Northeast Ohio continues to have some of the healthiest counties in the state, and some of the least healthy, divided largely along urban/suburban lines.
The released Tuesday shows that the Northeast Ohio counties struggling the most with health issues are two largely rural counties: Ashtabula and Trumbull. Each has worsening rates of poverty, premature death, adult obesity, sexually transmitted infections and a lack of primary care physicians.
Throughout the region, air pollution has lessened and more people are insured, but childhood poverty, sexually transmitted infections and adult obesity are an increasing problem in urban, rural and suburban counties. Throughout Ohio, the rate of children living in poverty is 20 percent.
Geauga County, which was the third healthiest in the state, ranked well on “health behaviors” including a low percentage of smokers and obese adults but also on socio-economic factors like children living in poverty (seven percent).
Just southeast, Trumbull County ranked 72nd out of the state's 88 counties. Children in Trumbull are three times more likely to grow up poor.
“People need access to good jobs, good education, safe places to be active and buy healthy foods and all of those factors contribute to making up the overall health,” said Zach Reat, an analyst with the Health Policy Institute of Ohio.
The report ranks counties in Ohio by outcomes: how long people live and how healthy they feel while alive. [Robert Wood Johnson Foundation]
The report ranks counties in Ohio by health factors: health behaviors, clinical care, socio-economic and physical environment. [Robert Wood Johnson Foundation]
Most of Northeast Ohio's largest counties fell in the rankings including Cuyahoga, Stark, Lorain and Trumbull. They were hurt by factors ranging from smoking and obesity to income inequality.
At 53rd in the state, Summit County received its worst ranking since the Foundation started issuing the reports in 2011. Among the big problems was a spike in premature deaths and sexually transmitted infections as well as ongoing issues such as obesity and smoking.
“The policy solutions that we look at developing have to address not only getting a person to the doctor,” said Reat, “but helping an individual to address all of these other areas in their life.”
Ohio fared better than many parts of the nation by one measure: housing.
The “severe housing problem” measurement takes into account factors including affordability, overcrowding, and plumbing.
In Cuyahoga County, 18 percent of households had at least one of these problems, ranking the county worst for housing in Northeast Ohio. But that was a fraction compared to places like Los Angeles (34 percent) and New York (25 percent).
Reat says housing and health are strongly correlated.
“People who spend too much on housing each month have less money left over to buy healthy foods or pay for their medicines,” said Reat. “People who live in violent neighborhoods deal with the stress of being in a violent neighborhood and being at a higher risk of injury.”
Here are the overall health outcome rankings for Northeast Ohio:
- Geauga: 3
- Medina: 4
- Holmes: 5
- Lake: 17
- Wayne: 18
- Ashland: 21
- Tuscarawas: 23
- Portage: 28
- Lorain:43
- Stark: 49
- Summit: 53
- Columbiana: 59
- Cuyahoga: 62
- Mahoning: 67
- Ashtabula: 69.
- Trumbull: 72
County Snapshots
Ashtabula County (Rank: #68 for health outcomes/#81 for health factors) Remains above the state and national rates in premature deaths and saw an uptick in the 2015-17 three-year average. Adult obesity remained above the state average and the margin is widening. Sexually Transmitted Infections (STIs) were well below the state and national rates but climbing steadily since 2009. The uninsured rate continued to decline, but the decline slowed and the rate remained above the state average. The ratio of primary care physicians to residents was significantly higher than the state average. 28 percent of children in poverty. Air pollution is improving.
Cuyahoga County (Rank: #62 for health outcomes/#54 for health factors)Follows the state's upward trend in premature deaths, though it's been consistently higher since the late 1990s. Adult obesity continued to tick up. Sexually Transmitted Infections (STIs) remained well above state and national averages and shot up after two years of leveling. Uninsured rate (six percent) fell slightly below the state average. Ratio of dentists to the county population improved. Ratio of primary care doctors to the county population continued to be far better than the state and national rate. Saw fewer preventable hospital stays. Continued to have a child poverty rate (27 percent) well above state and national averages. Violent crime remained well above state/national averages and climbed dramatically since 2014.
Lorain County (Rank: #43 for health outcomes/#37 for health factors)Three-year average of premature deaths spiked. Adult obesity climbed above the state average. Sexually Transmitted Infections (STIs) continued an uneven increase since 2007. The uninsured rate declined. There was an increase in preventable hospital stays but the rate was below 2012. The ratio of dentists to residents improved while the ratio of primary-care doctors per person declined. Both were higher than the state average. Children in poverty (20 percent) spiked to the state average and above the national average. Violent crime continued to fall and remained below state/national averages. Air pollution ticked up slightly but remained below 2002 levels.
Mahoning County (Rank: #67 for health outcomes/#58 for health factors) Remained above state and national averages for premature deaths. Adult obesity climbed slightly after a one-year decline. Sexually Transmitted Infections (STIs) remained just above the national average but the trajectory declined. Uninsured rate fell below state average. The ratio of primary care doctors and dentists to the county's population improved. Children in poverty (29 percent) remained well above the state average. Violent crime continued its decline since 2009, falling below state and national averages.
Stark County (Rank: #49 for health outcomes/#43 for health factors)Three-year average of premature deaths increased but remained below state average. Adult obesity continued its steady increase. Alcohol-related driving deaths continued an uneven decline since 2008. Sexually Transmitted Infections (STIs) increased to match the national average. The rate of people who were uninsured and the ratio of primary-care physicians and dentists to the county population all improved. The rate of children living in poverty (22 percent) spiked above state/national averages. Air pollution saw a slight uptick but remained well below the 2002 rate.
Summit County (Rank: #53 for health outcomes/#56 for health factors)Saw big uptick in in premature deaths in 2015-17 three-year average. Sexually Transmitted Infections (STIs) shot up and remained above state and national rates. The ratio of primary care doctors and dentists to the county population was better than the state average. Children in poverty (19 percent) was just below the state average but remains above 2002 levels. Improving in preventable hospital stays. Violent crime rate fell to the lowest level since 2007. Air pollution ticked up but remains below 2002 levels.
Trumbull County (Rank: #72 for health outcomes/#74 for health factors) Saw a big uptick in premature deaths in 2015-17 three-year average. Adult obesity has been higher than the state average since 2009. Alcohol-impaired driving deaths have been plummeting since a spike in 2012. Sexually Transmitted Infections (STIs) remained below the state and national average but show a general upward climb. The uninsured rate fell to the state average (seven percent), which is well below the federal level. Percent of children in poverty (24 percent) remained above the state and national averages and has been higher since 2007.
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