The Robert Wood Johnson Foundation and the University of Wisconsin have put together a web site which compares the health status of counties within states. Originally done by the University of Wisconsin for Wisconsinites, last year they expanded it to all (well, all but 115) counties in the United States. The local paper dutifully published an article, identifying Mobile County as a low performing county (#46, down from #43 last year) and the neighboring county of Baldwin as a high performing county (#3). The next day, the paper decided to get serious, publishing an editorial identifying what was measured

Social factors and health habits are taken into account in the health rankings, including obesity, smoking, high school graduation rates, air pollution, access to health care, access to exercise and life expectancy.

and pointed out that perhaps building a walking trail would solve all of our problems

From a health standpoint, trails offer cheap and easy opportunities for exercise. Families can walk together; those beginning an exercise program can try a one- or two-mile stretch of trail and improve.

In reality, being third in the 45th ranked state is nothing to brag about. Anyone who knows anything about who lives in cities as opposed to who lives in suburbs likely can make an educated guess as to why Baldwin (suburbs) has better health statistics than Mobile (city) and it has little to do with a 2 mile walking trail.

A more interesting comparison tool, found here, compares counties against others of similar demographics and economics. In this comparison Mobile County still doesn’t fare very well (average life expectancy 73.6 years, peers 73.5-77.8 years, every marker worse than peers except immunization rates and prenatal care access) but Baldwin is no great shakes either (average life expectancy 76.6 years, peers 75.5-78.2 years, worse than peers except in breast cancer survival, infant mortality, and suicide rates).

The purpose of the rankings is not, or so says the University of Wisconsin, to facilitate boosterism but in the hopes that communities will use this information to work towards improving the health of the citizens. I hope that the local paper (as well as the media outlet of any communities whose “rankings” were not what they would like) will look at this page where action steps are discussed. These action steps include working together as a community, finding programs and policies that work, implementing strategies, assessing needs and resources, evaluating efforts, and picking priorities. Additionally, they have targeted advice for community leaders, educators, health professionals, and government officials, and public health officials.

Here is the advice for the community leaders, in case anyone from the local paper is paying attention

  • Get the word out. Reach out to people you know and see every day about the County Health Rankings report, e.g., at a local Chamber of Commerce breakfast or at an urban planning meeting. Post information about the report on a listserv, website, or e-newsletter.
  • Organize. Meet with local leaders and community residents to discuss barriers to health and ways to overcome them. Host a town hall meeting or invite people to one.
  • Get policymakers to pay attention. Tell them about how their county or counties ranked and open a dialogue about ways to improve health in your community.
  • Be an advocate. Step out as a spokesperson about the rankings and the health issues you care about and rally other community leaders to take action.
  • Contact your local public health department about participating in a local task force or, if none exists, organize one to tackle these pressing issues in your community.
  • Ask your local or state health department about what they’re doing in response to the report to make sure you aren’t duplicating efforts.
  • Share your resources. Offer your time, staff, and/or funding with community partners. These are resources that can go toward community plans and programs aimed at tackling factors that affect health.
  • Communicate your message. Write an op-ed or talk to local media about the rankings and what needs to be done to improve the health of your community.
  • Start a conversation. Talk to your friends, colleagues, neighbors, and family members about the health of your community and what everyone collectively can do to make it healthier.

Now that the word is out in Mobile, I hope we’re able to make the rest happen here.