Area counties lead in health, but room for improvement

5 years ago

Five of the 10 healthiest counties in the state are in Northeast Iowa, according to the 2016 County Health Rankings and Roadmaps report.

Mitchell and Winneshiek counties remain in the top five Iowa counties for healthiest outcomes for the second year, at second and fifth, respectively. Grundy, Bremer and Chickasaw round out the top 10 in the region.

The health outcome ranks are based on the lifespan and quality of life for people in nearly every county in the country. They have been determined annually for the past seven years through a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

While Northeast Iowa has some high-ranked counties, others fall mostly in the middle. But Janna West Kowalski, a community coach with County Health Rankings and Roadmaps, said every community has room for improvement.

“What we really like to point out … is that every community has strengths to build upon and challenges to address, regardless of where they rank, so our hope is that the rankings spur action” Kowalski said.

Kevin Grieme, Iowa Counties Public Health Association board president and Siouxland District Health Department director, said some of that work is already underway in Iowa.

He said some communities are beginning to adopt active transportation plans — such as incorporating bicycle and pedestrian traffic — and have worked to increase physical activity and healthy eating while reducing tobacco use.

Grieme credited the work of the Blue Zones in the Cedar Valley as spurring action to make a healthier community.

“I think it’s within the (health) behaviors that communities really have an ability to make an impact,” Grieme said, adding, “The problem with these community-type changes is you will not see direct results after a year; it’s in more the three- to five-year (range).”

That is apparent in Black Hawk County, for instance, that saw its health outcomes and its health factors decline since last year’s rankings report.

It dropped from 68 to 73 in health outcomes and from 73 to 78 in health factors. There are 36 health factors, like adult obesity and access to health care, that are included in the rankings.

Chickasaw County, likewise, dropped from second to 10th healthiest Iowa county.

But Kowalski warns not to read too much into the year-to-year changes.

“The rankings aren’t actually a good indication of progress from year to year. It’s more important for communities to look at individual measures to identify progress or lack thereof,” Kowalski said.

“The rankings really serve as a conversation starter.”

She also said some changes in methodology from last year also could have contributed to some changes in the rankings from last year.

Kowalski said it’s important to look at trends over time to see where counties are improving or getting worse.

Black Hawk County, for instance, has been trending worse with adult obesity, unemployment and children in poverty, while also not making gains in areas like air pollution, violent crime, sexually transmitted infections and physical inactivity.

The county has made improvements in reducing its alcohol-impaired driving deaths, as well as reducing its rates of uninsured and preventable hospital stays.

Chickasaw County has seen similar trends.

This year’s ranking report began to look more closely at the health disparities in urban and rural settings, finding rural areas are often less healthy. Kowalski noted two-thirds of the counties across the United States are rural, so it’s important to pay attention to.

“In rural counties, we’re seeing higher rates of smoking, higher rates of obesity, some of the highest rates of children living in poverty. Then, the good side is we’re seeing lower rates of violent crime and fewer housing problems,” Kowalski said.

“We want our data to spark action, and people in rural areas need more opportunities, like good jobs, access to quality health care, quality education, access to healthy, affordable food. So, those are all things that can help improve health.”

Overall across Iowa, the five healthiest counties are Sioux, Mitchell, Dallas, Lyon and Winneshiek. The least healthy counties are Monroe, Pocahontas, Wapello, Clarke and Monona.

More details about each county’s health ranking are available at


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