How healthy is Mills County?
Not very, according to the County Health Rankings compiled by the University of Wisconsin’s Population Health Institute.
In results of a study released earlier this month, Mills County ranks as the fifth unhealthiest county in the Hawkeye state. The data, compiled by a survey of randomly selected adults in all 99 counties, showed Mills County ranked near the bottom at No. 95, just edging out Wapello, Wayne, Van Buren and Appanoose Counties, in overall health.
For Sheri Bowen, director of Mills County Public Health, the rankings are a report card for the county that didn’t show high marks.
“We tried really hard, we just didn’t get the grade we hoped to see,” said Bowen. “That’s never a positive experience.”
The rankings, based on the latest data available for each county in all 50 states, look at a variety of measures that affect health, such as the rate of people dying before age 75, high school graduation rates, access to healthier foods, air pollution levels, income, rates of smoking, obesity and teen births.
Those counties that have favorable or high ranks begin at one and work up to 99. The basis for the final ranking is compiled in “health outcomes” – a number derived by comparing mortality (length of life) and morbidity (qualify of life) – and “health factors” like obesity, smoking, excessive drinking, access to health insurance, social and economic status and physical environment. Mills county ranked 95th in health outcomes and 44th in health factors.
Delaware County in eastern Iowa, was No. 1 in health outcomes. Johnson County was No. 1 in health factors.
The numbers for Mills County indicate a startling 16 percent of those surveyed said they are in “poor or fair health” and have an average of 3.5 days of poor physical and poor mental health days per year. Both of those numbers come in above state and national averages.
“The rankings really show us with solid data that there is a lot more to health than health care. Where we live, learn, work and play affect our health, and we need to use the information from the rankings to shine a spotlight on where we need to improve so we can take action to address our problems,” said Dr. Patrick Remington, director of the County Health Rankings project and Associate Dean for Public Health at the University of Wisconsin School of Medicine and Public Health.
Mills County ranked 91st in last year’s ranking – four spots better than this year – so the fact the county remains in the 90s isn’t a shock to Bowen. The fact the county’s gotten worse, however, is disappointing.
“We were well aware our tobacco number was high, so that didn’t surprise me,” said Bowen. “We’re aware our obesity numbers are high. Those are two areas where we are throwing programs at, trying to address those issues. We were a little surprised just how much it lowered us.”
Bowen cautioned against looking too close on the health outcome ranking and ignoring the health factors section. The health factors section – where the county rated 44th – is still above state and national averages in obesity, smoking and excessive drinking but all three, Bowen said, are down in the county from the previous year.
Jacque Butler, a personal trainer who owns and operates JB Fitness on the Glenwood Town Square, wasn’t surprised 16 percent of Mills County survey responders said they felt in “poor or fair health,” nor was she surprised the county received generally poor numbers for overall health.
“That (16 percent) feels like a significant number, but 60 percent of the country is overweight and 30 percent of them are obese,” Butler said. “The statistics overall are not good. Children today will have a shorter life span than their parents for the first time ever. It’s a direct correlation of how we eat and how we move these days. It’s sad to hear, but it frankly doesn’t surprise me. That’s the state of our society right now.”
It’s that societal apathy towards health where Bowen and her group would like to target.
MCPH just completed a community health assessment which brought together several community organizations and members of the public to talk about what are the issues exactly in Mills County. MCPH is already planning a meeting for late April to gather the Healthy Mills County Coalition, a group spearheading an effort to be more active, and several other agencies and groups to draw more community involvement. The plan is to go over the data, the community health assessment and ways the information can be used “to leap forward.”
“What we want to know is: where do the statistical numbers indicate our problems are? We’re aware where we’re elevated, but we want to identity what we can do locally,” Bowen said. “What came out loud and clear was there is a big gap in communication in the county on getting the linkages to the people who need them. To change behaviors, we have to show these programs are there. Most of the programs to help are there. A lot of people and some of our providers even, aren’t aware of them.
“Addressing those issues while communicating better, getting information to the people and somehow motivating them to take some kind of action is the goal.”
Mills County was hardly alone in receiving bad grades in southwest Iowa. Pottawatomie County ranked 91st in health outcomes and 89th in health factors. Montgomery came in at 93rd in health outcomes and 96th in health factors. The one anomaly in southwest Iowa appears to be Fremont County, Mills’ southern-most neighbor, which was 19th in health outcomes and 84th in health factors. Fremont County was in much the same boat as Mills County last year, ranking in the 90s but that ranking jumped more than 70 spots this year.
“I have no idea,” Bowen said of the possible reason for the Fremont County jump. “If you pulled the county health data from last year, you’d see they were on the low end with us. Why have they in one year jumped to that number? I don’t want to say the data isn’t valid because we have to look at it and pay attention to what it’s telling us, but one of the challenges of gathering the data is that when you’re a small county, it doesn’t take a lot of responses for your data to change (in one year).”
Budget cuts haven’t helped the effectiveness or successes of county health programs, especially in sparsely populated counties. In the last year, Bowen has seen her anti-smoking grant from the Iowa Department of Public Health cut by one-fourth. And more cuts are on their way from the legislature.
“With the cuts we’ve had and more pending, its a concern,” Bowen said. “Obviously, we’ll continue to work on promoting tobacco secession with our JEL (Just Eliminate Lies) group which is very active in Glenwood, but the funds that support those programs are in real jeopardy.”
Bowen would prefer to look at the bright side of some admittedly pretty dark statistics. She sees a potential positive in even a failing report card.
“These county health rankings, to me, are a call to arms,” she said. “It’s an opportunity to gather some support for public health in general and help us rally around this and hopefully make progress.”
The statistics, Bowen hopes, could serve as leverage for constantly shrinking state appropriations to county health programs.
“If we can look at this as a chance to support public health programming and a chance to really focus on the need to make a change, then the questions becomes ‘How do we motivate the public to take action?’’’ she said. “The numbers are bad, but the focus it puts on it and improving it, is good. I’ve already included the statistics in my most recent grant application.”
So, is Mills County really the 95th least healthy county in Iowa?
“No, I don’t think so, in my opinion,” said Bowen. ”But according to the population of the specific people they called and asked on the phone, we definitely show we have room for growth and improvement.”