We Are Public Health Postcards
We are public health.
We use county health rankings to improve community health.
When the Robert Wood Johnson Foundation and the University of Wisconsin came out with county health rankings in 2010, it allowed counties across the nation to learn how they were doing in comparison to other counties. Sue Valhberg, Community and Marketing Manager of Walter Knox Memorial Hospital in Emmett, Idaho, recalls being intrigued by the new rankings. “They offered apples-to-apples comparisons so you could really see how your community was doing.”
What Valhberg learned wasn’t encouraging. Her county, Gem County, ranked dead last among the 42 ranked Idaho counties in the area of health behaviors. Health behavior is a category that tracks sexual behavior that increases the risk of adverse health outcomes along with tobacco and alcohol use and patterns of diet and exercise.
Valhberg says, “Being a nurse, I found our ranking embarrassing. Added to this, I knew that as a state, Idaho has a lot of challenges in the health behaviors category and the counties we were compared to were also struggling.”
“We didn’t know what to do. We are a small county of 13,000 residents and we don’t have that many resources. But on the health rankings website, there is good “roadmap” information about what counties can do to raise their rankings.” The website recommends that communities form coalitions that have representatives from local government, public health, area schools, health care organizations, and local businesses. Valhberg and others formed this group.
Once the coalition formed, Juanita Aguilar, a coordinator from Southwest District Health, helped the coalition conduct the CHANGE Tool from the Centers for Disease Control and Prevention to develop their community action plan. After this process was completed, the group developed both short- and long-term goals that they hoped would improve their county’s ranking. Looking back, Aguilar says, “With such a diverse group of people working towards the same goals, it made it easy to build bridges and combine resources.”
To tackle tobacco use in Gem County, the coalition helped change policy so that smoking in public places became more restricted. In the area of diet and exercise, the group has overseen a variety of efforts to make sure community members who do not have easy access to sufficient, healthy food can receive adequate nutrition. Those involved in planning and zoning are adding walking paths, benches, and water fountains so people find it easier to walk in their community. Emmett Mayor Bill Butticci has joined other public officials in participating in “Let’s Move!” the obesity prevention initiative led by Michelle Obama.
Each year in May, coalition partners put on a health fair for the residents of Gem County. At the fair, visitors can receive free health screenings. Last year they were the only county in Idaho to offer free oral, neck, and head cancer screenings.
The health rankings track high school graduation rate as well as how many residents have some amount of post-secondary education. This is because studies have found that the more education people have the more likely they are to make positive changes in their health. Valhberg says, “We’ve got the education people in our coalition, and we can directly ask them what they are doing to keep kids in school.”
All this effort is starting to pay off. In the 2013 overall rankings for Idaho, Gem County is ranked 12 places higher than in 2010. Valhberg says, “I was so excited when I found out, I was jumping up and down. It gives us enough enthusiasm to continue.” Because of the complicated factors that affect behaviors such as substance abuse and at-risk sexual activity, it has been harder for Gem County to move in the Health Behavior category, but this too has improved. In the 2013 ranking, Gem County was 38 out of 42. They are not in last place anymore.