Report: Vermont's relatively good health not equally shared among all counties

Vermont Business Magazine Health outcomes in Vermont largely follow health factors and demographic trends found everywhere in the United State: For instance, smokers have worse outcomes than non-smokers and white Americans have better health outcomes than Native Americans. Household wealth closely aligns with outcomes; especially related to poverty, which is associated with poorer health outcomes. But not all the data goes hand-in-hand in Vermont. Windsor and Windham Counties have relatively good health factors but relatively poor health outcomes. Chittenden County has the highest factors but only the third highest outcomes.

In nearly all measures, Vermont is healthier than the nation as a whole, with the noticeable exception of alcohol use and driving deaths related to alcohol in which Vermont is worse.

The Robert Wood Johnson Foundation recently released the County Health Rankings & Roadmaps (CHR&R). The report brings actionable data, evidence, guidance, and stories to communities to make it easier for people to be healthy in their neighborhoods, schools, and workplaces. Ranking the health of nearly every county in the nation, CHR&R illustrates what we know when it comes to what is keeping people healthy or making them sick and shows what we can do to create healthier places to live, learn, work, and play.

The green map above shows the distribution of Vermont’s health outcomes, based on an equal weighting of length and quality of life. The map is divided into four quartiles with less color intensity indicating better performance in the respective summary rankings.

The blue map above shows the distribution of Vermont’s health factors based on weighted scores for health behaviors, clinical care, social and economic factors, and the physical environment. Detailed information on the underlying measures is available at countyhealthrankings.org. The map is divided into four quartiles with less color intensity indicating better performance in the respective summary rankings.

Taken as a whole, measures of length and quality of life in Vermont indicate:

• American Indians/Alaskan Natives are less healthy than those living in the bottom ranked county.

• Asians/Pacific Islanders are most similar in health to those living in the healthiest quartile of counties.

• Blacks are most similar in health to those living in the least healthy quartile of counties.

• Hispanics are most similar in health to those living in the middle 50% of counties.

• Whites are most similar in health to those living in the middle 50% of counties.

Across the US, values for measures of length and quality of life for Native American, Black, and Hispanic residents are regularly worse than for Whites and Asians. For example, even in the healthiest counties in the US, Black and American Indian premature death rates are about 1.4 times higher than White rates. Not only are these differences unjust and avoidable, they will also negatively impact our changing nation’s future prosperity.

Health is influenced by a range of factors. Social and economic factors, like connected and supportive communities, good schools, stable jobs, and safe neighborhoods, are foundational to achieving long and healthy lives. These social and economic factors also interact with other important drivers of health and health equity. For example, housing that is unaffordable or unstable can either result from poverty or exacerbate it. When our homes are near high performing schools and good jobs, it’s easier to get a quality education and earn a living wage. When people live near grocery stores where fresh food is available or close to green spaces and parks, eating healthy and being active is easier. When things like lead, mold, smoke, and other toxins are inside our homes, they can make us sick. And when so much of a paycheck goes toward the rent or mortgage, it makes it hard to afford to go to the doctor, cover the utility bills, or maintain reliable transportation to work or school.

Poverty limits opportunities for quality housing, safe neighborhoods, healthy food, living wage jobs, and quality education. As poverty and related stress increase, health worsens.

• In Vermont, 13% of children are living in poverty.

• Children in poverty among Vermont counties range from 10% to 22%.

Housing is central to people’s opportunities for living long and well. Nationwide, housing costs far exceed affordability given local incomes in many communities. As a result, people have no choice but to spend too much on housing, leaving little left for other necessities. Here, we focus on stable and affordable housing as an essential element of healthy communities. We also explore the connection between housing and children in poverty to illuminate the fact that these issues are made even more difficult when family budgets are the tightest.

There is a strong and growing evidence base linking stable and affordable housing to health. As housing costs have outpaced local incomes, households not only struggle to acquire and maintain adequate shelter, but also face difficult trade‐offs in meeting other basic needs.

• In Vermont, 16% of households spend more than half of their income on housing costs.

• Across Vermont counties, severe housing cost burden ranges from 13% to 18% of households.

• Severe housing cost burden ranges from 14% to 28% among households headed by different racial/ethnic groups in Vermont.

Homeownership has historically been a springboard for families to enter the middle class. Owning a home over time can help build savings for education or for other opportunities important to health and future family wealth. High levels of homeownership are associated with more stable housing and more tightly knit communities. • In Vermont, 71% of households own their home. • Homeownership rates among Vermont counties range from 63% to 81% of households. • Homeownership rates among racial/ethnic groups in Vermont range from 19% to 71%.

Published online at countyhealthrankings.org, the Rankings help counties understand what influences how healthy residents are and how long they will live. The Rankings are unique in their ability to measure the current overall health of each county in all 50 states. They also look at a variety of measures that affect the future health of communities, such as high school graduation rates, access to healthy foods, rates of smoking, obesity, and teen births.

The Robert Wood Johnson Foundation (RWJF) collaborates with the University of Wisconsin Population Health Institute (UWPHI) to bring this program to cities, counties, and states across the nation.

Health outcomes in the County Health Rankings represent measures of how long people live and how healthy people feel. Length of life is measured by premature death (years of potential life lost before age 75) and quality of life is measured by self‐reported health status (percent of people reporting poor or fair health and the number of physically and mentally unhealthy days within the last 30 days) and the % of low birth weight newborns. Detailed information on the underlying measures is available at countyhealthrankings.org.

Source: Robert Wood Johnson Foundation