Meadville Tribune

January 20, 2014

County tops region rankings, fares well statewide in health study

By Nina Bell
Meadville Tribune

— The 2013 County Health Rankings showed that Crawford County ranked the highest in overall health among all five northwestern Pennsylvania counties.

The recently released county-by-county health rankings, compiled as a complementary document to America’s Health Rankings, measured the overall health and health factors combined to rank the health status of all the U.S. counties.

Out of the 67 counties in Pennsylvania, Crawford County came in just above midway mark at No. 32 in overall health outcomes. While only at No. 32, Crawford County far exceeded the health outcomes of its neighboring counties of Erie, Mercer, Warren and Venango.

Erie County to the north came in at No. 49; Venango (southeast) slotted in at No. 37; Warren County (east) ranked No. 40; and Mercer County to the south fared the worst of the five counties at No. 51. The closest county with a higher ranking is Butler County, just to the north of Pittsburgh, which came in at No. 10.

This implies that Crawford County may be doing more to improve the overall health of its residents than its neighbors. A complete scientific analysis would have to be done to make an official determination of this nature.

However, despite the positive outcome in comparison to its neighbors, the county is still struggling with several key health concerns. Its biggest overall health outcomes that kept it from a higher rank included a significant number of premature deaths, a high number of self-reported poor health days and low birth weights among newborns. Factors that affected those outcomes included high rates of smoking, obesity, excessive drinking, physical inactivity and sexually transmitted infections; as well as poor access to health care insurance, lower education levels, unemployment/low incomes and lack of adequate social support systems.

Furthermore, the county ranking report indicated that low water quality, high levels of environmental pollution, limited access to healthy foods, an increasing number of fast food restaurants and poor access to recreational facilities all factored into the county’s ranking.

Of interest, Chester County in the southeast part of the state ranked as the healthiest county with Philadelphia County on the eastern side of the state ranking the worst. The county rankings were performed by the University of Wisconsin and Robert Wood Johnson Foundation.

Pennsylvania’s overall health ranking was similar to Crawford County’s mid-range rank. The recent release of America’s Health Rankings 2013 placed the commonwealth at No. 29 out of the 50 states, three places worse than the previous year when it was ranked at 26, and one place lower than the No. 28 spot it earned in 2011. Based on this report, Pennsylvania, as a whole, has grown weaker in the areas that were measured to determine overall health.

America’s Health Rankings is the longest-running annual assessment of our nation’s health listed on a state-by-state basis. This report, put together by United Health Foundation, American Public Health Association, and Partnership for Prevention, analyzes various health measures and compares changes over time.

Measures factored into the rankings included behaviors such as smoking, drinking, obesity and physical activity; environmental factors such as crime, poverty, pollution and occupational hazards; polices such as access to health insurance, public health funding and immunization requirements; and clinical care such as primary care physician and dentist shortages, low birth weight, and preventable hospitalizations.

For Pennsylvania, the three biggest issues that led to the lower ranking were high rates of drug deaths, high levels of air pollution and low levels of public health funding. Furthermore, the report revealed that obesity rates increased from 2012 to 2013 to nearly 30 percent. That means that nearly 3 million adults in Pennsylvania are obese.

Despite these issues, there was some good news in the report. It was discovered that smoking rates did decrease by about 5 percent; yet, more than 2.1 million adults still smoke in Pennsylvania. Also, physical inactivity decreased from 26.2 percent to 23.4 percent over the past year; youth immunization rates increased to nearly 75 percent; and cardiovascular deaths decreased by 31 percent.

The highest ranking states were Hawaii, Vermont, Minnesota, Massachusetts and New Hampshire, respectively. What stands out for these states is the low prevalence of smoking and obesity, high childhood immunization rates, low preventable hospitalization rates and reduced cancer deaths.

The lowest ranking states were Mississippi (50), Arkansas (49), Louisiana (48), Alabama (47) and West Virginia (46). These states measured high in obesity rates, physical inactivity, poverty, low birth weights and a very low graduation rate. Furthermore, these states suffer from doctor and dentist shortages, a factor that has been affiliated with poor health outcomes.

Regardless of how you spin either the county or state rankings, we still have some work to do to improve our health and reduce our risk of diseases. By improving our health, we can ultimately reduce the expense of health care and the financial strain on the health care system.

Nina Bell, Ph.D., MPH, is a public health professor with Ashford University and works in health promotions for the Meadville Family YMCA. She is a co-author of the book “Community and Public Health,” published by Bridgepoint Education Inc. You can email her at