Marquette County ranks close to last in health study, but what does that mean?

 

By Kathleen McGwin
In a recently released study, Marquette County ranks 70 out of 72 counties in overall health of its residents, but just what does that mean and how does anyone know how healthy we really are? The study, County Health Rankings, is a program of the HYPERLINK "http://www.rwjf.org/" \t "_blank"Robert Wood Johnson Foundation and the HYPERLINK "http://uwphi.pophealth.wisc.edu" \t "_blank"University of Wisconsin Population Health Institute (WPHI). On its website, WPHI says that the publishing of the ranking of counties’ health should “serve as a call to action for communities to understand the health problems in their community, get more people involved in improving the health of communities, and recognize that factors outside medical care influence health.”

“Health problems are really complex,” said Nathan Luedke, Director of Public Health in Marquette County, when asked recently about the report. “It’s not feasible to single out one or two factors as the most important. The Health Department wants everyone to know that we are available for input to integrate measures to improve health through current or new efforts.”

The County Health Rankings report uses two sets of information. One is health outcomes, the other health factors. In health outcomes, Marquette County ranks 70 out of 72. In health factors, Marquette County ranks 68 out of 72. Each of these information sets has data that are used to formulate a picture of each county. The data used is from a variety of sources, some hard facts like death rates, and others “softer” data like self-report. The website HYPERLINK "http://www.countyhealthrankings.org"www.countyhealthrankings.org clearly states the strengths and weaknesses of each data source. For each measure, the most reliable and valid research data is used.
Health Outcomes

Health outcomes are divided into mortality and morbidity. Mortality is based on premature deaths. Morbidity is based on both health-related quality of life and birth outcomes.

Perhaps the easiest data to understand is the mortality ranking. This uses information from death certificates and counts the number of years a person’s death occurs prior to age 75, the average age of life in the US. The more years of life that are lost because of people dying before age 75, the poorer the ranking of health outcome. The overall State of Wisconsin value is 6,172 lost years caused by premature death. Marquette County has a value of 8,787.

“These are years you won’t see your grandchildren growing up,” said Luedke.

Morbidity is assessed on self-reporting of the number of poor or fair health days, number of poor physical health days, and poor mental health days as well as on low birth weight of babies. In Marquette County, 7.9% of babies born had a low birth rate in the years 2000-2006, the time used for this survey. The State rate was 6.8% of live births.

Seventeen percent of Marquette County residents responded that they had poor or fair health in the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This survey is taken through randomly dialed land-line phone calls. Data was collected over 7 years, through 2008. The state average of self-reporting fair to poor health is 12%.

Health Factors
Four types of health factors are measured. They are health behaviors, clinical care, social and economic, and physical environment factors. A fifth set of factors, genetics and biology, are not included in this report. Each factor is broken down as follows.
• Health behaviors: tobacco use, diet and exercise, unsafe sex, and alcohol use
• Clinical care: access to care and quality of care
• Social and economic factors: education, employment, income, family and social support, and community safety
• Physical environment: environmental quality, build environment
Within the health behaviors study, Marquette County has higher rates of smoking, obesity, motor vehicle crash death rate, and teen birth rate than the state-wide average. Additionally, 25% of women surveyed reported they smoked while pregnant while the state-wide average is 14%. In the 7 years of data used in this report, there were 904 motor vehicle crash related emergency room visits compared to a statewide county average of 714. Off road motor vehicle crash related emergency room visits number 247 compared to the statewide county average of 90.

Marquette County fares a little better, but not much, if you look only at clinical care (ranks 64) and social and economic factors (ranks 59). The number of uninsured adults in the county is at 14% compared to statewide average of 10%. Having a primary care physician is also a measure where Marquette County falls far short of the state average, with only about a fifth of the number of people having a provider compared to the state-wide average.

Marquette County ranks 59th in social and economic factors. High school graduation rates are 5% below the state average, 12 % of the population have college degrees compared to 25%, and 22% of the population reports inadequate social support compared to 17% state-wide. However, Marquette County has fewer single parent households (7% compared to 9%) and has a violent crime rate 75% lower than the state-wide rate.

Marquette County climbs to number 28 in physical environment and could be even higher except for one vital factor, liquor store density. The county has no air pollution particulate matter days, only a quarter of the state-wide number of air pollution-ozone days, and is close to the state average in access to healthy foods. However, in liquor store density, a factor that is associated with assaultive violence, motor vehicle accidents, drinking and driving, riding with a drinking driver, high mortality rates due to liver cirrhosis, and binge drinking, Marquette

County is almost double the state average.
Least/most healthy county trends
Comparisons of the 50 healthiest counties and 50 least healthy counties in the country highlight some trends, WPHI reports. Urban/suburban counties are generally healthier than rural counties. The least healthy counties have significantly higher rates of premature death. People living in the least healthy counties report being in poorer health at a rate 2 times higher than those living in healthier counties. People living in less healthy counties are more likely to smoke. People living in the least healthy counties are 60% more likely to admitted to the hospital for preventable conditions (Marquette’s number is about 15% higher than the state wide rate). The least healthy counties have more people living in poverty, and the least healthy counties have fewer places where people can find healthy food.

What to do
So what are we supposed to do with this information and why should we care? People often cite the cost of preventable health problems that are passed on to everyone through higher insurance rates, lost work days, and higher public health costs as reasons to care about individual and community health. WPHI tells us that people are using the information to raise awareness about factors that influence health, initiating community health assessment and planning efforts, celebrating successes and promoting existing community health improvement efforts, informing policy makers about factors that affect a community's health and about community health improvement planning, revitalizing or refining existing community health assessment and improvement plans, and citing the County Health Rankings as justification in securing grant funding to conduct community health improvement efforts.

Director of Public Health in Marquette County Luedke said, “The Marquette County community doesn’t need me to tell them you should do this or that. Public Health has a responsibility to communicate what we understand through science and evidence and support change that can improve health and support demonstration of that value. The biggest struggle is for communities and individuals to demonstrate value.”

In layperson’s terms, demonstrating value means acting. There’s plenty each individual can choose to do in Marquette County to improve his or her own health which in turn affects change in the overall health of the community. Join in the Marquette County Wellness Challenge, talk about the County Health Ranking with others, support the creation of more miles of the Ice Age Trail, use the trails already developed including the Neshkoro Trail and Westfield Trail, participate in No Families Left Inside in April at the Westfield High School, use the Tobacco Quitline to drop the cigarette habit, promote a healthy, safe attitude towards alcohol, don’t drink and drive, support efforts that work to reduce underage drinking, support the efforts of the Tri-County Economic Development Corporation to bring more opportunities to Marquette County, learn about preventable health conditions and take action to live a lifestyle that promotes health, support schools’ efforts to teach healthy lifestyles to youth, and take advantage of Marquette County’s natural environment, caring communities, and opportunities to get involved.

Luedke said, “The likelihood of living an unhealthy lifestyle is that you will experience more tragedy.”
And fewer years to watch your grandchildren grow up.