New county rankings reveal health of local communities

A newly released annual county health ranking highlights systemic inequities that have influenced the health of Miami Valley residents long before COVID-19.

The annual health rankings from the Robert Wood Johnson Foundation and University of Wisconsin researchers rank each of Ohio’s 88 counties based on health outcomes. They also detail more than 30 clinical and social factors that impact residents’ health.

While each Ohio county receives a rank 1 through 88, the researchers who created the rankings encourage people to look at which quartile each county is grouped in and to focus on the data underlying the ranks, and not the rankings themselves.

Locally, Montgomery and Clark counties were among the lowest group of counties for health outcomes. Greene, Miami and Warren were among the highest.

“These gaps in opportunity have to be addressed if we want a fair, inclusive and equitable recovery from the pandemic,” researchers said of the latest rankings.

Montgomery County’s ranking looks at the most recent health data available for like factors such as adult obesity (36%), low birthweight babies (9%), and flu vaccination rates (49%). But the rankings also consider a range of social factors that drive health like high school completion (90%), households with severe housing problems (15%), and children living in poverty (23%).

Marietta Orlowski, chair of the Department of Population and Public Health Sciences at Wright State University, said it is important to measure social drivers of health because they are important root causes of health outcomes and because things that get measured tend to also get resources.

For example, people can learn at the doctor’s office how to properly manage their asthma.

“But if they’re living in an environment with poor air quality and mold, doing a behavior oriented intervention isn’t going to change that health outcome. It’s the housing environment that needs to change,” Orlowski said.

While the 2021 Rankings do not measure COVID-19 cases or deaths, researchers wrote their data are helpful in providing the context for the systemic inequities that have influenced the health of communities long before COVID-19. They anticipate that COVID-19′s impact will begin to be reflected in the 2022 County Health Rankings.

The researchers also pair the data at with lists of evidence-based strategies that can improve health outcomes around specific topics, including COVID-19, community safety and violence prevention, and climate change.

Orlowski said in public health, people have made significant progress in some behavior oriented interventions on issues like tobacco use and HIV infection “but in portions of our community they’ve not made equal gains and it’s because of these root causes of social and economic resources.”

She said solutions will need to purposeful and require policy interventions and significant outreach.

Orlowski said a great example of this is Public Health - Dayton & Montgomery County working to make COVID-19 vaccine distribution equitable, including setting aside 25% of their vaccine supply for minority patients and complementing that with outreach.

“Those are going to be some of the solutions that we have to look for, to address some of these social levers or social drivers of health,” she said.

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