Gila County brings up rear in health rankings

The County Health Rankings and Roadmaps report ranked counties by

health outcomes, or rates of illnesses and deaths. The dark-green

counties had the worst outcomes in Arizona in 2012. (Graphic by Robert Wood Johnson Foundation and the University of Wisconsin School of Medicine)

The counties in dark blue exhibit the least healthy behaviors, such as smoking, obesity, access to doctors and other factors, according to a report by the Robert Wood Johnson Foundation and the University of Wisconsin School of Medicine. (Graphic by Robert Wood Johnson Foundation and the University of Wisconsin School of Medicine)

By STEPHANIE SNYDER

Cronkite News Service

WASHINGTON – Arizona continued to fall well short of national averages on a range of health indicators, from the prevalence of fast-food restaurants to the availability of primary care physicians and the teen birth rate, according to a national health report Tuesday.

The state numbers were drawn from a Robert Wood Johnson Foundation study of more than 3,000 counties that were ranked from healthiest to least healthy in each state. And for the third year in a row, Gila and Apache counties were the worst in the state for health outcomes and heath factors, respectively.

Neither Gila County nor Apache County health officials responded to requests for comment Tuesday. But state health officials said the county statistics, more than statewide numbers, are important because the most effective solutions happen at the local level.

“Their (the ranking’s) purpose is to inform communities to create their own priorities,” said Laura Oxley, spokeswoman for the Arizona Department of Health Services. “The best way to make an intervention is on a very local instance.”

Because Arizona is made up of diverse counties that vary by population and environment, Oxley said, the county-by-county health ranking “allows a better opportunity for action” and gives localities the chance to “talk about the problems they face.”

Gila County‘s last-place standing for health outcomes in Arizona was based on its premature death rates, percentage of low-birthweight babies and reported days of poor physical and mental health. The county’s premature death rates were about 50 percent higher than the state’s.

Gila County’s poor health outcomes came despite the fact that the county ranked in the middle of the pack – ninth among Arizona’s 15 counties – for health factors, or characteristics such as tobacco use, diet and exercise, access to care, income and environment, among others, that affect health.

Apache County was ranked the worst in the state for health factors – a title it has claimed for the past three years. For the past two years, Apache County was also second-worst for health outcomes, according to the report.

The county’s ratio of 2,575 residents for every one primary care physician, 33 percent adult obesity rates and 28 percent adult physical inactivity rates all exceeded the state averages, and all helped contribute to its low rank for county health factors.

But one of the report’s authors cautioned that a county maintaning the same rank over several years does not necessarily indicate a lack of progress.

“Ranking really doesn’t allow you to follow progress as well as you might expect,” said Patrick Remington, a professor and associate dean at the University of Wisconsin School of Medicine and Public Health – a co-producer of the report.

“We use the most recently available data, but for some indicators – they are from almost a decade ago,” he said. “Some of these measures don’t change very quickly.”

While there are limits to the county-by-county data, Remington said, it is still the best option because there is an abundance of localized data that are compiled by many national organizations, which were used to calculate the rankings.

Counties could chose to ignore the findings of the report, because in some instances it uses older data, said Michelle Larkin, assistant vice president for Robert Wood Johnson Foundation. But that would be “ignoring a problem that’s continuing to grow,” she said.

“The rankings make clear that we all have a role to play when it comes to better health for our communities,” Larkin said.

County health rankings:

A new national report ranks counties on the factors that contribute to good, or ill, health and the outcomes in 2012. In Arizona, the rankings from most- to least-healthy were:

Arizona counties ranked by “health outcomes”:

1. Santa Cruz

2. Yuma

3. Maricopa

4. Coconino

5. Pinal

6. Pima

7. Greenlee

8. Yavapai

9. Cochise

10. Mohave

11. Graham

12. Navajo

13. La Paz

14. Apache

15. Gila

Arizona counties ranked by “health factors”

1. Pima

2. Cochise

3. Coconino

4. Yavapai

5. Maricopa

6. Greenlee

7. Pinal

8. Santa Cruz

9. Gila

10. Yuma

11. Mohave

12. Graham

13. Navajo

14. La Paz

15. Apache

Source: 2012 County Health Rankings and Roadmaps