We say this every year after the annual County Health Rankings report is issued: While these rankings can be interesting (and even useful), they need to be taken with a grain of salt — maybe two.
But not too much salt: That can be bad for your blood pressure.
The rankings, which are compiled annually by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, do offer a vivid illustration of how our understanding of public health, and the factors that influence public health, have expanded over the years.
But that's the kind of nuance that tends to get lost in the overall headlines: Benton County ranks No. 2 in terms of health outcomes among the state's 36 counties, which is no surprise, since the county traditionally has landed near or at the top of this list since the county rankings began. (And, in some ways, all this tells you is that Benton County has relatively high income and education levels.)
Linn County continues a slow but steady move up the list, landing in the most recent rankings at No. 18, up from No. 20 in 2018.
These county rankings blend together a variety of statistics to attempt to generate a broader picture of a county's overall health.
So, for example, the rankings take into account factors such as low-birthweight babies, the number of adults who smoke, the amount of obesity in a county and the number of sexually transmitted diseases.
But they also include information about other areas that doesn't seem to have a direct connection to community health — until you think about it.
For example, both Linn and Benton counties are experiencing issues with a shortage of adequate and affordable housing: In Benton County, 22 percent of households are experiencing severe housing problems, defined as overcrowding, high housing costs or lack of kitchen and plumbing facilities. The number in Linn County is 19 percent, which is better than the state average but still higher than the national average, 18 percent.
At first glance, you might wonder how housing ties into public health. But give it a moment's thought: For starters, a family that's spending more than half of its income on housing costs has much less to spend on health care.
No one is suggesting that county health officials should add to their busy to-do lists the task of developing affordable housing. But there's no doubt that there's a connection between adequate housing and health.
In some of the more traditional health measurements, Linn County still lags behind state averages: For example, 35 percent of county residents report a body mass index greater than 30, a common metric for obesity, as opposed to a state average of 28 percent. The county also is ahead of the state average in teen births.
Benton County has issues as well: The number of sexually transmitted diseases (the number of newly diagnosed chlamydia cases per 100,000 population) is substantially over the state average. And the number of people in the county who report excessive drinking also is higher than the state average. Both of those numbers could be driven by the presence of Oregon State University students — but they also suggest areas for local health officials to attack.
Both counties ranked well for clinical care, with Benton coming in at No. 1 and Linn ranking No. 7. A key metric there, the percentage of uninsured people, has dropped in Linn County from 20 percent in 2008 to 7 percent in 2016. The number in Benton County has dropped from 15 to 7 percent in the same time frame.
So the health rankings help illuminate areas where we're doing relatively well — and areas where we could do better. But the overall message is a useful reminder about the multitude of factors that combine to shape the overall health of a community. (mm)