McDowell County has the worst health outcomes of any West Virginia county for the seventh year running, according to a report released by the Robert Wood Johnson Foundation on Wednesday.
The RWJF County Health Rankings report, now in its seventh year, is designed to provide a local snapshot of the factors that influence health and the health outcomes for people in every county in the U.S.
As in previous years, the 2016 report looks at public health across a range of factors, including smoking, obesity, binge drinking, motor vehicle accident deaths, teen births, sexually transmitted infection rates, the rate of uninsured adults and educational attainment. It also measures health outcomes for each county, including the rate of premature deaths, low birth weight and poor physical and mental health.
Jefferson County is the state's healthiest, according to the report, followed by Putnam, Monongalia, Pleasants and Tucker counties. Five of West Virginia's southernmost counties - McDowell, Wyoming, Mingo, Logan and Mercer - round out the bottom of this year's list.
The gaps between Jefferson and McDowell are wide - 32 percent of McDowell County residents are in poor health, compared to just 18 percent of Jefferson County residents, and nearly half of McDowell County children live in poverty, 46 percent, compared to just 13 percent of Jefferson County kids. (The full rankings are available at www.countyhealthrankings.org.)
Dr. Rahul Gupta, state health officer and commissioner for the West Virginia Bureau for Public Health, said the report highlights the various factors that can affect health, especially in West Virginia's southern counties, where energy industry jobs have been lost and other opportunities are often scarce.
"There are multiple factors considered that include socioeconomic and educational factors, as well as contemporary challenges like drug abuse and substance abuse. That all combines in a way to impact health," Gupta said. "What we're seeing, basically, is the culmination of when opportunities are being lost in terms of economics, education and health, and as a result, further opportunities get lost.
"To them, toughing it out is the only option, but what happens in those communities - whether it's the closure of a Wal-Mart or what have you - is that they're seeing businesses as well as jobs leave the community, and it causes more hopelessness, and those social determinants of health are all connected."
Kanawha ranked 36th in health outcomes, despite ranking 12th in health factors, which include things like smoking rates, access to exercise opportunities and teen birth rates. Neighboring Putnam County fared better, ranking second in health outcomes and first in health factors. Only 17 percent of Putnam County residents are in poor or fair health, according to the report.
This year, the report also looked at the differences between urban, suburban and rural areas and found that the two-thirds of Americans who live in rural areas tend to live shorter lives than their suburban and urban counterparts. Nearly 1 in 5 rural counties saw rises in premature death rates over the past decade, while most urban counties have experienced consistent improvement, according to the report.
"In rural communities, we saw that premature death rates are higher than those of their urban and suburban counterparts," said Aliana Havrilla, a community coach with County Health Rankings and Roadmaps who has worked in West Virginia. "With that said, we saw some bright spots related to rural communities - they have lower crime rates, shorter commutes and fewer severe housing problems, and those bright spots should be celebrated."
Gupta said the report is a guidepost for understanding the state's problems, but agencies and stakeholders will need to continue to work together to impact health in a state that is struggling economically.
"Nowhere in the country has this been exemplified more than in southern West Virginia," he said. "One of the challenges is how to get communities to work together in an across-the-system approach, meaning that it isn't just the health care delivery system, but employers, businesses, faith-based organizations, schools, the media and the infrastructure of public health together to ensure our resources are being utilized as effectively as possible at the local level.
Reach Lydia Nuzum at lydia.nuzum@wvgazette.com, 304-348-5189 or follow @lydianuzum on Twitter.