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Posts tagged ‘County Health Rankings & Roadmaps’

County Rankings 101: A basic primer

Lately I’ve been updating several data sets and taking a fresh look at various county rankings.  Generally, I find the rankings systems a little frustrating because they tell you who’s best and who’s worst but usually don’t provide much help in the way of explaining the chasm between best and worst.

That said, the rankings systems are still sort of an unavoidable starting point in evaluating the relative standing of Georgia’s 159 counties.  In the process of updating all these rankings, I wound up mapping a bunch of the data and decided that all this might make for a fair primer on how Georgia’s counties stack up in terms of economic vitality, population health, and educational attainment.

A quick description of the rankings I’ll be using below in a table and in a map:

  • Economics – For local economics, I rely on the Georgia Department of Community Affairs. DCA manages the state’s Job Tax Credit program, which is designed to steer jobs to the state’s poorest counties.  As part of that program, it ranks all counties in the state using a formula based on local per capita income, poverty rates and unemployment rates.  Because the JTC program is focused on helping poor counties, DCA ranks the counties from worst-to-best; for my Trouble in God’s Country purposes, I turn the reverse the JTC rankings and list them best-to-worst.
  • Health – Here I used the 2019 county Health Outcomes Rankings produced by the Robert Wood Johnson Foundation’s excellent County Health Rankings & Roadmaps program. This program produces county-level rankings for each state using a formula that factors in premature death rates and a variety of quality-of-life metrics.  (This program also produces a county-level Health Factors ranking, but that ranking includes a number of economic rankings that bump up against the DCA rankings above and the education rankings explained immediately below.)
  • Education – I haven’t been able to find a comparable set of county-level rankings for education, so I’ve created one. Here I’ve taken the most recent educational achievement data I can find (for 2013 through 2017) and created a ranking by averaging the counties’ ranks for the largest percentage of college graduates and the smallest percentage of high school dropouts.

All that done, I’ve created what I call a “rank of ranks” by adding up each county’s economic, health and education ranking and then ranking them based on their totals (see the full list below).  I’ve also mapped that data in a way that slices the state into 16 tiers (creating 15 groups of 10 counties and one of nine counties).

Combined Econ Health & Education Rankings

The color-coding is simple: the darker the green, the better the overall ranking; the darker the red, the worse the ranking; the palest shades of green and red constitute the middling counties.  (You can access an interactive version of this map here.)

(You can find 16-tier interactive maps for the economic, education and health rankings here, here and here, respectively.)

The mapping is useful in a couple of ways, perhaps mostly by spotlighting regional patterns that are virtually impossible to see in a printed list.  For example, you can see, in dark red, five contiguous southwest Georgia that are all in the bottom 10 counties overall: Stewart, Quitman, Clay, Randolph and Calhoun.  At the same time, just south of those five counties, most of the counties strung along the Florida border have more middling rankings; they have at least some positive metrics.

So, one question, it seems to me, is this: If the state has finite resources to invest in economic development, does it invest them in areas that aren’t showing much signs of life?  Or in those that can demonstrate a pulse?  I’ll take a stab at an answer in future posts.

One of the obvious takeaways from the list below is that the economic, health and educational rankings tend to run fairly close to one another.  This is especially true at the top and bottom of the rankings; you’ll find some divergence in the middle ranks, and that’s where you’ll also find the most churn year in and year out.  Conversely, it’s difficult to dislodge counties that occupy the top ranks of these lists, and counties at the bottom have a tough time even getting a toe-hold to try to move up these ranking ladders.  These lists have not changed much in the time I’ve been watching them.

One frustration I have with these and other rankings is that they don’t answer what I call the “so what” question, and there are other metrics that I think would help create useful measures and rankings of the overall viability of Georgia’s counties.  I’m working on a few of those now and hope to be able to update this in the near future.

Here’s the list.   The sort is based on the overall rank, from highest to lowest.

County 2019 DCA Reverse JTC Rankings 2019 RWJ Health Outcomes Rankings 2013-17 Educational Achievement Rankings Total of Ranks Rank of Ranks
Forsyth County 2 1 1 4 1
Oconee County 1 2 1 4 1
Fayette County 4 4 1 9 3
Cherokee County 3 3 8 14 4
Cobb County 5 7 5 17 5
Columbia County 6 6 6 18 6
Harris County 7 8 14 29 7
Gwinnett County 15 5 14 34 8
Coweta County 14 10 13 37 9
Fulton County 23 11 4 38 10
Bryan County 11 20 9 40 11
Dawson County 10 15 21 46 12
Lee County 8 17 21 46 12
Paulding County 18 9 24 51 14
DeKalb County 34 16 11 61 15
Jones County 22 13 30 65 16
Henry County 30 25 12 67 17
Pickens County 9 19 40 68 18
Houston County 33 22 16 71 19
Morgan County 16 27 32 75 20
Camden County 40 18 18 76 21
Jackson County 12 12 53 77 22
Effingham County 13 29 38 80 23
Union County 29 24 28 81 24
Catoosa County 26 23 36 85 25
Chatham County 25 52 10 87 26
Walton County 20 26 42 88 27
Douglas County 41 31 21 93 28
Pike County 21 30 42 93 28
Hall County 17 14 70 101 30
White County 36 21 44 101 30
Lumpkin County 38 39 33 110 32
Glynn County 32 64 18 114 33
Bartow County 27 33 57 117 34
Barrow County 24 35 59 118 35
Monroe County 19 67 38 124 36
Rockdale County 55 45 27 127 37
Rabun County 48 48 37 133 38
Putnam County 53 46 35 134 39
Liberty County 51 57 29 137 40
Chattahoochee County 96 44 6 146 41
Towns County 69 62 20 151 42
Oglethorpe County 28 32 93 153 43
Fannin County 50 59 47 156 44
Long County 80 28 55 163 45
Floyd County 47 54 64 165 46
Habersham County 45 36 86 167 47
Newton County 74 51 45 170 48
Lowndes County 59 78 34 171 49
Carroll County 43 72 57 172 50
Greene County 46 82 46 174 51
Troup County 39 80 56 175 52
Dade County 37 43 96 176 53
Pierce County 49 47 88 184 54
Clarke County 114 56 16 186 55
Hart County 42 58 87 187 56
Crawford County 72 49 69 190 57
Gilmer County 64 63 68 195 58
Madison County 56 68 71 195 59
Thomas County 61 86 50 197 60
McDuffie County 113 34 66 213 61
Muscogee County 68 120 25 213 61
Stephens County 52 105 61 218 63
Walker County 62 87 72 221 64
Whitfield County 54 42 125 221 64
Banks County 31 65 127 223 66
Bulloch County 124 73 26 223 66
Tift County 70 92 65 227 68
Jasper County 35 53 142 230 69
Peach County 81 112 40 233 70
Glascock County 60 37 137 234 71
Gordon County 65 61 113 239 72
Brooks County 73 74 94 241 73
Bibb County 82 135 31 248 74
Haralson County 57 97 95 249 75
Lamar County 99 101 49 249 75
Clayton County 136 69 52 257 77
Lincoln County 85 90 84 259 78
Richmond County 88 125 48 261 79
Seminole County 71 127 63 261 80
Bacon County 58 113 91 262 81
Montgomery County 140 50 72 262 81
Heard County 75 70 118 263 83
Bleckley County 127 85 53 265 84
Schley County 111 71 83 265 84
McIntosh County 90 55 121 266 86
Evans County 67 108 100 275 87
Talbot County 92 77 109 278 88
Franklin County 63 100 117 280 89
Treutlen County 120 60 100 280 89
Lanier County 135 66 80 281 91
Ware County 89 114 79 282 92
Baker County 66 88 129 283 93
Charlton County 102 38 143 283 93
Cook County 93 98 92 283 93
Laurens County 104 118 62 284 96
Pulaski County 115 75 100 290 97
Upson County 86 106 100 292 98
Butts County 78 84 131 293 99
Wayne County 107 96 90 293 99
Washington County 110 81 104 295 101
Miller County 44 155 97 296 102
Worth County 76 95 126 297 103
Echols County 100 40 158 298 104
Screven County 131 94 74 299 105
Polk County 87 91 123 301 106
Grady County 97 102 106 305 107
Elbert County 79 103 124 306 108
Wilkinson County 77 124 108 309 109
Decatur County 95 136 80 311 110
Wilkes County 83 131 97 311 110
Spalding County 98 139 75 312 112
Dodge County 133 117 67 317 113
Coffee County 109 111 99 319 114
Early County 94 150 75 319 114
Baldwin County 143 121 60 324 116
Dougherty County 123 151 50 324 116
Macon County 139 110 78 327 118
Colquitt County 84 116 133 333 119
Chattooga County 103 83 148 334 120
Appling County 91 109 139 339 121
Toombs County 121 144 77 342 122
Wilcox County 134 93 116 343 123
Wheeler County 156 41 147 344 124
Murray County 118 76 151 345 125
Brantley County 129 104 121 354 126
Berrien County 126 123 112 361 127
Meriwether County 105 130 131 366 128
Johnson County 132 89 146 367 129
Webster County 138 119 110 367 129
Dooly County 119 99 150 368 131
Candler County 101 154 115 370 132
Irwin County 145 143 84 372 133
Tattnall County 125 115 134 374 134
Turner County 117 138 119 374 134
Sumter County 147 148 80 375 136
Crisp County 141 152 89 382 137
Atkinson County 108 122 157 387 138
Emanuel County 150 134 106 390 139
Taylor County 153 107 130 390 139
Burke County 137 140 114 391 141
Clinch County 106 149 136 391 141
Mitchell County 130 133 128 391 141
Telfair County 159 79 156 394 144
Terrell County 112 141 141 394 144
Jeff Davis County 116 146 139 401 146
Warren County 122 159 120 401 146
Ben Hill County 155 147 111 413 148
Jenkins County 152 128 135 415 149
Clay County 158 156 105 419 150
Stewart County 154 126 144 424 151
Randolph County 151 137 137 425 152
Calhoun County 149 132 148 429 153
Taliaferro County 144 129 159 432 154
Jefferson County 146 142 145 433 155
Marion County 142 145 151 438 156
Twiggs County 128 158 154 440 157
Quitman County 148 157 154 459 158
Hancock County 157 153 153 463 159

 

 

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 34th nationally; Forsyth, 49th.  At the very bottom of the EIG rankings, in 3,124th 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 2nd; their national ranks were 55th and 185th, 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 2,866th with a YPLL 75 rate of 15646; Warren County did a little better, finishing 2,862nd with a rate of 15422.  Twiggs County came in 2,850th with a score of 15001 and Quitman County finished at 2,841st 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 8th 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 21st 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).

——————–

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.

EIG Top 10 Georgia Counties – 2017
County Region EIG Distress Score EIG National Rank
Oconee North Georgia 1.1 34
Forsyth Metro Atlanta 1.6 49
Cherokee Metro Atlanta 2.9 92
Fayette Metro Atlanta 4.9 152
Paulding Metro Atlanta 5.2 163
Coweta Middle Georgia 5.6 174
Cobb Metro Atlanta 6.1 191
Harris Middle Georgia 8.3 261
Henry Metro Atlanta 11.6 362
Gwinnett Metro Atlanta 12.0 375

 

EIG Bottom 10 Georgia Counties – 2017
County Region EIG Distress Score EIG National Rank
Jefferson Middle Georgia 97.8 3,057
Sumter South Georgia 98.1 3,065
Lanier South Georgia 98.4 3,075
Telfair South Georgia 98.9 3,093
Macon Middle Georgia 99.1 3,099
Hancock Middle Georgia 99.5 3,110
Calhoun South Georgia 99.7 3,117
Wheeler South Georgia 99.8 3,119
Taliaferro North Georgia 99.8 3,120
Stewart South Georgia 99.9 3,124

 

County Health Rankings & Roadmaps

Top 10 Georgia Counties for Premature Death (2015-2017)

County Region Premature Death Rate National Rank
Forsyth Metro Atlanta 4265 55
Oconee North Georgia 5131 185
Gwinnett Metro Atlanta 5283 223
Fayette Metro Atlanta 5521 278
Cobb Metro Atlanta 5605 299
Cherokee Metro Atlanta 5654 315
Columbia North Georgia 6084 466
Harris Middle Georgia 6104 476
Wheeler South Georgia 6384 581
Echols South Georgia 6476 633

 

County Health Rankings & Roadmaps

Bottom 10 Georgia Counties for Premature Death (2015-2017)

County Region Premature Death Rate National Rank
Crisp South Georgia 11837 2,639
Emanuel Middle Georgia 11862 2,645
Clinch South Georgia 12262 2,694
Clay South Georgia 12341 2,706
Jeff Davis South Georgia 12805 2,742
Candler South Georgia 13551 2,792
Quitman South Georgia 14797 2,841
Twiggs Middle Georgia 15001 2,850
Warren Middle Georgia 15422 2,862
Miller South Georgia 15646 2,866

 

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