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A County Health Rankings report that was released last month gave us a detailed list of health demographics for every county in Missouri. But the rankings among local counties, such as St. Louis County, St. Louis City, St. Charles County, and Jefferson County, varied drastically despite their close geographical proximity. For example, St. Louis County was ranked fourth in state for health factors, while St. Louis City was ranked 114th in the same list, especially interesting due to Barnes-Jewish Hospital's recent U.S. News and World Report ranking as the eighth best hospital in the country. The Robert Wood Johnson Foundation collaborated with the University of Wisconsin Population Health Institute to develop these rankings for each state’s counties. The counties are ranked in two broad categories: health outcomes, which includes mortality and morbidity rate, and health factors, which includes health behavior, clinical care, social and economic factor and physical environment. Both factors take different issues into account that influence the health of the counties, like tobacco and alcohol use, unsafe sex, access to care, quality of medical care, education, employment, environmental quality, etc.
“It has a lot to do with education and socioeconomic situation of the counties. Due to higher unemployment rates, people are less likely to have health insurance“, says Dr. Kate Lichtenberg, family physician with St. John's Mercy Medical Group. St. Louis City is also ranked low in the health behavior and physical environment sections, which might have resulted in the low morbidity ranking. Lichtenberg adds that “older housing in the city exposes people to lead poisoning. In the county, brand new housing do no use lead base paint.” Also, St. Louis City does not have as many grocery stores as St. Louis County, potentially depriving them of healthy foods such as fresh fruits and vegetables. Environmental reasons, like the availability of bike and walking paths, might also effect the rankings, she says.
St. Charles County has been ranked very high in both health outcome and health factors in almost all the sections. “There is a lot of consciousness out here about health” says Gil Copley, the director of the St. Charles County Department of Community Health and the Environment, citing fitness and nutrition programs in elementary schools. St. Charles is a younger county compared to other counties like St. Louis City, and a large percentage of the housing is new, which reduces the possibility of lead poisoning and other built-in environmental hazards, he adds. Copley also says that the purpose of the rankings should not be to judge which health department is better than another. “The purpose of the report is to let us know what programs and policies should be further developed to target the health areas that are weak."
