One of the things I’ve been working on lately is a piece ranking all 159 Georgia counties nationally on a range of socioeconomic measures. The last chunk of data I needed was the 2024 release from County Health Rankings & Roadmaps (CHRR). That report hit the web on March 24th, and I’ve decided it merits a quick report of its own.

As a little background, CHRR has, for more than a decade now, been collecting and reporting key population health metrics on the vast majority of counties in the nation (there are always some counties you can’t get data for). The program is run by the University of Wisconsin’s Population Health Institute and funded, at least in part, by the Robert Wood Johnson Foundation. As part of its annual report, it has historically included in-state rankings; with this year’s report, it includes data that makes it possible to rank all counties nationally.

Which is just what I needed.

As faithful TIGC readers know, I’ve been focused for a while now on putting the performance of Georgia counties into a national context. The main reason for this focus — okay, obsession — is that a year or so ago I stumbled onto the fact that Georgia had more counties and people mired in the bottom national quartile for per capita income (PCI) performance than any other state in the country.

From there, I began looking at other metrics — median household income and educational attainment, in particular — and found the picture was very similar in those categories as well. Pick your measure of socioeconomic well-being and you’d find that about half of Georgia’s 159 counties were in the bottom national quartile. The vast majority were south of the gnat line, but you’d also find a string of bottom-quartile counties running up the state’s border with South Carolina.

So, the question I’d been waiting to get an answer to was simply: Would the same thing hold true with health?

The answer, sadly, is … absolutely.

CHRR gauges county-level health outcomes by stirring together local data for the following measures: premature death rates, the percentage of live births reported with low birthweight, the percentage of adults reporting fair or poor health, and the average number of physically and mentally unhealthy days reported in the past 30 days.

As the map at right shows, 83 of Georgia’s 159 counties are in the bottom national quartile for health outcomes, based on the CHRR rankings—more than any other state. According to the Census Bureau’s latest population estimates, those 83 counties are home to 2.43 million Georgians. I’m still stitching together the national population analysis, but I’ll go out on a limb and say I’ll be more than a little surprised if we don’t also lead the nation in the number of people living in bottom quartile counties.

One other factoid I can include here is that the Georgia-North Carolina contrast I’ve found with other measures holds true with health outcomes as well. Generally regarded as perhaps Georgia’s closest peer state, North Carolina has somehow managed to do a much better job than Georgia of limiting the number of its citizens who fall into the nation’s bottom tier for economic performance and educational attainment.

The same is true with CHRR’s health outcomes. Only 19 of North Carolina’s 100 counties and 6.7 percent of its population fell into the bottom national quartile for health outcomes in the latest study. In contrast, 22 percent of Georgia’s population live in the 83 counties that landed in the bottom quartile for health outcomes. The graph at left shows the population splits for both states by health outcomes quartile.

With both per capita income and educational attainment, I’ve been able to demonstrate that the gap between Georgia and North Carolina developed over time. With both those measures, there was a time when the two states had very comparable data profiles, but clear differences evolved over time (see my earlier stories here and here). I’ll be surprised if the same pattern doesn’t hold true with health outcomes, but I’ve got a good bit of work to do to figure out if I’m right about that.

I’ll report these and other county rankings in the near future, but here’s a teaser. The top five Georgia counties for health outcomes, per the CHRR report, are: 1. Forsyth County; 2. Oconee County; 3. Cherokee County; 4. Cobb County, and 5. Columbia County. The bottom five are: Early County at 155th; Crisp at 156th; Randolph County at 157th; Hancock at 158th, and Miller County at 159th.

Stay tuned.

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