New Report Suggests That Where You Live Will Determine When You Die


A new report suggests that where you live in America is one of the single greatest determinants of how long you’ll survive and how healthy your life will be.

County Health Rankings & Roadmaps is a joint effort by the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute (UWPHI) to quantify dozens of economic, environmental, and public health factors in each of the country’s 3,143 counties. That includes data on everything from local infant mortality and STD rates to how easily Americans can access food, places to exercise, and medical resources in their respective counties.

The 2014 County Health Rankings is the fifth annual report being released by the groups — and it underscores that the state of local economies, environments, and safety net programs are highly correlated with residents’ personal health.

“The County Health Rankings show us how health is influenced by our everyday surroundings — where we live, learn, work, and play,” said Dr. Bridget Catlin, director of the County Health Rankings, in a statement.

For instance, the least healthy U.S. counties have death rates that are twice as high as the healthiest ones. They also have twice as many children who live in poverty and twice as many teenage births. That highlights ongoing health inequities in certain parts of the United States, even as teen birth rates have fallen by 25 percent nationally since 2007.

The newest rankings include mental health data for the first time. While the West Coast and the Northeast United States have the largest number of mental health providers in the country, with some areas having as many as one mental health specialist for every 72 people, that’s not true everywhere. Several U.S. counties have just one such provider per 60,000 residents. These areas tend to have worse overall health, too, as the number of mental health providers in the healthiest counties in each state is 1.3 times higher than in the least healthy counties, according to the report. Many of the counties with a spotty access to mental health care are in rural and less populated regions, which make up more than 85 percent of areas that the federal government classifies as “mental health professional shortage areas.”

Food insecurity is also much more prevalent in the least healthy counties compared to the healthiest ones. The American South, Southwest, and West have the highest concentrations of areas where families have little recourse for buying healthy foods. That has an especially big impact on children, since studies have shown that food insecurity leads to “inadequate intakes of several important nutrients, cognitive developmental deficits, behavioral and psychosocial dysfunction in children and adults, and poor health in children and adults.”

And in a striking illustration of how disparate health factors may actually have significant interplay, food shortages can also cause stress that leads to mood disorders which may, in turn, “exacerbate poor health caused by other factors” such as malnutrition, according to researchers writing in the journal Community and International Nutrition.

State lawmakers and local officials could also use the data to encourage more public works projects such as parks, since people who live in the healthiest counties also have 1.4 times higher access to parks and recreational facilities than those who live in the least healthy counties.

The new health rankings do include some positive trends. For instance, national smoking rates have dropped by more than 14 percent since 2005 and the rate of preventable hospital stays decreased by about 20 percent between 2003 and 2011.