Residents of Washington County smoke more, weigh more and are less active than their peers across the state.
According to the County Health Ranking and Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Washington County ranks in the bottom third of the state in terms of overall health.
The rankings measure the overall health of every county in the country based on a number of factors that affect health such as a person’s social and economic conditions, environment, health behaviors and access to clinical care.
Of the 62 counties in New York, Washington County is ranked 42, behind Saratoga (5), Warren (12), Essex (16) and Rensselaer (41): the closest counties in terms of geography.
This is the fourth year the rankings have been compiled and Washington County fared only slightly better this year than it has in previous years. The county was ranked 44 in 2010 and 2012 and 45 in 2011.
Counties are ranked based on how they fare in two areas: “Health Outcomes,” which is a picture of a county’s current health and includes things such as mortality, and “Health Factors,” which are things that contribute to the future health of a county, such as smoking and access to clinical care.
Based on the rankings, one impediment to good health in Washington County is access to clinical care.
The ratio of physicians and dentists to the overall population is much lower in Washington County than it is around the state and researchers found that residents living in healthier counties are 1.4 times more likely to have access to a doctor and dentist than those in the least health counties
According to the data, there is one physician for every 2,700 residents and one dentist for every 4,100 residents. Compare that to the state average where there is a physician for every 1,200 residents and a dentist for every 1,400 residents. There also isn’t much access to mental health providers, with one for every 10,500 residents.
Interestingly, the percentage of uninsured county residents (13 percent) is on par with the state average (14 percent), but Patricia Hunt, director of Washington County Public Health and Patient Services, said local residents in some instances are using that insurance less.
“There’s a low utilization rate, especially in terms of preventable screenings,” she said, pointing to factors like transportation to and from doctor’s offices as to perhaps one reason why.
But access to care may not be the biggest factor influencing health in the county, according to Angela Russell, who worked on the rankings for the University of Wisconsin Population Health Institute.
“We know that access to healthcare is important, but a lot of what influences health happens outside the doctor’s office.”
The most significant impediment to county residents’ health is themselves.
Washington County ranks 56th in health behaviors, which measures actions people take that affect their health.
For instance, the rate of smoking among county residents (28 percent) is 10 percent higher than the state average. The rate of obesity (29 percent) is also higher than the state average (25 percent), which can at least partially be attributed to the fact that local residents are more likely to be physically inactive (31 percent in the county compared to a state average of 25 percent). The rate of teenage pregnancies and death from automobile accidents are also higher.
Some of those numbers are likely even higher because the data is self-reported and people tend to under-report their behaviors, Hunt said.
Russell said the counties where people don’t live as long and don’t feel as well mentally or physically have the highest rates of smoking, teen births, and physical inactivity, as well as more preventable hospital stays.
So why are county residents more likely to engage in these activities?
According to both Hunt and Russell, the answer may very well have to do with education.
“The factor that seems to be most influential to a community’s health is education. The more educated a community, the healthier it seems to be,” Russell says.
Hunt points out that while the rate of Washington County residents graduating high school is a tick above the state average (78 percent compared to 77 percent), the percentage that completed at least some college is significantly less.
Only 45 percent of county residents have attended college, well below the state average of 64 percent.
The physical environs of Washington County may also be a limiting factor to health.
The percentage of residents exposed to drinking water that exceeded a violation limit in the last year is more than five times the state average (22 percent compared to 4 percent). The population of low-income county residents who do not live close to a grocery story is also twice the state average (4 percent compared to 2 percent) and there are fewer parks and recreational facilities.
Russell said they are supposed to serve as a call of action to improve health.
“The key is collaboration. In takes educators, public health professionals, elected officials and business leaders working together to a make a healthy community,” she said.
Hunt made the analogy to a village.
“It takes a whole group working together to make an impact,” she said.
She says the county has used the data from past rankings to implement strategies aimed at improving health.
The county for instance has partnered with Stewart’s to get a greater variety of healthy foods in communities that don’t have grocery stores; have two health educators who visit local schools to discuss the importance healthy eating and being active; and have an annual meeting with school nurses to discuss health concerns they may be encountering in their districts.
“The rankings show that health isn’t affected by a single factor. Health is affected by employment, education, access to care and healthy food and places to recreate,” Hunt said.
“We didn’t fare well but I think there are lots of areas for improvement.”