County health rankings still worst in state


In some categories

When Jefferson County ended up at the bottom of county health rankings a couple months ago, officials were neither surprised, nor complacent.

They were not surprised, because it was the fifth consecutive year that the county had received such a ranking, but they knew that they were continuing to work to improve the factors that negatively impact the county's ranking.

"We know the data is old and often combines years," said Tom Machala, director of the Jefferson County Public Health Department. "But it does give a general view of the county that reflects largely on the socioeconomic issues that affect health."

Machala, who sees it as a "call to action" for communities to address the issues in the rankings, added that "I believe we have been doing just that."

The rankings, from a collaboration between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, measure health outcomes and health factors in most counties in the country. For Oregon, Jefferson County was ranked 32nd out of 33 counties surveyed for health outcomes (Klamath was 33rd), and 33rd for health factors.

Three counties, Wheeler, Gilliam and Sherman, were considered to have too small a population to be included in the rankings.

Deschutes County ranked sixth best, and Crook County, eighth, for health outcomes, while Deschutes was fifth best, and Crook was 28th for health factors.

Health outcomes consisted of length of life and quality of life. For premature death, Jefferson County was somewhat more likely than any other county to have someone die before age 75, but ranked 16 of 33 for quality of life.

In fact, the county had fewer people in fair or poor health than the state average, and county residents were less likely to have "poor mental health days" than the state as a whole, Deschutes or Crook County, or 90 percent of the counties across the country.

Counted in health factors were behaviors, such as smoking, obesity, activity and access to exercise options, excess drinking and impaired driving deaths, sexually transmitted infections and teen pregnancy.

The county ranked particularly poorly in obesity, with 31 percent of adults considered obese; sexually transmitted infections for having 639 cases of chlamydia per 100,000 population (the state averaged 352); and 68 teen births per 1,000 females ages 15-19 — more than double the state average of 32.

Machala took issue with the teen birth rate, which dated back to 2005-11. "Teen births are down across the nation," he said. "Our rate the past two years has been half of what is reflected in the data."

Under clinical care, the county ranked 30th, with 25 percent uninsured; a ratio of 1,814 residents to each primary care physician; 2,267 residents to each dentist; and 1,889 residents to each mental health provider. However, the county scored at the state average for diabetic screenings and better than the state average for mammography screenings.

For social and economic factors, the county again ranked the worst among the state's counties, with a lower high school graduation rate (62 percent); lower number attending some college (47 percent); high unemployment (12.2 percent); more children in poverty (34 percent) and single-parent households (43 percent); and more injury deaths (107 compared to a state average of 65).

On a positive note, the county had fewer people reporting inadequate social support (14 percent compared to a state average of 16 percent), and significantly less violent crime, with a rate per 100,000 of 106 (the state averaged 251).

Finally, under the rankings for physical environment, air pollution, severe housing problems, long commutes and driving alone to work were on par with the state averages.

The surprise in the category was in drinking water violations, where 20 percent of the county's population was exposed to a violation limit during the fiscal year 2012-13 — the year Jefferson County's water won best in the state.

Machala explained that the water violation was a fluke, noting, "A break in the water line at Crooked River Ranch counted as a violation and put 20 percent of our population at risk for a short time, and gave us a bad score." The Ranch's water ranked best in the state earlier this year.

"Locals know this is a good place to live," he said. "Many of the indicators are not that far off from our neighboring counties and even the top county."

"We have many groups that are working to improve their communities, which contributes to our overall success," Machala said, citing the Culver and 509-J school districts, which are making changes that will take time to be reflected in the data.

"The medical community has joined forces to make St. Charles Madras a success through a shared call rotation and recruitment," he said, adding that the medical community is trying to recruit more health care providers, including doctors and dentists.

The Public Health Department provides programs aimed at healthy births and growth for children, and other agencies provide early education programs, such as Head Start, Relief Nursery, and Child Resource Centers for day care.

As for fighting obesity and improving access to exercise opportunities, the Madras Aquatic Center coordinates recreation options for the community, and the county and local cities have expanded their parks, walking trails and bike paths.

"People are more health conscious, supporting community gardens, farmers' markets and using the expanded walking trails," said Machala.