Health Rankings for NJ Counties Reflect Impact of Social and Economic Factors

When Robert Wood Johnson Foundation officials describe their annual county health rankings, it isn’t so much the ranking that they emphasize, as what goes into the numbers.

The Plainsboro-based organization wants the fifth annual statewide rankings, released yesterday, to spur local and state officials, as well as local charities and businesses, to push for improved public-health measures.

The 2014 rankings found that Hunterdon County was the healthiest in the state, while Cumberland County was the least healthy.

While the relative wealth of each county is a major factor in determining the outcomes, foundation officials emphasized that there are many policy changes that can help improve the health of residents of any county in the state.

The foundation also stressed the importance of social factors in determining helath by including several new measures in this year’s ratings: the percentage of households with housing-related problems like overcrowding, high costs, or a lack of kitchens or plumbing; the percentage of people who drive alone to work; and the percentage of the population with access to locations for physical activity.

Robert Wood Johnson Foundation Senior Vice President Dr. James S. Marks and Stephanie Carey, president of the New Jersey Association of County and City Health Officials.

Foundation Senior Vice President Dr. James S. Marks said at a Statehouse press conference announcing the report that it “shows us that where we live matters for our health, and it matters a lot.”

Stephanie Carey, president of the New Jersey Association of County and City Health Officials, emphasized that “most of what determines our health happens outside the doctor’s office,” adding that the rankings shine “a bright light on where our communities may be stumbling or succeeding.”

Carey said health officials are using the annual rankings to promote smart policy choices, such as smoke-free parks, “walkable streets,” and safe routes for children to walk to school. Last year, the state association encouraged land-use planners to “rethink the very way we’re designing communities” to make them healthier.

Health officials will use the rankings at an April 17 event at Mercer County Community College to talk about how the information can be leveraged to garner support from government, community organizations and policymakers.

Marks said health quality is frequently linked to medical care, “but that’s only part of it – it’s not where health begins.”

The 29 factors used to calculate the rankings include the rate of premature deaths; behaviors like percentages of residents who smoke, drink excessively or are physically inactive; accessibility and quality of clinical care; social and economic factors like the unemployment rate and the percentage of children living in poverty; and the physical environment, including air and water quality, as well as housing and transportation issues.

Marks pointed to Mercer County as an example of how counties can excel in certain areas. While Mercer ranks 12th out of the 21 counties in health outcomes, it’s third in the state in how its physical environment affects health.

On the other hand, Somerset and Hunterdon ranked ahead of Mercer in the overall rankings, but behind it in the physical environment.

“These rankings can help all the counties see what they should focus on, where they should work,” Marks said. “No one county gets it all right and no one gets it all wrong.”

He noted that healthcare costs are becoming a burden on the economy and on government.

“We can’t get and stay fiscally healthy without becoming physically healthy,” Marks said.

The foundation, which develops the rankings with the University of Wisconsin Population Health Institute, also released What Works for Health, which is designed to be an easy-to-use list of policies and programs shown to improve community health.

Clicking on “tobacco use,” for example, leads to a list of 15 policies and programs] that can improve health, such as cellphone text-message services that have been shown to help teens and young adults quit smoking.

Assemblywoman Donna M. Simon (R-Hunterdon, Mercer, Middlesex and Somerset) noted that counties have helped their rankings by instituting a wide variety of local public-health efforts, while New Jersey Partnership for Healthy Kids Deputy Director Darren Anderson talk about his organization’s work with five cities to establish programs to help children and Campbell Soup Co. Healthy Communities Director Kim Fortunato described her company’s efforts to reduce hunger and obesity in Camden.

Disclosure: The Robert Wood Johnson Foundation provides funding for NJ Spotlight’s health coverage.