County health ranking shifts

The statistics were released this week by the University of Wisconsin’s Population Health Institute, which began conducting the annual research in 2010 — the year Koochiching ranked 73rd out of 85 counties.  Last year, Koochiching rose to 56th, before it dropped by two slots this year.

 “It’s a snapshot of Koochiching County, and we need to pay attention to it in terms of what we need to improve on, what are our strengths, and how can we build on those,” said Susan Congrave, director of the Koochiching County Health Department, about the report. “It helps identify challenges so we can try to put things in place for that to get better.”

The nationwide research project’s purpose is to serve as a “call to action” for communities to understand the health problems in their area, get more people involved in improving health, and “recognize that factors outside medical care influence health,” according to the report.

Researchers ranked communities on specific “health factors” including health behaviors (such as smoking); clinical care (such as percentage uninsured); physical environment (such as air pollution); and social and economic factors (such as education, unemployment and poverty). Specific factors in these categories affected the rankings in the “health outcomes” for each county.

“Where we live, learn, work and play influences how healthy we are and how long we live,” Congrave said “It’s a recurring theme in public health.”

The factors in Koochiching that stuck out to Congrave include a low ranking of percentage of women getting mammography screening, she said. The report concluded that 67 percent of the county’s women (in the age range for screenings) get mammograms. The statewide percentage was 75.

“We’re low on that, and I knew that — I discovered that a long time ago, but I’m not sure why this is happening,” Congrave said. “We do have accessibility to mammograms throughout the county, whether (women) have insurance or not. So that’s a big question mark there.”

Another concern is the ratio between primary care doctors and the county’s population, which determines care accessibility. In Koochiching County, there are 946 people to one primary care physician — while the state and national benchmark are 636 per doctor.

“It’s a real accessibility problem: not being able to get in to see a primary care physician, in the International Falls area anyway. I don’t think it’s such a problem in greater Koochiching County like Littlefork, Northome, and Big Falls,” Congrave said. “It’s a problem in being able to see a doctor when you need one.”

For mental health providers, there are more than double the amount of patients per provider compared with the statewide average. There are 2,648 people in Koochiching County per mental health provider; the state shows 1,306 per provider.

Congrave pointed out that in the social and economic factors categories, high rates of children in poverty is “a very troubling thing.”

“In a low-income family, children are not going to grow up as healthy of that of a family with a higher income,” she said.

In Koochiching, 22 percent of children are living in poverty, whereas the state overall has an average of 15 percent. The national benchmark is 13 percent.

Unemployment also affects the county’s health significantly, according to Congrave. Koochiching was ranked as having an 8.8 percent unemployment rate. Compared with the state, at an average of 7.3 percent, both are above the national benchmark — 5.4 percent.

“When you’re unemployed, you’re not feeling very well about yourself, you don’t have any money coming in, so you’re not eating well, you’re kind of scrimping on things, you don’t have any gas money to go anywhere — it just goes on and on,” she said. “It’s just a vicious circle.”

Overall, the report can be used as a tool, Congrave said, although she doesn’t “get too caught up in the numbers,” she added.

“We have work to do as a county health department and a community as a whole,” she said. “Everyone needs to take ownership of the condition of their community. It’s not just a local health problem for the health department to work on — we all need to work on it.”

Church, business and community events that include nutrition or exercise help everyone stay healthier, she said.

Nancy Lee, Koochiching public health nurse and coordinator of the county’s Statewide Health Improvement Program — which encourages active lifestyles — said a little bit of activity goes a long way, but it will take time to improve.

“It took us — not just locally, but the American population as a whole — a long time to get where we are with things like obesity, diabetes, heart disease, lung disease,” Lee said. “We can’t change it overnight when it’s been decades in the making.”

The health department has its own assessments of the community’s health throughout the year, Congrave added.

“We pride ourselves on knowing the pulse of the communities throughout the county,” she said.

To see the complete results of the county health reports, visit www.countyhealthrankings.org.