Grays Harbor and Pacific counties remain among the least healthy in the state, according to an assessment of health factors that is compiled annually.
In the 2014 County Health Rankings, released Wednesday, Grays Harbor County was 38th of 39 counties in terms of self-reported health behaviors of residents, social and economic factors, physical environment and access to medical care.
The study is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute and assesses every county in the country annually. While Grays Harbor scored dead-last in the category last year, changes in how the scores were measured has more to do with the different number than any real improvement, said Joan Brewster, director of Grays Harbor Public Health and Social Services.
“Our health picture remains unchanged … it doesn’t necessarily reflect a major change in health status,” she said of the ranking, adding that many of the issues measured in the survey cover “very broad social issues” and will require community players working together to effect change, which she said is happening.
“If we’re going to make changes the whole community needs to assist and a lot of people are (currently) doing that,” she said.
In health outcomes, that measure length of life and quality of life, Grays Harbor County ranked 36, the same as last year, with 19 percent saying they’re in poor or fair health, compared with the state average of 14 percent.
Pacific County ranked last in the state for health outcomes. Last year it was 37th. In the category of “health factors,” Pacific County was 36th, the same as last year.
Both counties have adult smoking and adult obesity rates high above state and national averages – but Pacific County is ranked better in terms of excessive drinking and alcohol-impaired driving deaths. Twenty-two percent of Grays Harbor residents drink excessively, compared with 15 percent of Pacific County residents and 17 percent of state residents the study indicates. Fifty-nine percent of driving deaths on the Harbor are alcohol related, compared with 25 percent in Pacific County and a state average of 42 percent. Top performing states nationally only see 14 percent of driving deaths connected to alcohol consumption.
Calling it part of a cultural issue on Grays Harbor, Brewster said the county no longer has funding for outreach through things such as anti-drinking and driving advertisements – but that they often work alongside groups like the Liquor Control Board in distributing the message. She reminded of the progress made in combating the epidemic of alcohol related driving deaths, calling it a “good illustration of the power of the public health message.”
Another tough reality for both Grays Harbor County and Pacific County is high percentages of uninsured (22 percent in Pacific County and 21 percent in Grays Harbor County, compared to state average of 16 percent), and outlandish ratios of primary care physicians, dentists and mental health providers to patients compared with state averages. For example, on Grays Harbor, the ratio of 2,267 patients to one doctor stands in stark comparison with the 1,216 patients to one doctor that is the state average. Such numbers lay the groundwork for corresponding issues the county ranks poorly on including preventable hospital stays and diabetic and mammography screenings. Brewster said the county has exceeded its goal for signing up uninsured residents under Medicaid or through insurance under the Affordable Care Act, and that she expects the numbers to change next year. But just having insurance doesn’t always mean there is a doctor available to that patient and better access to medical care and mental health providers may take more time, she said.
“I don’t think we can move that needle in 12 months, we’re dramatically under resourced here,” said Brewster, adding she consistently makes recommendations at the state level about the kind of changes she thinks need to be made to create “strong rural health systems,” but there is currently no legislation she sees potentially benefiting the situation.
One of those recommendations is paying doctors more, or potentially a medical school loan reimbursement plan for doctors that are willing to travel to rural communities they may not otherwise decide to consider for jobs.
“It’s worth it in the long run, if you don’t have enough doctors people get sicker” she said, adding legislators should be aware that its not enough to simply implement health care benefits if the capacity or resources do not exist to allow them to function.
The section of the report that looks at social and economic factors such as high school graduation rates, college attendance rates, unemployment, amount of children in poverty and children in single-parent households all show Grays Harbor County continues to lag behind state averages. For example, fifty-one percent of children in Grays Harbor County are eligible for free lunch, in comparison to 33 percent in the state as a whole. The results reflect the “direct results of generational poverty and changes in the economy,” said Brewster, adding the county has a number of programs in place designed to mitigate the impacts. One example is that as part of the federal Women, Infants and Children program, the county has implemented a home visitation program working directly with first time mothers to help influence positive parent skills, and to better prepare children early on for academic and social success. Especially for teen-aged mothers (37 percent of children in Pacific County and 46 percent in Grays Harbor County are born to single mothers) and for children in single parent households, which accounts for 38 percent of children on the Harbor and 33 percent for Pacific County — both of which contribute widely to the amount of children in poverty— such help is crucial.
But, combating such issues is an ongoing battle.
“Where Grays Harbor scores the poorest are on very broad social issues,” said Brewster. “It will take lots of effort (to make lasting changes).”
To view the full 2014 County Health Rankings, go to www.countyhealthrankings.org.