Posts tagged ‘County Health Rankings & Roadmaps’

Putting the divide between Georgia’s rural and urban counties into perspective

One of the hard things about telling the “Trouble in God’s Country” story is figuring out how to explain the magnitude of Georgia’s urban-rural divide in ways that are actually useful – to the general public as well as policy makers.    It’s not exactly news that Metro Atlantans are more prosperous economically, better educated and healthier than their country cousins.

And, we’ve long had various types of county rankings, and one county is always No. 1 and another is No. 159.  (Right now, Forsyth County ranks first in most categories you can come up with, and we have something of a barroom brawl amongst a fair-sized group counties to see which is at the bottom of the heap in Georgia.  More later on this.)

But rankings don’t give you a real sense of the gap between Georgia’s best and worst, or whether that gap is getting bigger or smaller.  Lately I’ve been wallowing around in various piles of national and 50-state data to see if I could find anything that might be helpful.  I’ve still got more work to do, but herewith a few nuggets from my wallowing to date:

• The gap between Georgia’s best-off and worst-off counties is probably bigger than in just about any other state. I’ve got a couple of sources on this.  One is from a Washington think tank called the Economic Innovation Group (EIG).  EIG has pulled together several tons of economic, educational, poverty and housing data on all 3,000-plus counties in the country and generated what it calls a “Distressed Communities Index,” or DCI, for each county.  Then it used those index scores to create national rankings.  The best possible DCI is 1 and the worst is 100.  For 2017, the top Georgia county in EIG’s rankings was Oconee County, with a DCI of 1.1 (Forsyth County came in second with a DCI of 1.6).  Oconee ranked 34^th nationally; Forsyth, 49^th.  At the very bottom of the EIG rankings, in 3,124^th place, was Stewart County, with a DCI score of 99.9.  That’s about as big a divide as you can find.  Also worth mentioning: Stewart County had some real competition for that last-place finish.  Five other Georgia counties were nipping at its heels in a race to the bottom: Macon, Hancock, Calhoun, Wheeler and Taliaferro counties all had Distressed Community Indexes of more than 99.
• My second pot of data on this comes from the folks at County Health Rankings & Roadmaps. Because their data is presented on a state-by-state basis, it takes a little work to build a national picture.  Their report includes premature death rates for 2,900 counties (a couple of hundred had such small populations that they couldn’t generate reliable rates).  Premature death rates – known formally as Years of Potential Life Lost before Age 75, or YPLL 75 – are sort of the Dow Jones Industrial Average of population health.  It’s the best single number to watch to get a feel for the general health of a community.  (EIG, by the way, doesn’t include any health data in its DCI calculations, so this is a useful complement to its work.)  In these rankings, Forsyth is the top-ranked Georgia county and Oconee came in 2^nd; their national ranks were 55^th and 185^th, respectively, and their respective YPLL 75 rates were 4265 and 5283 (with YPLL 75 rates, the lower the number, the better).  At the bottom of this list of 2,900 counties, we find a somewhat different list of Georgia counties.  Miller County came in 2,866^th with a YPLL 75 rate of 15646; Warren County did a little better, finishing 2,862^nd with a rate of 15422.  Twiggs County came in 2,850^th with a score of 15001 and Quitman County finished at 2,841^st with a rate of 14,797.  These are truly third-world numbers and obviously among the worst in the nation.
• One of the things that becomes clear from studying the EIG and County Health Rankings data is that it’s not just rural areas that are in trouble. Just about every major population center outside Metro Atlanta ranks poorly nationally on just about every metric available.  Worst-off is Albany, which posted a 2017 EIG Distress Score of 99.1 and finished 8^th on EIG’s list of America’s most-distressed small cities – just barely ahead of Flint, Michigan.  But most of Georgia’s other regional cities didn’t fare a lot better.  On EIG’s list of cities with populations of more than 50,000, Athens-Clarke County, Augusta-Richmond County, Columbus and Valdosta all finished in the bottom quintile nationally, and Savannah just barely avoided falling into the lowest grouping.  (For some reason, EIG didn’t include Macon on its list of Georgia cities, but Bibb County was the second-worst major Georgia county on EIG’s county list, not far ahead of Albany’s Dougherty County.)  The City of Atlanta was in the middle of the pack nationally, with a DCI score of 59.6.  At the top of the Georgia pile was the City of Alpharetta, which ranked 21^st nationally with a Distress Score of 2.6 (again, contrast that with Albany’s 99.1 and you find about as big a divide as possible between otherwise comparable Georgia cities).  I won’t go into detail here, but the same is generally true with the County Health Rankings data; Muscogee, Bibb, Richmond and Dougherty all finish in the bottom 500 of the 2,900 counties it ranked nationally.

I think this is important because I’ve long believed that any effort to improve Georgia’s rural areas has to include – and probably start with – the regional hub communities.  Whether they like to admit it or not, rural areas depend on those major populations centers for a wide range of support systems, including employment, healthcare, education and shopping.  If the Macons and Augustas are allowed to slip past some hard-to-discern tipping point, it may well doom dependent rural areas for multiple generations.  As a practical matter, it may already be too late for Albany and much of Southwest Georgia, where the population that isn’t already packing up and leaving is among the least-educated and least-healthy in the nation (if not the world).

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Following are four tables showing the top and bottom 10 Georgia counties in the Economic Innovation Group’s 2017 Distressed Communities Index scores and rankings, and premature death rates as published by County Health Rankings & Roadmaps.  The national rankings shown with the premature death data were developed by the writer by assembling a spreadsheet combining County Health Rankings & Roadmap’s from all 50 states and the District of Columbia.

© Trouble in God’s Country 2019