County health rankings paint picture of work to be done
Each year, the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute release health rankings for every county in all 50 states. This year, in comparison with all 62 New York state counties, the north country saw a wide range of ratings — Oswego County came in 56th, St. Lawrence came in 45th and Jefferson County 41st, while Lewis was ranked 23rd in the state.
The overall rankings, or health outcomes, are based on a long list of health indicators and are further broken down by rankings for projected health, healthy behaviors, clinical care, socioeconomic factors and physical environments.
Over the years, some north country rankings have fluctuated wildly, especially for physical environment, which has been measured in many different ways since the surveys began in 2011, including air quality and commute times.
Some scores, however, have remained more or less constant in the last seven years. Healthy behavior rankings are near constant and among the worst in the state for Jefferson, St. Lawrence and Oswego counties.
The region remains very much in a health professional shortage, though strides have been made. In Jefferson County, clinical care is ranked 17th in the state, up from 51st in 2017, and the number of mental health professionals has increased greatly since 2014.
Jefferson County Public Health Planner Stephen A. Jennings sees the county rankings as just one piece of a more complex puzzle.
“It’s more than just the numbers. You have to know every county’s individual story, and Jefferson County might have one of the most unique stories,” Mr. Jennings said, explaining that certain health behaviors associated with younger generations are disproportionately represented in Jefferson County by Fort Drum.
Such factors include teen birth rates, which include 18- and 19-year-olds regardless of marital status, and excessive drinking.
“Which isn’t to say we just accept (poor rankings), we’re working hard,” Mr. Jennings said. “For example, we do not do well on smoking (rankings), we’re working on increasing education and cessation resources.”
St. Lawrence County’s ranking improved from 51 last year and from 57 the year before that, showing that progress is being made, said SLC Public Health Director James O. Rich.
The number of uninsured county residents decreased from 12 percent in 2015 to 9 percent in 2016, partly as a result of people enrolling through the federal Affordable Care Act program.
“They are getting increased access to care. A lot had insurance for the first time and are utilizing physicians,” Mr. Rich said. “The Affordable Care Act may have had a larger impact on our county because we had a disproportionate number of individuals without insurance compared to the wealthier counties, like Saratoga.”
Over the past couple of years, the hospitals in St. Lawrence County have been successful at recruiting more specialists, pediatricians, primary care physicians and other medical care providers to the area.
Giving an example, a rheumatologist is now available in the county, he said.
“Prior to that time, individuals had to travel to Syracuse or Burlington or Watertown,” Mr. Rich said. “The hospitals are working extremely hard to recruit and retain individuals. It’s difficult, though — a lot of physicians don’t necessarily want to come up here. It’s a rural area and some other areas do pay better.”
Oswego County ranks among the lowest counties in health outcomes, projections, behaviors and socioeconomic factors.
“I think the methodology is valid, but we need to realize these numbers are just a snapshot,” Oswego Public Health Director Jiancheng Huang said, explaining that the county’s most recent efforts aren’t necessarily reflected in annual rankings. “The rankings provide a very good tool, and I talk to my community about them ... They do a very good job of putting current and future health together and reminding us we need a long-term vision.”
In just the last two years, the county’s healthy behaviors went from last in the state to 54th in 2016 and 59th in 2017, though Mr. Huang suspects with reasonable variation the reality is probably somewhere between the two. Mr. Huang says compared to even five years ago, the county is moving in the right direction.