. In Cass County, the number jumped to 53.
Sexually-transmitted infections (chlamydia rate per 100,000 population) were also higher in Cass County, at 191, compared to 145 for McLeod, 107 for Carver, and 142 for Wright, but all of these counties were well below the state average of 276.
How do counties improve public health?
Kathy Nowak, McLeod County’s agency coordinator for public health, said the key to success in her county has been collaboration with a lot of partners in the communities across the county.
Her department works with schools, law enforcement agencies, other county departments, and other diverse public and private groups.
The county secured a tobacco-free communities grant, and worked with youth groups and cities to establish tobacco-free city parks.
Initiatives such as Take it to the Box (safe disposal of prescription drugs), Zero Adult Providers (reduce youth access to alcohol), and Toward Zero Deaths (improve highway safety), are examples of groups working together to improve community health.
One of the areas that Nowak is most happy about is the physical environment.
“We were eighth this year, and we were 30th last year,” Nowak said.
Part of this success came from making people aware of options that are available for recreation, which contributes to a more healthy lifestyle.
The county secured a Statewide Health Improvement Program (SHIP) grant to install new signs in all county parks to encourage people to be more physically active.
The county has also worked on creating maps for cities and countywide to show the location of trails.
Another area of improvement is clinical care, which includes categories such as uninsured adults, ratio of population to primary care providers, preventable hospital stays, diabetic screening, and mammography screening.
“We were number 43 last year, and we were 20 this year,” Nowak said.
One area of concern for Nowak is the percentage of adults who reported they felt there is inadequate social/emotional support in the county.
McLeod County was listed at 18 percent in this category, which is higher than the state average of 14 percent.
She said this may be based, in part, on peoples’ perception, and she hopes to improve this by continuing to work with community partners to get the word out and make people aware of the choices that are available to them.
Despite the fact that she is happy with the success the county has had in improving health, and with being ranked the second-healthiest county in the state, there are still areas in which Nowak said the county needs to improve.
All are in the area of health behaviors.
These include adult obesity and smoking, which contribute to chronic health problems; and the teen birth rate, which did not improve from last year’s report.
Nowak said the county completes a community assessment every five years, and had already identified teen birth rate as an area that needs improvement.
Nowak said the key to success is working together with other groups.
“We are drawing on people who already have expertise in different areas, which allows us to be as efficient and effective as we can,” Nowak said.
The focus of community health is on prevention.
In addition to making people aware of where to get healthy foods and access to recreation, Nowak said there has been increasing focus on things such as community gardens and healthy nutrition in schools.
There is also an increasing focus on worksite wellness.
Nowak said by investing money on the front end and promoting prevention and healthy lifestyles, it reduces the cost of treating chronic health problems later.
This was echoed by the state health commissioner.
“The rankings not only shine a light on the health of individual counties; they also demonstrate the need to include prevention in our health reform efforts,” said Dr. Edward Ehlinger, Minnesota Commissioner of Health.
“Our local health departments already do an excellent job measuring the health of their populations, to help them understand what they do well and where they can improve,” Ehlinger said. “This is one reason why Minnesota consistently ranks as one of the healthiest states in the nation.”
Who is healthy and who is not?
The state’s healthiest counties are:
1) Lac qui Parle
The state’s least healthy counties are:
78) Yellow Medicine
Note: Cook County (northest) and Traverse County (west) were not ranked for this study.
The full report is available at: www.countyhealthrankings.org/minnesota.