New report on county health outcomes gets to the heart of the ideological debate
At the most basic level, it’s beyond debate that one’s location can have an enormous impact on one’s health and wellbeing. If you have any doubts about this, ask the people who live near the Fukushima disaster, in the Gaza Strip or in Port au Prince, Haiti.
Human intellect, drive and initiative can make a huge difference for people in just about any place or set of circumstances, but at some point, reality sets in; if you live in an impoverished or unhealthy place, it just stands to reason that your odds of leading a safe, healthy, high-quality life are a lot longer than if you’re comfortably ensconced in Greenwich, Connecticut, the Kensington section of London or even any number of pleasant neighborhoods in Wake County, North Carolina. Again, you may be able to overcome those odds – people do it occasionally – but you may win the lottery too.
New report on North Carolina counties
Looking for even more concrete evidence? Then check out this new report released this week by the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute  that includes data on every county in the United States.
Here, not surprisingly, is what they found:
“The County Health Rankings show us that much of what influences our health happens outside of the doctor’s office. In fact, where we live, learn, work and play has a big role in determining how healthy we are and how long we live,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of RWJF.
Here are some equally unsurprising details on the findings in North Carolina as reported by Tom Breen of AP :
“The North Carolina counties where people are healthiest tend to be urban and affluent, while poor, rural counties struggle the most with bad health, according to a study released Tuesday.
Wake, Orange, Union, Mecklenburg and Dare counties lead the state in measurements of health outcomes, which include factors like how long people live and their quality of life…. Ranking last in health outcomes is Columbus County, followed by Robeson, Halifax, Bladen and Edgecombe counties. All five are designated “Tier 1” counties by the state Department of Commerce, meaning they are among the counties with the highest levels of economic distress in North Carolina. Four of the five healthiest counties are “Tier 3,” meaning they are among the least economically troubled, with Dare being designated a “Tier 2” county.”
The debate over causes and effects
So, armed with these facts, what do we do? While to most caring and thoughtful people the answer may seem obvious (i.e. “Do something!!”), for many, amazingly enough, it is not.
For some ideologues on the political right these sobering county-by-county statistics are indicative of little more than that the inhabitants of the troubled areas are making poor choices. Check out, for instance, the following comments that accompany the story on WRAL.com :
“I see a lot of poor people smoking and eating junk food for dinner. There is nothing news worthy here. Just more class warfare.”
“I thought people in rural areas could grow food, especially if they are unemployed…buy some seeds like we did when I was a kid.”
“What a crock. The government gives them everything they need. They have welfare with which to buy food, it’s their own fault if they don’t buy healthy foods. They have access to healthcare, it’s their own fault if they don’t utilize it. The media loves to portray the poor as victims of society when, in fact, most are in the lower income bracket because of personal choices.”
“because the poor lazy people prefer to buy mcdonalds and fast food for meals than to spend an hour in the kitchen cooking. Has nothing to do with money and everything to do with values.”
Got that? According to these bitter and troubled people, the problems in North Carolina’s poorer counties and presumably, any number of other struggling places in the world, are simply a matter of bad decisions by shiftless people who know (or ought to know) better!
Cruel and extreme as this may seem, the above comments are not all that remarkable or surprising. Though usually somewhat more polished, such absurd statements are, in fact, the daily stock in trade of the Rush Limbaughs and Glenn Becks of the world as well as the inhabitants of the conservative “think tanks” like the John Locke Foundation and the Pope Civitas Institute.
Their message to the people of places like Columbus and Robeson Counties is this:
“Move somewhere else. Either that or work harder to pull yourselves up by your own bootstraps. Public systems and structures can do you no good. What your community needs to do is to sell off its schools, roads and public health departments to private corporations and get rid of business regulations.”
Meanwhile, back in the real world…
In any sane debate, of course, North Carolinians would have long ago moved well past the bizarre claims of extremists pushing survival-of-the-fittest market fundamentalism. Unfortunately, 2012 is frequently not a year of sane debates . Despite several decades (centuries, really) of compelling evidence that intentional public solutions can and often do make life dramatically better for communities and nations, sometimes a reminder is in order.
So here goes:
Public education works; so do public health programs, public roads, environmental protection laws, consumer protection and safety rules and dozens of other public structures and systems. Despite all of their many human imperfections, these structures and systems are the lynchpins of a free, middle class society and among modern America’s greatest accomplishments. Together, they make the market economy work and provide civilized society with the tools and rules to intentionally and directly address human suffering and shortcomings (and build and spread wealth) on a large scale.
Obviously, there are scores of variables and limitations. But generally, when we pull together, invest more and pay more attention, we get better results. When we fend only for ourselves, invest less and neglect we get poorer results. The proof can be seen wherever one turns. Can it really be seriously suggested that the problems of the Third World or of the impoverished communities of the North Carolina will be better served with more official neglect and fewer of the public structures and systems that bind us together?
Apparently, it can be seriously suggested – see the comments above and the numerous websites of the Pope Empire. Happily, though, this doesn’t mean caring and thinking people have to take such suggestions seriously.
As the release accompanying yesterday’s report noted:
“The good news is that businesses, health care providers, government, consumers and community leaders are already joining forces in communities across the nation to change some of the gaps that the Rankings highlight.”
This brief story on American Public Media’s Marketplace radio show  provides even more confirmation.
In other words, Americans know in general what to do about the poor counties with terrible health outcomes. All that’s needed is the data to pinpoint the problems and the political will to act. The new report provides the former. Let’s hope we can overcome the roadblocks thrown up by our confused friends on the far right to muster the latter.