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Health director: There is room for improvement

ALBANY -- While the data is a bit disturbing, officials in Southwest Georgia say they weren't all that surprised by what they saw.

While Southwest Georgia did not fare well in the ratings, experts say the overall health of the area can be improved if residents would eat better, have physical screenings and stop using tobacco products.

The County Health Rankings, the first set of reports to rate the overall health of the individual counties in all 50 states, were recently released by the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation at a briefing in Washington, D.C.

The overall goal was to allow the public to look at how healthy their county is, see what factors affect their health and compare their county to others within the state. They also serve as a way for public health and community leaders to measure the well-being of counties in every state in the nation so they can see how well they are doing and where they need to improve.

"I do feel the process went well," said Jessica Athens, senior population health assessment analyst at the University of Wisconsin. "We'll see what happens (in regards to impact)."

This region of the state still has a ways to go. In comparison to the rest of Georgia, the majority of the counties within the Southwest Public Health District were in the bottom 50 percent in terms of health outcomes. Only three out of the 14 -- Lee, Miller and Baker -- made the top half out of 157 counties. Two counties in the state, Echols and Taliaferro, were not ranked.

Officials here did not seem too shaken up by the results.

"There is nothing (about the data) that is surprising," said District Director Dr. Jacqueline Grant.

The results were similar in terms of health factors with only Lee, Miller and Thomas counties making the top half.

Researchers used five measures to assess health outcomes by county: the rate of people dying before age 75; the percentage of people who reported being in fair or poor health; the number of days people reported being in poor physical health; the number of days a person is in poor mental health and; the rate of low-birth weight infants. Researchers then looked at factors that affect a person's health within four categories: health behaviors, clinical care, social and economic factors and physical environment.

"There are a lot of variations in health depending on where you live," said Athens. "There are multiple contributors to a person's health."

Counties within the state were ranked on how healthy people are and how long they live. They also are ranked on key factors that affect health such as smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and the number of children living in poverty.

Poorly-ranked counties often have multiple challenges to overcome, including two- and three-fold higher rates of premature death, often from preventable conditions; high smoking rates that lead to cancer, heart disease, bronchitis and emphysema; high rates of obesity which can put people at risk for diabetes, disability and heart disease; high unemployment and poverty rates and; a high number of liquor stores and fast-food outlets but few places to buy fresh fruits and vegetables.

"I do think it (the report) does signal for us that there are some things that are in our control," Grant said. "There are some things that are modifiable factors. There is personal responsibility about improving behavior and lifestyle."

Eating better, promoting physical screenings and tobacco cessation are among the things that can improve the circumstances for this corner of the state, experts say.

"These are the things people in rural communities can do," Grant said. "The only thing we can't have much control over are social and economic factors."

Health outcome rankings were weighted evenly between mortality and morbidity. The health factor scores were weighted 30 percent by health behaviors, 20 percent by clinical care access and quality, 40 percent by social and economic factors and 10 percent by physical environment.

Over the years, many Southwest Georgia counties have not been up to par in a number of those areas.

"Those are the factors that affect (the health) of a community," Grant said. "In rural areas, you are going to have access to care issues."

In the long run, improving the numbers won't really matter as much as making progress on the circumstances that are pushing certain counties down on the list, the district director said.

"Rankings are tricky," Grant said. "The issue to me is not who runs the fastest, but getting us to a certain level. It doesn't matter how we compare, as long as we are improving.

"It (the study) certainly lets us know there is work to be done, but we knew that anyway. It doesn't tell us something we didn't already know."

The analysis came about after a similar project had been set up in Wisconsin in 2003, which brought on some gentle competition among communities. It was built on from there.

"Other states then adopted the model," Athens said.

The study has been given the funding to continue the county-by-county analysis for two more years. The hope is that the program will have a future beyond that.

"We've gotten feedback from stakeholders and the response has been positive," Athens said.

In future rankings, some of the other factors officials hope to expand on, given that the appropriate resources are intact to do so, will include a population's access to healthy food.

"That would be something we would improve on," Athens said.

The online rankings also included snapshots of counties with a color-coded map that compares each county's overall health with other counties in each of the 50 states. Researchers used the latest data available for each county, ranging from the years 2000-2008.

The results of the study can be found at www.countyhealthrankings.org.