The County Health Rankings and Roadmaps program is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin's Population Health Institute. We know that much of what influences our health happens outside of the doctor's office – in our schools, workplaces and neighborhoods.
The rankings are a compelling case to educate our communities that the health system is really everyone in the community. Health is everybody's business, and we can't improve health in communities by simply looking at more health care or more services delivered by local health departments.
The rankings are a call to action; the use of ranks can serve as a more effective tool for drawing attention to community health issues than lengthy lists of indicators. The rankings use a variety of data sources (i.e. National Vital Statistics System, BRFSS, etc.) and also, in many cases, use a range of years of data. Thus, it is not suggested that ranks themselves represent statistically significant differences from county to county. They do not rank individual measures. To de-emphasize the difference between county ranks, quartile maps are provided that can be used to draw attention to areas of the state with better or worse health rather than specific discussions of small differences in rank.
Counties with smaller populations may see substantial variations in some measures from year to year (and consequently in some ranks), which in fact we have. It is suggested to use the rankings as a tool to raise awareness annually of many factors that affect health, but know that it is not the best tool for measuring progress from year to year. Because the rankings are not the best way to track improvement over time, since they are based on broad measures and in many cases multiple years of data in order to be valid, counties are encouraged to use their own local data sources to measure progress from year to year.
Considering rankings in this context, a few notes of interest for Lee County from this year: overall health outcomes rank decreased from 32 last year to 40 this year. Mortality (years of potential life lost before age 75) rank dropped even further from 26 last year to 54 this year. The morbidity (illness/disease) rank improved, however, from 37 last year to 21 this year. Disappointingly, there was not adult smoking data included this year for Lee County. Adult obesity remains at 27 percent.
The County Health Roadmaps are helping communities bring people together from all walks of life to look at the many factors that influence health, focus on strategies that have been shown to work, learn from other communities so as not to have to reinvent the wheel and make changes that will have a lasting impact on health.
The County Health Rankings website provides information on why certain indicators were used, what the data sources used were and for what time frame, as well as suggested policies and programs to address areas of need. See www.countyhealthrankings.org.
In Lee County, we'll be looking at this year's report with our community partners to identify indicators that might be feasible to improve through collaborative work. We already have some things in progress, too new to have had an impact on indicators or rankings, but that are very promising alliances of partners in the Lee County public health system.
• Partnership for a Healthy Lee County (PHLC) (Mission): To collaborate with our community to increase physical activity and healthy eating in order to reduce and prevent overweight and obesity.
This group brings together a diverse group of community organizations with a vested interest in reducing obesity and its related adverse health impacts. Considering that Lee County's adult obesity rate has remained stagnant at 27 percent for the last four years of rankings, it appears that convening this group was very timely.
• Lee/Whiteside/Stephenson Breastfeeding Task Force (Mission): To increase breastfeeding initiation, duration, and exclusivity in Lee, Whiteside and Stephenson Counties.
This group includes the three health departments and three hospitals in Lee/Whiteside/Stephenson Counties. A main focal point currently is facilitating the Baby Friendly USA Hospital Initiative accreditation process in the three hospitals.
• Partnership with Whiteside and Stephenson County Health Departments on the We Choose Health Community Transformation grant. In addition to the Baby Friendly Hospital Initiative, this includes a worksite wellness policy-based initiative and increasing smoke-free public places. This is a grant received by the Whiteside County Health Department, which is subcontracting with Lee and Stephenson County Health Departments to effect change through policy and evidence-based initiatives. This is a multi-year grant, which should allow us to have lasting impacts in our communities.
• Recent conversations between administrations of Lee County Health Department and KSB Hospital to work together on their required community health needs assessments, as well as shifting from sick care to a community wellness approach.
I am personally involved and invested in all four of these initiatives. As the county health administrator, I have long known that although the health department provides many valuable services, provides a safety net for many of our vulnerable citizens, and in fact impacts the lives of every citizen in some way or another, we simply do not have the resources to address the health of our community on our own. We rely on our partners in the public health system.
So – these four projects are incredibly exciting to me, as I am witnessing the investment, enthusiasm and teamwork of a variety of partners. We are blessed in Lee County to have some outstanding and dedicated individuals working toward the common goal of improved health outcomes. I'd like to expand the involvement beyond organizations to interested citizens, community leaders, etc.
We have much work to do, but I believe with our competent teams and exciting recent coalition developments, we are up to the challenge.
Note to readers – Cathy Ferguson is administrator of the Lee County Health Department.