The County Health Ranking report by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation ranked Orange County No. 1 in health factors and No. 2 in health outcomes.
Orange County Commissioner Penny Rich said she was excited by the report and the health department’s progress.
“I’m actually really encouraged by the reports and only because our health department has been doing such a good job thinking outside the box and challenging the norms to try and get our county healthier,” she said.
The countywide ban on public smoking and focus on green spaces has contributed to the county’s overall health, Rich said.
Rich said there’s not a better place to go out to hike, walk and enjoy the outdoors than Orange County.
“We’ve kept a really good hold on preserving some of the beautiful parks that we have and we use them,” Rich said. “And it’s good — it’s really good.”
Anna Schenck, director of the North Carolina Institute for Public Health, said the report did a good job of showing the numerous social and environmental factors that contribute to health. The divide between urban and rural communities in the ranking was also apparent, she said.
“It’s a combination from actors in education, income, health care access and lifestyle factors that will make a person healthy or not and then those that congregate in counties that are wealthier,” she said. “In North Carolina, we have a real divide in terms of the haves and the have-nots and the wealthy counties.”
The report said Orange County ranks as one of the worst in the state in terms of income inequality.
Stacy Shelp, a spokesperson for the Orange County Health Department, said 30 percent of county families do not earn a living wage.
“That’s a significant issue, especially when you are looking at things like health — because what we know is that poverty and some of the situations that poverty creates for a family and an individual and a community create long-term effects, such as chronic disease,” Shelp said.
She said one of the biggest challenges for the health department is educating the public about income inequality in the county.
“We don’t tend to hang our hats on ‘We’re number one or number two out of a hundred counties,’” Shelp said. “We hang our hats on we have got a heck of a lot of work still left to do.”
The health department is continuing to work to combat poverty’s effects on health through early childhood education programs, Shelp said.
“It’s about a holistic approach, giving children the opportunity to start equal to their peers and will ultimately impact lifelong chronic disease,” she said.
Alice Ammerman, a nutrition professor at the Gillings School of Public Health, said Medicaid expansion would reduce health disparities and help to provide preventive care for people with lower income.
“Most of the funding would come from the federal government, so it’d be quite a benefit. But there’s been a lot of pushback from the legislature, which is very conservative,” Ammerman said. “They don’t want to take that federal funding. Ultimately it’s a big loss to the state, especially for lower income classes.”
It is important to understand the rankings don’t indicate everyone is doing well, Ammerman said.
Schenck said the recent county and state rankings reflect a broader problem not only in North Carolina, but also in the United States.
“The United States ranks (lower) than other countries, we spend a whole lot on expensive hospital emergency care, rather than spending our money in prevention,” Schenck said.