Chattanooga Times Free Press

Health can be affected by where you live

- BY ELIZABETH FITE STAFF WRITER

Where people live can affect their quality and longevity of life, and health is influenced by many factors beyond medical care, including social, economic and environmen­tal conditions, according to a new report that ranks counties across the country.

In Tennessee, Williamson, Wilson and Rutherford counties outside Nashville rank as the healthiest in the state, according to the ninth annual County Health Rankings. Grundy and Meigs counties in Southeast Tennessee and Lake County in the northwest corner of the state are Tennessee’s least healthy counties.

Those counties are 100 percent rural, have no listed primary care physicians and face myriad other challenges. People living in Grundy, Meigs and Lake counties are on average 2.4 times more likely to die before age 75 than people from the top three counties.

Hamilton County moved up from 25th last year to 13th out of the state’s 95 counties, showing strength in length of life, medical care and some health behaviors, such as teen birth rate, adult smoking rate and rate of alcohol-impaired driving deaths below the state average.

The county is among the best in the nation in its access to exercise opportunit­ies and ratio of population to primary care physicians. For every 910 residents in Hamilton County, there is one primary care physician, compared to the state’s overall ratio of 1,380 to 1.

The rankings were released today by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute and provide a detailed analysis of the nation’s health outcomes.

In Georgia, the healthiest county is Forsyth, situated northeast of Atlanta, and the least healthy is Quitman County along the southwest border

with Alabama. Shelby County outside Birmingham is Alabama’s healthiest county, while Wilcox to the southwest is the state’s least healthy county.

“The County Health Rankings are not only an excellent way of seeing where each of our home counties are today, they also provide an opportunit­y to follow our progress over time,” said Dr. Randy Wykoff, public health dean at East Tennessee State University and Tennessee Institute of Public Health board member.

“For those counties not ranked near the top, my advice is to bring together a cross-section of community leaders to identify what your greatest health challenges are and start a process to address those challenges.”

Although it ranks lower than top counties in the United States, Hamilton County shows trends toward improving its rates of sexually transmitte­d infections, uninsured, preventabl­e hospital stays, high school graduation, violent crime and pollution.

The adult obesity rate — 31 percent — and child poverty rate — 19 percent — in Hamilton County worsened, but are better than the state’s rates. They are, however, well below the nation’s healthiest counties, which have about 26 percent adult obesity and 12 percent children in poverty.

The new report highlights that health disparitie­s exist not only by place, but also by race and ethnicity.

For example, Hamilton County’s teen birth rate of 30 births per 1,000 females age 15-19 is below Tennessee’s rate of 36 births. Yet, the teen birth rate is 22 for whites, 45 for blacks and 59 for Hispanics. Teen mothers are less likely to finish school and face other economic challenges that can create a cycle of disadvanta­ge for their children.

Low birth weight, an important predictor of lifelong conditions and early death, affects 17 percent of black babies in Hamilton County compared to 8 percent of white newborns, and black infants in Hamilton County are more than twice as likely to die compared to white infants.

When it comes to poverty, which limits opportunit­y and increases the chance of poor health, 10 percent of white children in the county live in poverty compared to 43 percent of black children. Children in poverty are less likely to have access to quality education, another key health indicator, and have less chance of attaining quality jobs.

Dr. Richard Besser, Robert Wood Johnson Foundation president and CEO, said in a statement that communitie­s should look at the data difference­s to form a more complete understand­ing of their health and create policies that foster greater health equity, meaning everyone has a fair shot to be as healthy as possible.

“We can’t be a healthy, thriving nation if we continue to leave entire communitie­s and population­s behind,” he said. “Every community should use their County Health Rankings data, work together, and find solutions so that all babies, kids and adults — regardless of their race or ethnicity — have the same opportunit­ies to be healthy.”

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