The healthiest counties in America tend to be in urban and suburban areas, while the vast majority of the 50 unhealthiest counties are rural, according to the first nationwide, county-by-county survey of health status. Although the study, from the Robert Wood Johnson Foundation and the University of Wisconsin's Population Health Institute, covers more than 3,000 counties across the country, it isn't absolute.
For example, Philadelphia and Baltimore, home to some world-renowned medical institutions, trailed other areas in Pennsylvania and Maryland, respectively, in terms of overall healthiness. "This is a complicated story about what makes a community healthy and another not so healthy," report author Pat Remington, associate dean for public health at the University of Wisconsin, is quoted as saying in USA Today.
The report ranks each county by health outcomes--disease and mortality rates--and by health factors, which include obesity and smoking rates, as well as several socioeconomic factors. "The 'Health Outcomes' rank is about where they are now. The 'Health Factors' rank is about where they are going--predictors of health," explains James Marks, director of the Robert Wood Johnson Foundation's health group.
The University of Wisconsin participated because researchers there have been compiling reports for that state for six years. Counties that have lagged in statewide rankings have been spurred to take action. "It's been an exceptional tool to motivate my community," says Barbara Theis, health officer for Juneau County, Wis., which came in last among the state's 72 counties in 2006. "We've made some drastic changes," including opening a dental clinic late last year.