Officials in Hanover and at regional and statewide public health organizations will utilize newly released data, which ranks Grafton County second in New Hampshire in health outcomes, to help plan health policy on various scales over the coming months.
The County Health Rankings and Roadmap, an annual study of public health that examines nearly every county in the United States, published jointly by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, was released last week for the sixth consecutive year.
“The purpose of the rankings report is really a call to action to communities to see that health is much more than going to see a doctor,” Jan O’Neill, a researcher at the UWPHI, said. “While that’s necessary, it’s not sufficient. And it’s an opportunity for communities to have conversations about the many other additional factors in addition to clinical care.”
Numerous public health organizations operate in Hanover and Grafton County, including the New Hampshire Department of Health and Human Services, the Mascoma Valley Health Initiative and the New Hampshire Public Health Association.
“We want to get an accurate picture of what’s happening in our region, and we will look for multiple sources of data, in particular validated approaches like the Robert Wood Johnson [Foundation] approach, that can create scales and put that data in perspective for us,” Alice Ely, executive director of the Mascoma Valley Health Initiative, said.
The Rankings and Roadmap data put Grafton County second of 10 in the state for overall health outcomes, judged by how healthy people feel and how long they live. In terms of overall health factors, Grafton County placed third in the state. That ranking is based on measures of health behaviors, clinical care, social and economic factors and the physical environment.
Grafton faired better than some neighboring counties. Sullivan County, ranked ninth for both health outcomes and health factors, while Coos County to the north placed 10th in both.
Ely said that Grafton’s performance, however, does not necessarily indicate that the entire county is faring well.
“That doesn’t mean that every community in our region is sharing in the same positive health outcomes that everybody else is, so it’s our job to dig down deeper and look community-by-community at where the health status is in fact as high as they say, and where we still need to look at the equity issue and bringing people up to this high level of health outcome,” she said.
Grafton County residents can expect a longer than average length of life, with the county ranking first in the state by that metric, according to the rankings. Grafton had 4,955 premature deaths per 100,000 residents last year, compared to 5,275 per 100,000 overall for New Hampshire.
Grafton’s rate of adult smoking and adult obesity matched the state’s overall averages of 17 percent and 27 percent, respectively, while fewer residents were physically inactive, at 18 percent compared to 21 percent for the state as a whole.
Conversely, 19 percent of Grafton residents reported excessive drinking compared to just 18 percent in the state as a whole. Insurance rates were lower in Grafton than in New Hampshire as a whole, with 15 percent uninsured compared to 13 percent statewide.
Grafton, however, boasts a much higher rate of primary care physicians per capita than most the state as a whole, with 537 residents per primary care physician compared to 1,080 residents per primary care physician in New Hampshire.
The data from the study will likely be incorporated in public health projects in the Upper Valley and statewide. Katie Robert, the president-elect of the New Hampshire Public Health Association, said that the organization will work to ensure that regional public health networks are making full possible use of the data available to them from the study.
“We are very invested in taking that data and looking at it and making sure we are supporting our partners across the state in achieving improved health outcomes,” she said.
On a local level, Hanover will work with other towns and organizations in the region to implement public health initiatives, town manager Julia Griffin said.
“We tend to look at the data through regional organizations and then use that data to inform the public health priorities that we want to focus on in the next year or two,” Griffin said.
Griffin, who also serves on the Public Health Advisory Council of the Upper Valley, said that regional priorities currently focus on seasonal diseases, such flu immunization, drug and alcohol abuse and the expansion of mental health services. They also plan for potentially major public health issues.
“In the fall, we were heavily focused on preparing to respond to a potential Ebola outbreak,” she said.
Later, the Town began to focus more on ensuring that flu immunization was available, particularly in schools.
Griffin said that, while the rise in heroin use that has struck New Hampshire and Vermont in recent years has yet to make a major impact in Hanover, preparing and training law enforcement and public safety officials has played a major role in Upper Valley health projects.
At the national level, the data looks more at educational attainment and income inequality than it has in past years, O’Neill said. The links between education, inequality and public health have become more clear through recent research, and the Rankings and Roadmaps project aims to incorporate those metrics into its public health research, she said.
One of the most important components of the data is its potential to raise public and media awareness, Ely said. While public health officials in local communities typically have an understanding of the challenges they face, quantification of those issues is an asset and allows officials to better understand their position relative to other areas and also can be useful when applying for grants.
“It’s nice to see the data validating what we see happening, and it’s nice to see the data and what Robert Wood Johnson bring to the table raising awareness,” she said.
