Crawford County’s health rankings, compared to other Wisconsin counties, are trending in opposite directions, according to a recent report released by an education and public policy institute located in Madison.
The County Health Rankings & Roadmaps report, released by the University of Wisconsin Population Health Institute with funding from the Robert Wood Johnson Foundation, show Crawford County falling behind most of the other 72 Wisconsin counties in health outcomes and health factors. The county currently ranks 50th in health factors that include behaviors like tobacco and alchohol use, clinical care factors including access to doctors, social and economic factors such as unemployment and environmental factors such as access to clean water. In the first report, released in 2010, the county ranked 24th.
Health behaviors including diet and exercise, sexual activity, and alcohol and tobacco use have a strong impact on the rankings and also slid significantly. Ranked 19th in 2010, the county has fallen to a rank of 36th.
Geraldine Smith, a Gays Mills Village Board Trustee, expressed some shock and concern over some of the findings in the report. Smith, who has been a health advocate from her seat on the board, said the rise in obesity and smoking were particularly concerning to her. “I’m disappointed that people are not awake,” she said. “What are they teaching their children? They aren’t teaching them to cook from scratch.”
The report also contained some good news. Crawford County improved its overall health outcomes ranking from 51st in 2011, to 44th in 2012, to 39th in 2013. The health outcomes ranking is a measure of length of life and quality of life. For example, the number of poor mental or physical health days reported per month by local citizens dropped between 2010 and 2013.
Angela Russell, associate researcher and community engagement lead, pointed out that it’s important for community and government leaders to dig down into the report.
“We really want this to be a call to action for officials,” Russell said. The main purpose of the report, Russell added, is to give a wide range of public and private community leaders the ability to find opportunities to improve public health.
Gloria Wall, Director of Public Health for Crawford County, said this is exactly how county officials are using the rankings and accompanying data.
“The thing that concerns me most is the motor vehicle accidents,” Wall said.
The county ranking is 31st and that is down from 24th in 2010. Wall says it is also much higher than the national benchmark.
Spurred by this and other issues, Wall said Crawford and Grant counties decided to partner in developing a plan to deal with some of the issues brought to light by the institute’s yearly reports.
At their first meeting, officials decided to focus on three issues where they felt confident they could make a difference, said Wall. One will be improving nutrition in the community. Another will be driving down the number of car and ATV accidents, while the third will be development of a holistic approach so that the community maintains citizen health instead of simply treating illness.
Wall cautioned that the group is just getting started, but said she is hopeful that a strategic plan will emerge.
“We hope to do this as a system, so that we have a three to five-year view,” Wall explained.
Since the rankings are only four years old, Russell said the institute is just beginning to develop ways to assess the impact of the rankings. But they know they are having an effect because of actions like the ones Wall described. On their website, the institute lists stories from across the nation and here in Wisconsin. Officials in lowest-ranked Menominee County, for example, didn’t like what they saw in the rankings. The tribal administration organized all its many programs to focus on reducing childhood obesity and brought a grocery store back to their community.
Nutrition and access to healthy food seems to rise to the surface repeatedly because of the rankings. Smith said she believes that officials have a responsibility to provide healthful food choices.
“When we hired a swimming pool manager, I said, ‘no candy,’ your supplies should be from the health food store. If a kid wants to bring junk from home, that’s their choice,” she said.
Russell also said that just because the county rankings have fallen does not mean that local citizens are less healthy then they were when the institute began issuing the report ten years ago.
“Rank is dependent on what happens in other counties,” she said. She pointed out that other counties may have improved their overall health factors more than Crawford County.
Despite that caution, the status of the top and bottom rankings have not changed significantly over the years. Suburban Ozaukee County remains first in most rankings and rural Menominee County ranks at the bottom this year.
According to Wall, rankings from neighboring counties puts the Crawford County numbers in some perspective. Aside from health behaviors, one of the things that have brought down the rankings are social and economic factors like unemployment, according to Wall. Unemployment in Crawford County at 8.1 percent, at the time of the report’s release, was above the state average of 7.5 percent.
While neighboring Grant County (ranked 11th) and Vernon County (ranked 9th) have a much higher ranking for Health Outcomes in the report, Crawford County still maintains strength in some areas. The high school graduation rate remains higher than some surrounding counties, while the obesity rate is slightly lower.
The institute has been ranking counties since 2003, though rankings only are available since 2010 online. Many of the statistics that go into the health behavior rankings come from the Centers for Disease Control. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing telephone survey that gathers information from across the country. Health care quality measurements are sourced through the Dartmouth Atlas of Health Care.