Alabama counties ranked by health factors |
This year's rankings found that rural counties by far had the highest rates of premature deaths, continuing if not accelerating a recent trend. Nearly one-fifth of rural counties have experienced worsening premature death rates over the past decade, while nearly all large urban areas have seen declines. One reason for the higher rates in rural areas could be an increase in drug use. Drug-overdose deaths have increased 79 percent overall since 2002, but are highest in rural counties, especially Appalachia, the study found.
Rural areas generally rank poorly in adult obesity, adult smoking, teen births, uninsured, preventable hospital stays, childhood poverty, injury deaths and college education. Favorable rankings for rural areas included the lowest amount of violent crime and shortest commutes to work.
Some places have seen big declines in their health status. For example, Luzerne County, Pennsylvania (Wikipedia map), an Appalachian coal community, dropped over the past year from 26th to 40th in health behaviors and from 20th to 34th in physical environment. (The state has 67 counties.) One key may have been physical inactivity, with 28 percent of adults reporting living inactive lifestyles, the sixth worst total in the state, Mark Guydish reports for the Times Leader in Wilkes-Barre.
Dr. Tina George, a local family practice doctor who thinks the county's poverty and excessive drinking levels were under-reported for the rankings, "said part of the problem is simply the physical environment of municipalities built before urban design was a thing," Guydish writes. She told him, “We don’t have cities like they do out west, where communities were planned and laid out to be walkable, to have places for exercise, to have food markets. We didn’t have the advantages of making a community that promotes a healthy lifestyle."
In Iowa, rural Black Hawk County was ranked 85th of 99 counties in health, its lowest spot since the rankings were started in 2010, Christina Crippes reports for The Courier in Cedar Valley. The county ranked low for obesity, lack of physical activity, high rate of sexually transmitted diseases and a rise in violent crime.
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