slides: The Healthiest Counties in Massachusetts

Thursday, September 26, 2013

Paige Pihl Buckley, GoLocalWorcester Contributor

Massachusetts's counties get ranked by a combination of health indicators in the Robert Wood Johnson Foundation's Healthy Counties Rankings.

Worcester County ranks 9 out of 14 Massachusetts’s counties in overall health according to 2013 rankings by the Robert Wood Johnson Foundation, a national foundation focused on improving public health. The 2013 County Health Rankings ranking places Worcester County somewhere near the bottom of pack. Dukes and Middlesex counties are the healthiest, while Suffolk and Hampden counties are the least healthy.

To see how all of Massachusetts's counties were ranked for overall healthiness, see the slides, below.

The Foundation considered several factors in its overall ranking, including the number of premature deaths and babies born at low birth weight, and rates of obesity, smoking, and low activity levels. Other factors included access to recreational facilities and healthy foods, and the number of uninsured. According to the Foundation, these data points are key factors that, when improved, help to make communities healthier places to live and work.

A representative at the Massachusetts Department of Public Health was unfamiliar with the study, initially released this spring, and therefore unwilling to comment on its findings.

How Does Worcester County Stack Up

Worcester County fared both better and worse in individual categories. In health outcomes, which include mortality and morbidity, it ranked 8 out of 14. In health factors, which includes health behaviors, clinical care, social and economic factors, and physical environment; it ranked 11 out of 14.

Worcester County’s rates of adult smoking, adult obesity, physical inactivity, and excessive drinking are all higher than state averages. 19% of adults in Worcester County smoke, and 21% drink excessively. 26% of adults in Worcester are obese, and 21% are physically inactive.

Who Did Best and Why

In the state's healthiest county--Dukes County, which comprises Martha's Vineyard and the Elizabeth Islands--those numbers are lower almost across the board. Only 15% of adults smoke, and only 19% are obese or physically inactive. Rates of excessive drinking are higher though, at 28%.

Other counties that did well showed similarly lower rates of obesity, smoking, and physical inactivity. The majority of residents in these counties also had access to recreational facilities and healthy food options, though those figures did not vary as considerably across the board.

The factors that seemed to make the most difference were access to primary care doctors and the prevalence of fast food restaurants and poverty. In Dukes County, the ratio of residents to primary care doctors was 872:1. In Worcester County the ratio was 998:1, and in Hampden County (comprised of the Pioneer Valley surrounding Springfield) the ratio was 1,368:1. Of the all the dining out options in Dukes County, only 21% were fast food restaurants. That percentage rose to 46% in Worcester County and 45% in Hampden County, more than doubling.

What Makes Massachusetts Different

“There are 68 communities in Massachusetts, all of which have their own healthcare and public health priorities,” said Dr. Michael Hirsh, Acting Commissioner of the Worcester Department of Public Health. “That is why the data is not as applicable to states like Massachusetts because other states have public health initiatives for the county.”

MA counties, from left to right: BE/Berkshire, FR/Franklin, HP/Hampshire, HA/Hampden, WO/Worcester, MI/Middlesex, ES/Essex, SU/Suffolk, NO/Norfolk, BR/Bristol, PL/Plymouth, BA/Barnstable, DU/Dukes, NT/Nantucket.

By contrast, Hirsh said, Worcester County, Maryland, has one public health office for the entire county. According to Dr. Hirsh, our Worcester County is also moving in that direction. Shrewsbury, Leicester, Millbury, West Boylston, and Holden are already under the jurisdiction of the Worcester Department of Public Health.

“We’re hoping that now that we’re about two years into some of those arrangement that other towns will start taking notice,” said Dr. Hirsh. “We’re now considered the Central Massachusetts Regional Public Health District and have coordinated a lot of the services. If public health in Worcester affects people in Shrewsbury, couldn’t our Department of Public Health serve as a regional hub?”

Is Improvement on the Way?

Similar collaborative efforts have already been successful, said Dr. Hirsh, and there is no reason not to extend those efforts to public health.

“We have a federal grant for emergency preparedness that spreads out to 91 communities and is administered out of Worcester Public Health,” said Dr. Hirsh. “That model has been initiated in several of the weather issues that have been happening and it portends well that these communities can play together well in the sandbox, and extend it out beyond emergency preparedness.”

The Robert Wood Johnson Foundation seems to agree. According to Dr. Hirsh the Foundation put out a request last year for proposals from cities looking to regionalize their public health systems, and Worcester was one of the 19 that won a grant.

“So they’ve recognized that we’re on the right track,” he said.