Category Archives: County Health Rankings
Beginning later next year, more than a million workers in New York City will have a brand new, health-promoting benefit: paid sick leave days that guarantee wages on a set number of days when they or a family member they care for is ill.
The new law, passed last June by the New York City Council and overriding an earlier veto by the mayor, begins to go into effect in April 2014. New York now joins San Francisco, Calif., Washington, D.C., Seattle, Wash., Portland, Ore., and the state of Connecticut in adopting at least some sick leave provisions.
Not every employee in New York City will get paid sick leave under the new law. The bill that passed the City Council initially applies only to businesses with 20 or more employees, who will be required to provide five paid sick days a year; that extends to companies with 15 or more employees beginning October 1, 2015. Smaller businesses and manufacturing firms are exempt from the paid leave provisions for now, though these workers will gain five days of unpaid sick leave, so they can take time off without fear of losing their jobs. Advocates hope to extend paid leave to cover those workers before long.
Advocates say paid sick leave is critical for smaller businesses, and especially for low wage earners. A survey by the Community Service Society (CSS) of New York found that half of low-income respondents said they have less than $500 to fall back on in case of an emergency, and according to CSS, without compensation for sick days, people are often forced to choose between caring for themselves or a loved one and heading to work.
A 2012 study in the American Journal of Public Health shows why the measure that is critical to individuals and families is equally crucial to society as a whole. The study found that lack of certain workplace policies, including paid sick leave, led to an additional 5 million cases of adult H1N1 (swine flu) during the 2009 outbreak.
Funding for much of CSS’s advocacy came through a County Health Rankings & Roadmaps grant to focus on four areas in two New York City boroughs, the Bronx and Brooklyn, that have very poor health rankings. The goal was to build support among small businesses, faith-based organizations and low-wage workers for passage of the ordinance through grassroots events, town halls, story collection and media coverage, as well as by encouraging partners and allies to include this policy as part of their policy agendas. The grant runs through November 2014 and CSS will be focusing its efforts, now that legislation has passed, on creating awareness and implementation of the new law.
NewPublicHealth recently spoke with Nancy Rankin, vice president for policy, research and advocacy at CSS about the new law and its impact.
NewPublicHealth: Key components of the legislation you advocated for passed. What’s next in your efforts on paid sick leave?
Nancy Rankin: We are continuing to work on this issue because we recognize that having a law pass is not the end of the story. We now need to do outreach to inform workers about their new rights and employers about their new requirements, because a new law requires compliance and it requires people to be aware of its provisions.
At the recent Place Matters conference in Washington, D.C., David Williams, PhD, the Norman Professor of Public Health at the Harvard School of Public Health and staff director of the reconvened Robert Wood Johnson Foundation Commission to Build a Healthier America, talked about the need for cooperation between the community development industry and health leaders.
“Community development and health are working side by side in the same neighborhoods and often with the same residents but often don’t know each other or coordinate efforts.”
NewPublicHealth recently asked Dr. Williams about how synergies between the two fields can help improve population health.
>>View David Williams' PowerPoint presentation from the conference:
NewPublicHealth: Is there progress on the community development and health fields working together to help improve the health of communities?
David Williams: I would say there is increasing recognition by individuals both in health and in community development that they are two groups working in many ways on the same challenges and often in the same communities and in many ways there can be there could be synergy from working together. But I would also say that this is all so new, and I don’t think the field has matured in terms of our full understanding of where the potential is. To me, one of the greatest hungers out there is for people to see examples of success and progress and initiatives that in fact have worked well together, and we’re still in the beginnings of seeing that—such as the Federal Reserve healthy communities conferences, which have raised awareness levels and have begun to help similar initiatives. But we’re still in the infancy of really capitalizing on the potential.
One of the key challenges is that this area of healthy communities is a broader issue. And that includes the need to recognize the importance of a health in all policies approach—that policies in many sectors far removed from health have health consequences. A good example is the education sector—and having teachers recognize that they are themselves are health workers in a certain sense because the work they do can have such an important impact on health.
The business sector is a critical partner when it comes to promoting the health of a community. Employment, income and overall economic stability greatly impact employee and community health. Increasingly, businesses are expanding their efforts from worksite-based health promotion programs to community-wide initiatives to ensure their employees’ access to healthy choices and environments.
Next Tuesday at 3 p.m., a County Health Rankings webinar will take a look at how local health leaders and businesses can work together to advance the health improvement efforts in their communities. The webinar will feature guest speaker Cara McNulty, Senior Group Manager for Prevention and Wellness at Target Corporation, which according to webinar organizers is “known for its commitment to community giving.” McNulty will share examples and lessons learned from her experience at Target to answer key questions:
- What kinds of partnerships are businesses looking for?
- What do communities and businesses need to understand about each other in order to forge successful partnerships?
>>Join the webinar to learn how to build common ground with businesses in your community and advance community health together.
Zachary Thompson, director of Dallas County Department of Health and Human Services, greeted the 1,000-plus attendees at last week’s annual conference of the National Association of County and City Health Officials (NACCHO) and expressed how honored he was to meet so many local health department leaders from across the country.
NewPublicHealth spoke with Thompson about Dallas’ particular health challenges and innovations the department has developed to help improve health in the community.
>>Read more NewPublicHealth coverage of the NACCHO Annual Meeting.
NewPublicHealth: Dallas ranks 67 out of 232 Texas counties in the County Health Rankings. What efforts are underway to help improve population health in the county?
Zachary Thompson: Dallas County is looking at various things, including adding more bike lanes and more parks where people can exercise. There’s a health assessment going on now to look at how all of the major stakeholders can come together to improve our health rankings. We have a great public health improvement work group that is working on ways to improve overall health in Dallas County.
NPH: West Nile virus was a major issue in Dallas last year. What are you doing this year to help keep the city safe?
Thompson: We had no deaths from West Nile virus in 2010 and 2011, then 20 deaths in 2012, which may have been a once-in-fifty-years event. Last year’s outbreak got everyone’s attention that West Nile virus is endemic in our community, and so we took the lessons learned and increased our resources.
We know what we improved on. We began to do year-round mosquito testing in 25 municipalities, and began meeting regularly with all the municipalities to assess their needs. Everyone has been on board with the overall integrated mosquito plan. So far this year we’ve had no human cases of West Nile virus. We definitely focused on preventive education—we started that earlier. We’ve also added additional ground-based truck spraying capabilities in the event that we needed to increase our spraying activity if we have a similar outbreak as last year. We have made insect repellent available for all senior citizens. Hopefully last year’s outbreak will have been a rare occurrence, but we’re prepared in any case.
Just a few metro stops can mean the difference between an extra five to ten years added to your lifespan. Using new city maps, the Commission to Build a Healthier America, which reconvened recently after a four year hiatus, is illustrating the dramatic disparity between the life expectancies of communities mere miles away from each other. Where we live, learn, work and play can have a greater impact on our health than we realize.
For too many people, making healthy choices can be difficult because the barriers in their communities are too high—poor access to affordable healthy foods and limited opportunities for exercise, for example. The focus for the Commission’s 2013 deliberations will be on how to increase opportunities for low-income populations to make healthier choices.
The two maps of the Washington, D.C. area and New Orleans help to quantify the differences between living in certain parts of the region versus others.
Living in Northern Virginia’s Fairfax and Arlington Counties instead of the nearby District of Columbia, a distance of no more than 14 miles, can mean about six or seven more years in life expectancy. The same disparity exists between babies born at the end of the Washington Metropolitan Transit Authority’s (known as the Metro) Red Line in Montgomery County—ranked second out of 24 counties in the County Health Rankings, metrics developed by the Robert Wood Johnson Foundation and the University of Wisconsin to show the health of different counties—and those born and living at the end of the Metro’s Blue Line in Prince George’s County, which ranked 17th in the County Health Rankings.
U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.
>>Read the full U.S. News & World Report article.
In February, the Robert Wood Johnson Foundation honored six communities with the inaugural RWJF Roadmaps to Health Prize, which recognizes outstanding community partnerships that are helping people live healthier lives.
Recently, NewPublicHealth spoke with Claude-Alix Jacob, chief public health officer at the Cambridge, Mass., department of health, one of the six prize-winning communities to be recognized by the Foundation. Mr. Jacob spoke to NPH about how collaborating around and winning the Prize has impacted the community, including resilience in the face of tragedy.
>>Apply to become a winner of the 2013-2014 RWJF Roadmaps to Health Prize. This year's application deadline is May 23, 2013.
NewPublicHealth: What did winning the RWJF Roadmaps to Health Prize mean to your community?
Claude Jacob: It has been great and exiting news for our community. Over the course of the last few months and through National Public Health Week last month we’ve had a chance to celebrate. We’ve been able to share our public health plans and community partnerships, but also under the aegis of the Robert Wood Johnson Foundation, we now have more credibility for all of our efforts. The Foundation is associated with promoting important health improvement efforts nationwide and just to be linked to the Foundation will open doors, especially now that we’re one of the six inaugural prize winning communities.
During National Public Health Week we invited our community stakeholders to celebrate to thank them for their hard work in helping us to prepare for the site visit that was required of prize finalists. So it’s been a phenomenal few weeks.
NPH: How has winning the prize impacted the health improvements of your community?
Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks.
NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?
Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.
So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.
NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?
How healthy is your county? Answers are out today in the 2013 County Health Rankings, which examine the health and well-being of people living in nearly every county in the United States and show that how long and well people live depends on multiple factors beyond just their access to medical care. The Rankings allow counties to see what’s making residents sick or healthy and how they compare to other counties in the same state. The County Health Rankings, now in its fourth year, is a joint project of the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute.
“The County Health Rankings can be put to use right away by leaders in government, business, health care, and every citizen motivated to work together to create a culture of health in their community,” said Dr. Risa Lavizzo-Mourey, RWJF president and CEO. “The Rankings are driving innovation, unleashing creativity, and inspiring big changes to improve health in communities large and small throughout the country.”
The Rankings examine 25 factors that influence health, including rates of childhood poverty and smoking, obesity levels, teen birth rates, access to physicians and dentists, rates of high school graduation and college attendance, access to healthy foods, levels of physical inactivity, and percentages of children living in single parent households.
Although the Rankings only allow for county-to-county comparisons of ranks within a state, this year’s Rankings show significant new national trends:
To mark the launch of the 2013 County Health Rankings, Risa Lavizzo-Mourey, MD, MBA, President and CEO of the Robert Wood Johnson Foundation will be taking questions and leading a group discussion via Twitter on March 20, from 2:00 p.m. to 3:00 p.m.
The Q&A will focusing on what's new in the 2013 County Health Rankings and how individuals and organizations can make use of the Rankings to create change for better health in their communities. Submit your questions to: @RWJF_PubHealth or @CHRankings and make sure to use the hashtag #healthrankings.
You can follow the County Health Rankings & Roadmaps on Facebook and Twitter to learn about the new data, find stories about how the project has improved health in communities like yours and get ideas for taking action where you live. The Facebook page will be posting useful new infographics, videos, quotes and images all week. On Twitter, join the Q&A, share your #healthrankings to fill in the “Race to 50” map, and ask an expert for help by tweeting your county to #myrankings.