2015 County Health Rankings show early deaths trending down

Premature death rates are declining in 60 percent of U.S. counties, according to the 2015 County Health Rankings & Roadmaps, recently issued by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. This is the first year since the rankings began in 2010 that such data, for counties with populations of 65,000 or more, have been available. The data are based on changes since the 2010 rankings, which relied on the then-most-recent available data, 2004 2006. And this year's rankings use the comparable data for 2010 2012. "The way we measure premature deaths uses the years of potential life lost before the age of 75," said Julie Willems Van Dijk, Ph.D., co-director of the County Health Rankings & Roadmaps (CHR&R) program. In many of these deaths are preventable, those who die at an early age are weighted more heavily in the calculation. The 10 most-improved counties, or county equivalents, are Washington, D.C. (-31 percent), Madison County, Miss. (-27.9 percent), Pinal County, Ariz. (-26.4 percent), Martin County, Fla. (-23.3 percent), Albemarle County, Va. (-23.2 percent), Imperial County, Calif. (-22.9 percent), Baltimore City, Md. (-22.8 percent), Orleans Parish, La. (-22.4 percent), New York County, N.Y. (-22.2 percent) and Fulton County, Ga. (-21.7 percent). Still, that means 40 percent of counties are not making progress in reducing early deaths. CHR&R officials say premature death is the single most important component of its evaluation of health outcomes. For that reason, the measure is given the highest weight in its calculations. Also new this year is a measure of the wealth gap, or income inequality, between the poorest and most affluent residents of counties. For each county, it's expressed as a ratio: income at the 80th percentile level divided by income for the 20th percentile. For example, if the 80th percentile for household income in a county is $200,000 and the 20th percentile is $40,000, the income inequality ratio is 5. According to this year's Rankings and Roadmaps' data release, the median U.S. income inequality ratio for counties is 4.4. The "top performing" counties are the 10 percent with ratios of less than 3.7. The worst performing 10 percent have ratios of 5.4 or greater. Nationwide, income inequality ratios are highest in large metropolitan counties, and those located in the Southeast, Southwest, and parts of Appalachia and the Plains regions. "We've always had a measure of the childhood poverty level in the community," Van Dijk said, "but we've had people telling us continuously since we started the rankings that we need more measures that tell us about the differences in our county. "This is an economic factor, but it also has an impact on the social fabric of a community," she added. "Where there's a much larger divide, there's often a loss of feelings of social connectedness." This year's "key findings" from the rankings offer several strategies to reduce poverty and income inequality, they include: Investing in education to boost employment and career prospects by providing support for educational achievement from early childhood through adulthood Increasing public and private sector wages and enhancing benefits for low-income earners by offering living wages and paid sick leave, and Investing in workforce development to improve job skills and promoting labor market participation, fostering more and better career options. "People get frustrated because they think these are really tough, complex sometimes intractable issues and there's nothing we can do about it," Van Dijk said. "We're really asking people to think about a variety of strategies to really focus on reducing poverty." NACo County Health Learning Challenge Application

NACo, in collaboration with the County Health Rankings & Roadmaps (CHR&R) program, is selecting up to three counties to participate in a one-year challenge to identify and address critical barriers to creating a Culture of Health in their communities. CHR&R is a partnership between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The easy-to-complete application, due April 13, asks county teams to identify the areas they propose to focus on during the Challenge. The selected focus areas must link to the County Health Rankings model . All teams must include an elected official as the lead applicant.