A new national report compares county-level health factors in every state and identifies public health assets and liabilities in each of Maine’s 16 counties.
The report, released Wednesday by the Robert Wood Johnson Foundation, ranks rural Franklin County as the healthiest in Maine, with the lowest rates of premature death, poor mental and physical health, and babies born at a low birth weight. Neighboring Oxford County is ranked the least healthy.
Hancock County ranks second-healthiest in Maine while abutting Washington County, identified in a similar 2007 report as one of the least healthy counties in the United States, ranks second from the bottom.
“There are no surprises in this report,” said Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention. Each county in Maine, she said, faces public health challenges as well as boasting strengths and successes.
“Improving economic and educational attainment are very important public health strategies,” Mills said, but Maine’s experience shows that public health is influenced by a number of variables.
Mills said top-ranking Franklin County is continuing a tradition of strong public health advocacy. In the 1980s, she said, health officials there launched a countywide initiative primarily aimed at preventing, detecting and treating heart disease. Strategies included public education, promotion of improved nutrition and physical activity, stepped-up medical screening, better disease management and other measures.
In the early 1990s, Mills said, health officials from Franklin County demonstrated that the effort had paid off in significant decreases in heart disease and related illness, hospitalizations and complications. The neighboring counties of Somerset and Oxford, with similar income and education profiles, did not demonstrate an improvement in heart disease rates, she said.
The experience in Franklin County prompted the Maine CDC to implement a statewide network of “Healthy Maine Partnerships,” Mills said — regional public health coalitions charged with promoting healthful lifestyles and driving down rates of chronic disease, substance abuse, obesity and tobacco use. More recently, Mills noted, the Maine Legislature in 2008 approved the development of an eight-district public health system to ensure consistency of public health resources and data collection throughout the state.
“This report is useful in that it points out many factors that influence public health,” Mills said, including social and economic elements, personal behavior, and natural and man-made environmental influences.
The new report, County Health Rankings, surveys standard measures — general health and the rate of premature death — and related factors that play a role in health, from smoking, obesity and binge drinking to the unemployment rate, childhood poverty, air pollution and access to grocery and liquor stores.
Looking at each state’s best and worst counties illuminates a well-known trend: The least healthful counties tend to be poor and rural, and the healthiest tend to be urban or suburban and upper-income.
The report is divided into two main categories: “health outcomes,” such as premature death and illness, and “health factors,” such as healthful behavior, access to clinical care, social and economic status, and environmental quality.
In Maine, populous Cumberland County ranks highest in positive health factors, and far-flung Somerset ranks lowest. Penobscot County ranks 10th in health outcomes and ninth in health factors.
The report’s Web site allows users to download a data sheet for each county. A side-by-side comparison between second-best Hancock and second-worst Washington counties, for example, shows that in the healthy behaviors category, Hancock County has lower rates of adult smoking, adult obesity and births to teenage mothers. Hancock County also has more primary care providers per resident, better rates of screening for diabetes and higher use of hospice services. Hancock County residents have more formal education and higher incomes than their Washington County counterparts. Rates of children living in poverty and of violent crime are half as high.
Washington County, on the other hand, boasts fewer adults without health care coverage — likely due to MaineCare enrollment — lower rates of sexually transmitted disease, and better access to healthful food choices and cleaner air, according to the report.
County-level data for Maine was collected from a number of state and national sources, including census data, the National Center for Health Statistics, the Medicare program for seniors, the Bureau of Labor Statistics and self-reported health and behavioral surveys.
On the Web: www.countyhealthrankings.org.
The Associated Press contributed to this report.