Every county has strengths and areas that could use improvement, according to people who worked on the report, and the rankings are meant to draw attention to the multiple factors that shape a community’s health.
“No matter where you live, there is still work to be done to create conditions so that everyone in the community thrives,” said Amanda Gatewood, a scientist with County Health Rankings & Roadmaps.
Local public officials say a lot of work is being done to try to address health disparities between communities and combat the root causes of risky and unhealthy behaviors that can lead to chronic medical conditions, poor quality of life and early death.
“In many ways your health has more to do with your zip code than your genetic code,” said Dr. Michael Dohn, medical director of Public Health – Dayton & Montgomery County. “Where people live, work, learn and play is a major determinant of an individual’s health status.”
Credit: Jim Noelker
Credit: Jim Noelker
Ohio has 88 counties, and Warren County ranked sixth in the state for health outcomes and second for health factors, according to the County Health Rankings data.
Delaware County, an affluent county north of Columbus, was the healthiest county in the state, while Scioto County, a small rural county in Appalachia, was the least healthy, the report states.
Health outcome rankings are based on data about premature deaths and the percentage of babies born with low birthweights, as well as the share of residents with poor or fair health and the amount of time they recently had poor physical or mental health.
Health factors rankings were determined using a wide range of metrics about drug, alcohol and tobacco use, diet and exercise, access to health care, quality of care, level of education, employment, income, air quality, housing, crime levels and other conditions and behaviors.
Health officials respond
The annual rankings provide a revealing snapshot of how health is influenced by where people live, learn, work, and the local-level data makes it clear that good health is influenced by many factors beyond medical care, such as housing, education, and jobs, said the Warren County Health District.
“The data illustrated by the rankings provides us with valuable information we can use to ensure our existing policies and programs align with the identified needs of our community,” the district said in a statement.
Warren County has a small share of children in single-parent households; a fairly low injury-death rate; good access to primary care physicians; and one of the smallest share of residents who report being only in fair or poor health.
Warren County has fewer adult smokers than every county but Delaware County, and it has one of the lowest adult obesity rates.
But Warren County had the sixth highest level of pollution in the state, based on particulate matter measurements.
Montgomery County fared well when it came to access to exercise opportunities, the availability of primary care physicians, flu vaccinations and high school and post-secondary education attainment, said Dan Suffoletto, a spokesman with Public Health - Dayton & Montgomery County.
But Suffoletto said it did not do well in measures like the number of people who smoke, the obesity rate, the share of uninsured residents, the unemployment rate and community safety, including violent crime and deaths due to injury.
Montgomery County had the second highest injury-death rate in the state.
In Montgomery County, 22% of residents smoke, 36% of adults are obese, 27% are physically inactive and nearly one-quarter of kids live in poverty (23%).
By comparison, 17% of Warren County residents smoke; 28% of its adults are obese; 21% are not physically active and just 5% of children live in poverty.
Warren County has seen explosive housing growth and has the third largest share of high-income earners in the state (only behind Delaware and Geauga counties), according to previous reporting by the Dayton Daily News.
Montgomery County trailed all of the the state’s other urban counties, except Clark County, in health outcome measures.
Public Health – Dayton & Montgomery County is working with community partners to take a collective approach to improving long-standing social conditions that lead to poor health, said Montgomery County Health Commissioner Jennifer Wentzel.
“As a health department we are uniquely positioned to facility community conversations with multiple partners to create lasting impacts in our community,” she said.
A community health assessment and improvement process has established workgroups, initiatives and goals focused on reducing overdose deaths, infant mortality, smoking rates and rates of chronic disease, as well as increasing physical activity and access to nutritious food and health care.
Individual community members can do their part by not smoking, eating well, regularly exercising and avoiding bad habits, like drug use and risky sexual behaviors, Wentzel said.
Other county’s rankings
Greene County ranked seventh in the state for health factors and 11th for health outcomes, and Miami County ranked 14th for health outcomes and 21st for health factors.
Greene County residents have higher incomes and education levels than their counterparts in most other Ohio counties, and they also have better access to good schools and quality food choices, said Donald Brannen, an epidemiologist with Greene County Public Health.
They also have good access to primary care physicians and one of the best access levels in the state to dental care, and only three other counties have lower adult smoking rates.
Preventive health measures like mammography screening and influenza vaccinations have helped keep Greene County one of the healthiest counties in Ohio, Brannen said, and local initiatives are helping increase access to fruits and vegetables and mental health and primary care services.
The county’s community health improvement plan identifies obesity, substance-use disorders and preventative health services as priority areas, he said, and a community health assessment will be conducted this fall.
Nate Bednar, director of community services for Miami County Public Health, said Miami County should be proud of its health rankings, which are in the top quarter of Ohio counties.
“Miami County is fortunate to have an abundance of high-quality service agencies, recreational and healthy lifestyle choice opportunities,” he said.
Compared to the rest of the state and most other local counties, Miami County has few babies born who are underweight and a small share of kids living with single parents,
However, Bednar said, there are still many challenges left to tackle, and one area in need of improvement is access to care.
Miami County has one primary care physician for every 2,043 residents; one dentist for every 2,140 residents; and one mental health provider for every 842 residents.
These are much higher provider-to-population ratios than the state as a whole and most local counties, except for Clark and Champaign.
The truth is not everybody has the same opportunities, and decisions about how to use resources in communities has enormous impacts on people’s health, said Gatewood, with County Health Rankings & Roadmaps.
“When we support communities with living-wage jobs, access to childcare, well-funded schools, safe and affordable housing, clean air, and green space so they can be outside — we know that these things are linked to good health,” she said.
Health rankings for local counties
Warren County: ranked #6 for health outcomes, #2 for health factors
Greene County: #11 for health outcomes, #7 for health factors
Miami County: #14 for health outcomes, #21 for health factors
Champaign County: #36 for health outcomes, #41 for health factors
Butler County: #47 for health outcomes, #27 for health factors
Montgomery County: #78 for health outcomes, #48 for health factors
Clark County: #79 for health outcomes; #66 for health factors
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