Nobles County healthiest in region?
WORTHINGTON -- Nobles County may have the highest rate of teen births and the largest percentage of children in poverty among its neighbors in southwest Minnesota, but a recent ranking of overall health among counties across the state shows residents here fare better than others when it comes to healthy living.
The study, conducted by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, looked at how education, income and the environment impact lives and how long people live. Nearly every county across the U.S. was evaluated and given a ranking.
Nobles County ranked ninth among Minnesota's 87 counties in the 2013 study, a dramatic improvement from just a year ago, when it was ranked 44. Meanwhile, neighboring counties all ranked in the bottom half, with Jackson at 51, Murray at 52, Rock at 70, Pipestone at 75 and Cottonwood at 78.
Pat Stewart, public health administrator for Cottonwood-Jackson Community Health and now interim CHS administrator for Nobles County, said health professionals may put more stock into the rankings than they should. Public health agencies in this state work with the Minnesota Department of Health on their own measurements.
"They really are not in favor of this kind of release and ranking," Stewart said of the Wisconsin study. In reference to the improvements for Nobles County alone, she said the changes, public health-wise, have not been that significant.
A likely reason for the dramatic difference in ranking from 2012 to 2013 is because some questions were changed and others were removed entirely from the study.
In previous years, Stewart said health agencies were asked how many liquor stores were located in the county. That question has a definitive answer. This year, however, some of the questions asked people to identify the number of poor physical health days and poor mental health days.
"That's a very opinionated type of response versus something that is a very concrete measurement," Stewart said.
Those types of questions may also explain why Jackson County, which had been in the Top 10 ranking in each of the last three years, dropped to 51st in 2013. Rock County dropped from 36th to 70th in the four-year period; while Murray County improved from 79th place in 2010 to 52nd in 2013. Pipestone and Cottonwood counties received fairly similar rankings in each of the past four years.
Stewart questions the parameters of the study and how the results were figured.
"How in the world, with Nobles County having the number of immigrants and refugees and minority populations, can they rank that high?" she questioned. "It's a mystery."
Unlike the Wisconsin study, Stewart said the studies conducted by MDH are more useful in that counties know what is being measured, and MDH explains the outcomes of its studies. Still, some say the data is helpful.
Carol Biren, public health division director for Southwest Health and Human Services (SWHHS), said it's always good to know where counties rank in the state in terms of health factors and behaviors. Their agency has done a lot of work in recent years to reduce tobacco usage and improve healthy eating habits through promotion of farmer's markets and the Farm-to-School program.
"There's always room for improvement," Biren said, adding that the study's results help show people in public health where they should focus their efforts.
"Are we getting all of the immunizations we could be? Are we doing enough with obesity? Do we need to focus on getting healthier options in our community?" she questioned. "It's always a way to look at where we can make improvement."
Those are the kinds of questions the University of Wisconsin Population Health Institute (UWPHI) and the Robert Wood Johnson Foundation had hoped to generate in communities.
Angela Russell, associate researcher with the UWPHI, said the study is viewed as a "call to action."
"We know that we can be healthier. We want to help community leaders ... from the ground up, improve health," she said. "We can do better than this, and we will do better than this."
The study examined 25 factors that influence health, from rates of childhood poverty, smoking and obesity to teen birth rates, access to physicians and dentists, rates of high school graduation and access to healthy foods.
Russell said all of the data used in the study is collected from national organizations, including the Centers for Disease Control, the Federal Bureau of Investigations and the American Community Survey. Each portion of the study is based on data provided, and the information isn't necessarily based on 2012 numbers.
"I think it's really important for communities to take the rankings as a starting point and then look at where there are opportunities for improvement," Russell suggested.
Compared to the national average, Nobles County suffered fewer premature deaths, had a lower rate of poor or fair health and had a greater percentage of people screened for diabetes and breast cancer. Obesity (a body mass of 30 or greater) and the number of adults ages 20 and older with physical inactivity ranked worse in Nobles County than the national average, and the percentage of fast-food restaurants for the county's population was significantly higher than the national average.
One of the more alarming statistics presented in the data pertained to drinking water. In Pipestone County, 64 percent of the population was exposed to water exceeding a violation limit during the past year. All five other southwest Minnesota counties had a range of 0 percent to 3 percent.
Rock County was shown to have the highest rate of violent crime of the six-county area at .007 percent (724 per 100,000 population). The statewide average is 248 per 100,000 population, while the national average is 66 per 100,000 population.
All six counties had a greater number of crash deaths per 100,000 population than the statewide average; and each also has a greater ratio of patients to primary care physicians and dentists than the statewide average.
Carver County ranked as the healthiest county in Minnesota, followed by Steele, Waseca, Dodge and Scott. The state's bottom five healthiest counties, in descending order, are Lake, Traverse, Mille Lacs, Mahnomen and Cass.