02.17.10 - St. Charles County ranks second in healthy residents in Missouri, behind Platte County, according to a first-of-a-kind study rating the overall health of counties in all 50 states. Missouri’s 10 healthiest counties, along with Platte and St. Charles, are Christian, Johnson, Osage, Nodaway, DeKalb, Clay, Moniteau and Cass. Pemiscot County, in southeastern Missouri, was listed as the least healthy. 

The study says the 10 healthiest counties in Illinois are Kendall, ranking highest, followed by DuPage, Woodford, Jo Daviess, McHenry, Henry, McDonough, Mercer, Carroll and Lake. St. Clair County was among Illinois' 10 least healthy counties.

The county-by-county findings were compiled by the Population Health Institute of the University of Wisconsin and the Robert Wood Johnson Foundation. The organizations released the report last night.

The data will allow for county-to-county comparisons of health conditions in a state, says Dr. Patrick Remington, associate dean for public health at the University of Wisconsin School of Medicine and Public Health.

Reports for each state show that there are big differences in overall health across counties due to factors ranging from “individual behavior to quality of health care, to education and jobs, to access to healthy foods and to quality of air,” he said in a statement.

In theory, the data should help a county determine whether it is getting sufficient value for its investment in improving health care and the quality of life of its residents. The report reveals that access to care isn’t the only factor that influences health outcomes. For example, St. Louis ranks fourth highest in clinical care, but it still earned a low overall ranking due to unhealthy behavior among residents, along with poor social, economic and environmental conditions.

St. Louis officials make note of that point, saying it wasn't unexpected that the city's health status didn't match that of wealthier counties in Missouri. They hope to use the data to improve health conditions.

In a statement, Pamela Rice Walker, acting director of health for the city, said the report "underscores how socioeconomic indicators, such as education, employment, income, family/social support and community safety impact public health. Children's health is a special concern for me, and studies like this provide evidence to improve policy and fund proven initiatives."

City officials also note that St. Louis is making progress in reducing lead poisoning and sexually transmitted diseases. The city is working with community groups to address issues ranging from childhood obesity to access to healthy and affordable foods -- all issues that affect health status.

The study also made clear that addressing some adverse health issues was beyond the reach of counties. While St. Charles County ranks at or near the very top of most health indicators, for example, it ranks near the bottom -- along with other counties in the region -- on environmental issues.

"That was due to air quality," says Gil Copley, director of the St. Charles County Health Department. "It's a state responsibility. That's something the Missouri Department of Natural Resources is trying to address" by focusing on emissions and other factors affecting air quality in the St. Louis region.

Copley says he's not surprised by the county's overall high ranking.

"One challenge is to make sure we stay high. As the population grows, we need to be aware of the potential for health problems. We need to be aware if something's going downhill and address it before it becomes a problem."

Copley formerly worked for the St. Louis Health Department for about two decades and can look at public health issues from two perspectives.

"I went from a city where people struggle with poverty, older housing and transportation to a county where the poverty level is much lower. There are two different ways of conducting public health. One is working hard to overcome existing problems (the way St. Louis is doing) and the other is working hard to prevent problems from occurring or getting of hand," the mission of St. Charles County.

He says the county can use data in the report to see "what we are doing right and know what needs to be done to keep our ranking."

Kit Wagar, chief information officer for the Missouri Department of Health and Senior Services, says the report's findings, in many ways, are no surprise. The researchers, he notes, generally "correlate good health with the quality of life," but he says the report is welcome in that it offers counties a different way to look at public health.

"It's a very interesting view of what public health includes," Wagar says. "There's information, for example, on how many liquor stores are in an area per capita. We don't use that. They do provide an insight."

In addition, the study ranked counties by health factors. These included healthy behavior, such as tobacco and alcohol use, diet and exercise and unsafe sex; access to clinical care and the quality of that care; social and economic factors, such as education, employment, income and community safety; and the quality of the physical environment.

St. Charles ranked second in good health outcomes and ranked 1st in positive health factors. St. Louis County ranked 18th in health outcomes and 6th in health factors. Franklin County ranked 19th in health outcomes and 32nd in health factors, while Jefferson County ranked 28th in health outcomes and 67th in health factors.

St. Louis city ranked 106th in health outcomes and 115th in health factors. By comparison, Jackson County, which includes Kansas City, ranked 64th in health outcomes and 97th in health factors.

In Illinois, Monroe County ranks 14th in health outcomes and 4th in health factors; Madison County ranked 78th in health outcomes and 86th in health factors, while St. Clair County ranked 94th in health outcomes and 96th in health factors.

To see how each county in Missouri and Illinois ranks, go to www.countyhealthrankings.org .