While healthier counties in Georgia continue to thrive, poorer rural counties such as those in the Augusta area struggle to overcome problems related to systemic ills including poverty and single-parent families, a new review of county health reveals.
The 2014 County Health Rankings were released today by the Robert Wood Johnson Foundation and the University of Wisconsin Public Health Institute. With now five years of data to look through, certain trends are emerging that do not spell good news for those who have performed poorly in the past, said Jan O’Neill, a community coach with the Public Health Institute.
“People in the least healthy counties are twice as likely to have shorter lives as people in the healthiest,” she said. “And there are twice as many children living in poverty (than) in the least healthy counties.”
Some statistics point to more systemic problems, such as teen birth rates. For Georgia, it is 48 per 1,000 births. For healthier Columbia County it is 26, but for Richmond County it is 63, for McDuffie County it is 70 and for Burke County it is 72, O’Neill said.
“And of course that’s related to poverty, children in poverty, employability, education,” she said. “They are all wrapped together.”
And those teen mothers could be part of a larger problem.
Richmond County was last among counties in a category called Family and Social Support, which looked at the percent of adults without social or emotional support and the percentage of children living in single-parent households. Often those problems are combined, especially in Augusta, said Dr. Lucy Marion, the dean of the College of Nursing at Georgia Regents University and a founding member of the Greater Augusta Healthcare Network.
“I think that included the young single moms that are isolated and they are there with the baby but they are not within that protective family,” she said. “The young single moms who are living with the grandmother parenting and the young single moms going back to school, that’s a very different group from those who are isolated. We have a fair number of those (isolated ones).”
Marion said there have been efforts to try and help bring together people, including the isolated elderly, with things such as community gardens and other activities, but they were not funded.
While there are often multiple coalitions within communities trying to address problems, a larger, more coordinated effort is needed, O’Neill said. Some communities are using a model program called Collective Impact, which seeks to bring together agencies in multiple fields around a common agenda whose actions are more coordinated and reinforcing, she said. And it can’t just be the usual suspects, O’Neill said.
“It’s obviously not just doctors and hospitals,” she said. “It’s going to be the people who teach in our schools, those who pass the laws and policies, our business owners, our parents and families raising children. It’s all those folks, it’s community planners, public health, all will have to get involved and get engaged.”
That could be why both Richmond and Columbia counties rank very high in access, and surrounding counties to varying degrees, but seem to do much more poorly on quality of care and on health outcomes. Social and economic factors can have twice as much weight as the clinical in determining length and quality of life, O’Neill said. And those are what have to be addressed.
“It requires systems change and policy change,” she said. “A lot of times people throw a lot of programs at these things and that’s necessary, but it is not sufficient and can actually work against people because it pulls resources from a more coherent strategy.”
While there are some early intervention programs in Augusta and those can be helpful, it is not being addressed in a systematic way yet, Marion said.
“I don’t see that,” she said. “But that’s our opportunity to do that.”