Do you live in one of America's unhealthiest states?
A new report released Wednesday ranked St. Clair County as one of the most unhealthy counties in the state, while its neighboring county came close to being the healthiest in Illinois.
Monroe County maintained its place among the healthiest counties in the state in a new report released Wednesday from the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. While Monroe County has the best ranking in the state for health outcomes, when it comes to overall health factors, it’s fourth.
But other metro-east counties did not fare so well. Out of 102 counties, Clinton County ranked eighth; Randolph, 63rd; Madison, 70th; and St. Clair, 91st.
St. Clair drops even lower when it comes to health outcomes — 95th out of 102.
Factors used to determine these rankings include behaviors like tobacco use, diet and exercise, alcohol and drug use; care factors such as access and quality of medical care; social factors like education, income, safety and employment; and physical factors such as air and water quality, housing and transit.
Health outcomes focus on the length of life and quality of life.
The survey illustrates that where you live influences how well and how long you live, according to the study directors. The study also noted that children in poverty and people of color are disproportionately affected.
Mark Peters is the director of community health systems integration for the St. Clair County Health Department, and says the studies are showing them that the best way to fight health problems is to address all the socioeconomic factors, not solely the ones directly related to healthcare.
'When you think about our health, about 40 percent is driven by where you live, by your education, by other socioeconomic factors," Peters said. "About 30 percent is your behaviors, 10 to 20 percent by access to clinical care, and about 15 percent environmental, plus or minus about 5 percent. ... Those of us trying to address this are not only from the health department, but our partners in health care services, in the business community, schools, churches."
Peters said that means the health department is getting involved with issues such as high school graduation and workplace preparedness that might not have been traditional health issues before.
Other areas of focus for improving the health of St. Clair County include community safety, not only preventing violence but also childhood injuries, infant mortality and healthy pregnancies.
“Those have historically been challenges for us,” Peters said.
There is a significant difference between healthy pregnancies and infant mortality between black and white patients, he added.
In addition, the health department will prioritize chronic disease prevention such as diabetes, asthma and obesity by targeting tobacco use, active living and healthy eating.
The county with the poorest health was Alexander County in both rankings. DuPage County had the best health factors, and Monroe topped the list for health outcomes.
What’s the biggest difference for St. Clair, then, with top-rated Monroe County very close geographically but so much further away in their health care outcomes?
“The economy is a big part of driving that difference,” Peters said. “We have more children living in poverty and growing up in single-parent households.”
There’s also a stark difference between St. Clair County and the rest of the state in terms of access to mental health providers and general practitioners. Statewide, the ratio is about 1,240 residents to one general practitioner, and 580 residents to one mental health provider. Peters said in St. Clair County, it’s about 1,690 residents to one general practitioner and 1,090 residents to one mental health provider — or nearly double the statewide rate.
It's still a marginal improvement over last year, when the ratio was 1,710 residents to one physician.
Peters said anywhere that the county is more than 20 percent off the statewide median, that’s an area they’ll be focusing on. There’s a new push called “Healthier Together,” he said, trying to bring together business, faith and school leaders to improve health and quality of life by improving these other socioeconomic factors.
"We need to get people at the community level to see that it’s not all about health, there are a lot of things to work on together," Peters said. "We started on this path in 2010 when the first rankings came out ... but we aren’t moving the needle.”
Other factors explored in the survey include:
• Approximately 16 percent of Illinois adults are in fair or poor health, which matches the national median.
• Illinois adults are thinner than average — 27 percent report a body mass index over 30, lower than the national rate of 31 percent. They are also more active, with 21 percent reporting no leisure physical activity compared to the national rate of 26 percent.
• Drinking is slightly above average, however, with 21 percent reporting binge or heavy drinking and 34 percent of driving deaths involving alcohol.
• Sexually transmitted diseases are much higher than the national median: the survey found 517 cases of chlamydia diagnosed per 100,000 residents, compared to 295 cases per 100,000 nationally.
• About 11 percent of Illinois residents under age 65 are uninsured, and the ratio of residents to physicians is 1,240 to 1. That is significantly better than the national rate of 14 percent uninsured and a 2,030 to 1 resident-to-physician ratio.
• But violent crime rates at 388 incidents per 100,000 residents, almost double the national rate of 198 incidents per 100,000. About 19 percent of Illinois residents live in households that are overcrowded, rank with high housing costs, or lack kitchen and plumbing facilities.
The county study was released just as another international study from the Commonwealth Fund and Harvard University found that the U.S. ranks last among developed nations in health care outcomes, but spends more on health care than any other country, according to the Los Angeles Times.
Elizabeth Donald: 618-239-2507, @BNDedonald