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Is Rural Georgia Dying? Literally?

A basic premise of Trouble in God’s Country is that rural Georgia is dying.  Truth is, I’ve meant that figuratively rather than literally – a reference to local economies gutted by globalization and other factors, failing schools and small hospitals in danger of closing, among other things.

Recently, however, I read an article that made passing reference to the growing number of rural counties across the country where deaths outnumber births.  I wondered if that might be the case in Georgia.

A quick dive back into the Georgia Department of Public Health’s (DPH) OASIS system produced some pretty startling results. Read more

AJC: Rural hospitals bailing on babies

The AJC is up today with an excellent and hugely important story by Lynne Anderson about the state’s rural hospitals bailing out of baby business.  This is the bow wave in the slow-motion disaster that is rural healthcare in Georgia in the 21st century.

One of several money grafs:

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A Tale of Two Regions

Our recent research on premature death rates in Georgia produced a couple of unexpected revelations, and we decided to loop back for a closer look.  The revelations involve two of our five regions, North Georgia and Middle Georgia.  (For a quick primer on that earlier work, click here, here and here.)

For our purposes, North Georgia is made up of 41 counties that lie outside Metro Atlanta and above the gnat line (see map below and click on the map for a larger view).  As a region, it has clearly benefited from its proximity to Metro Atlanta; in recent decades, it has posted far and away the second-strongest population and economic growth in the state, outpacing not only Middle and South Georgia, but the Coastal region as well. Read more

Peachcare and Young YPLL

In a recent post, we began to explore premature death rates within Georgia’s working-age population, men and women between the ages of 18 and 65.  We were initially surprised to learn that improvements in the so-called YPLL 75 Rate for this segment of the state’s population lagged gains for the population as a whole.  That led us to drill down a bit and look at premature death trends in the younger and older age groups – specifically, Georgians under the age of 18 and between the ages of 65 and 75.

Both groups saw significantly stronger gains in their premature death rates than did working-age Georgians.  The question was why; what factors were driving premature death gains for younger and older Georgians that were somehow not impacting working-age Georgians?

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Forsyth County moves to the top of the 2015 TIGC Power Ratings

With the publication Wednesday of the Robert Wood Johnson Foundation’s 2015 County Health Rankings, we can indeed report that, as expected, Forsyth County has slipped past perennial leader Oconee County and claimed 1st place in the 2015 Trouble in God’s Country Power Ratings. Read more

A new Power Ratings champ?

Every year during the old Partner Up! for Public Health campaign, we built a major part of the annual publicity effort around what we called Power Ratings that paired county health rankings produced by the Robert Wood Johnson Foundation with county economic rankings generated each year by the Georgia Department of Community Affairs (DCA).

Throughout the 2010-through-2014 period for which we compiled rankings, Oconee County reigned supreme.  For each of those five years, it was No. 1 in DCA’s economic rankings,[1] which are generated by a formula that incorporates local unemployment and poverty rates along with local per capita income.   And, it ranked either 2nd or 3rd in RWJ’s annual health outcomes rankings, which are based on a formula that includes premature death rates, the percent of the population reporting being in poor or fair health, number of days worked missed for reasons of physical or mental health, and low birthweight. Read more

Working Age YPLL

Throughout the Partner Up! for Public Health campaign, when we were conducting the research and analysis that enabled us to “connect the dots” between community health and economic vitality at a local level, one of the key health metrics we relied upon was premature death – better known as Years of Potential Life Lost before Age 75, or YPLL 75.  YPLL 75 is generally regarded as the Dow Jones Industrial Average of a community’s (or a state’s, or a nation’s) health.  If you want to look at one metric and get a sense of a community’s health, look at its YPLL 75 rate.

YPLL 75 is part of the formula the Robert Wood Johnson Foundation uses to calculate a county’s overall Health Outcomes Rankings, and it’s easy enough to pull from the State of Georgia’s excellent online public health data system, OASIS (for Online Analytical Statistical Information System).  So it was a natural data point to work with. Read more

Thanks, New York Times!

Over the past several weeks, I’ve been working on a presentation I’ll be delivering next month to the Kentucky Public Health Association.  I was invited to speak to the group after one of its leaders saw me deliver an early version of the “Connecting the Dots: Community Health & Economic Vitality” presentation we developed as part of the Partner Up! for Public Health campaign that officially concluded last year.

It was literally yesterday afternoon that I finished double-checking data and proofing maps I’ll be using to demonstrate the overlap between good health and strong economies in the Bluegrass State – and this morning The New York Times gave me a major assist by publishing a front-page story built around a first-ever look at county-level smoking rates.

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Chicken and the Egg

In the four years we’ve been talking about the relationship between health and economic vitality at a community level, the one question we’ve gotten more than any other is the chicken-and-egg question.  Which comes first?  Which is the driver?  Does health make wealth?  Or vice versa?

My answer is that the relationship between health and economic productivity is pretty clear first and foremost at a personal level.  We all know we’re more productive when we’re in good health than when we’re down with a cold or the flu, let alone something more serious.  We also know that when we’re sick, we inevitably have to divert some of our income to medical care.

The same thing plays out at a community level.  Recently we updated an analysis of the Georgia counties that came in at the top and bottom of our 2013 Partner Up! for Public Health Power Rankings – Oconee County at the top and side-by-side South Georgia neighbors Crisp and Wilcox counties tied for last.

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The High Cost of Premature Death

Here at the Partner Up! for Public Health campaign, we’re always looking for ways to illustrate the high cost of poor health.  Recently we began to study the mountains of public health and economic data we’ve collected to see if we could develop a reasonable methodology for putting a price tag on premature death in Georgia.

This is not a new idea, but most of the studies and reports we’ve found rely on complex formulas that most of us can’t understand and produce results that people have trouble relating to.  Truth is, those are easy traps to fall into; it’s difficult to deal with data without dealing with data.  One formula we found looked like this: Read more