Risks vs. Outcomes: How Does Your County Measure Up?

March 26, 2015

How healthy is your county? How many years are lost to premature deaths? How frequently are babies born underweight? Does it do better than the state average? Better than the national average?

What about wellness? Do residents have insurance? Can they find physicians when they need care? Are they able to exercise? Is the air clean? Are there resources to help individuals achieve wellness? How effective are they?

Why not check out the data on County Health Rankings? The database, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, uses 34 measures of health risk factors and outcomes to assess and rank health risk factors and performances in every state in the nation. It also allows for easy comparison of risk and performance factors in between different counties.

For example, take Los Angeles County and Imperial County. The disparity between how healthy a county is and how many challenges there are to achieving wellness can be quite striking. Imperial county is ranked last in the State of California for its health risk factors1, indicating that there are many more challenges to achieving good health outcomes than there are in Los Angeles County, which is rated 36th in the State2. The health risk factor differences are quite significant, and in some cases, seemingly impossible to overcome. In Imperial County, there are 4,537 residents per primary care physicians compared to 1,389 residents per primary care physician in Los Angeles County. Nearly a tenth of the population in Imperial County has been exposed to unsafe drinking water, as opposed to only 1% in Los Angeles.

Nonetheless, Imperial County on the whole is ranked 25th in the State for its health outcomes, ahead of Los Angeles County, ranked 26th despite having a better health risk profile. This suggests that on the whole, Imperial County consistently overcomes serious barriers to wellness. This apparent disparity between health risk factors and health outcomes suggests avenues for investigation, such as how is Imperial County improving its residents’ health outcomes, and can those measures can be replicated elsewhere in the State.

Useful insights can also be achieved even when looking at counties with similar levels of performance, as data insights can illustrate the unique challenges faced by different counties. Los Angeles County, ranked 26th in California for health outcomes and 36th for health risk factors, reports poorly on indicators such as STI occurrence, high school graduation rate, violent crime, and severe housing issues. Sutter County, ranked 27th for health outcomes and 37th for health risk factors, reports poorly on a different set of indicators such as access to exercise opportunities, unemployment, and injury deaths3. Despite the similar risk levels and health performance of the two counties, they face distinct challenges to well-being. Policy makers, community workers, managed care organizations, and local governments need to be cognizant of those unique challenges to craft well-targeted effective solutions.

By making data both easy to find and easy to use, it is in turn easier for policy makers and community workers to incorporate data-driven insights into their work, allowing them to better understand the populations they work with and develop more effective solutions to the challenges they face using the resources they have.