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Posts tagged ‘EIG’

Covid-19 seems to be hitting Georgia harder than its neighboring states

Over the weekend I published a post comparing Georgia’s Covid-19 performance with North Carolina’s and wondering out loud why the differences are so dramatic.  Today I’ve cast a wider net and put together this table comparing Georgia with its neighboring states.

March 30 SE Covid Table

Clearly, Georgia — at least so far — is being harder hit than its five contiguous neighbors.  Only Tennessee has a slightly higher Covid-19 infection rate, and Georgia leads the region in both Covid-19 deaths and hospitalizations; even Florida, with twice Georgia’s population, trails Georgia in both those categories.

The question is why?  There are obviously a great many variables at work in this situation, but at this point there’s enough data in the pot to warrant a little head-scratching.  Even if these southern states are using different protocols to determine who gets tested, we’re left with the fact that Georgia is outpacing its neighbors so dramatically in deaths and hospitalizations.

I’ve got lines out to several contacts in the public health world and hope to gather some informed answers to these questions over the next day or so.

[A note about the data above: The population numbers are 2019 Census Bureau estimates.  The raw Covid-19 data came from each state’s respective public health website as of about mid-day today.  The infection and mortality rates were calculated by dividing the number of positives or the number of deaths by the population and multiplying the result by 100,000.]

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Another interesting chunk of Covid-19 data comes from the Institute of Health Metrics and Evaluation (IHME) at the University of Washington.  It’s now out with state-by-state projections of how the now infamous Coronavirus curve — or wave — is likely to move across each state and its healthcare system.  IHME has developed a computer model that stirs together data on available healthcare resources with testing and mortality rates to date.

The projections for Georgia are grim.  IHME’s model predicts that Georgia will hit its “peak resource use” on April 22, when it calculates that the state will be short 755 ICU beds and 1,075 ventilators.  It also projects our “deaths per day” will peak the following day, April 23, at 84, and that the state will suffer a total of 2,777 deaths by August 4, 2020.

These projections are generally in line with the performance numbers posted above.  North Carolina is projected to hit its peak resource demand on the same day, April 22, but will only be short 278 beds and 676 ventilators; its “deaths per day” are projected to peak at 56, and total deaths by August 4 are forecast at 1,721.

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Meanwhile, the Economic Innovation Group, whose work I’ve cited on a number of occasions, is out with a new report focusing on the challenges Covid-19 poses for the country’s most “distressed communities,” many of which are rural.  Indeed, the new EIG report echoes and puts meat on the bones of an argument I started making nearly two weeks ago — namely, that Covid-19 represented a “perfect storm” for rural Georgia.

EIG annually assigns “Distressed Community Index” scores to all 3,000-plus counties in the nation, as well as all cities with populations of 50,000 or more.  It does this using a formula based on seven socioeconomic factors; a few years back, it named Albany one of the 10 most distressed mid-sized cities in the country.

This new EIG report offers four key takeaways:

  1. The uninsured rate for residents of distressed counties is much higher than those living elsewhere.
  2. Residents of distressed counties are more likely to be elderly and susceptible to complications resulting from coronavirus infection.
  3. Life-threatening health disorders are more prevalent and more dangerous in distressed areas.
  4. Life expectancy is already significantly shorter in economically distressed places.

After fleshing out each of those points, EIG then turns its attention to the state of healthcare systems in distressed communities.  It reports that it had analyzed more than a decade’s worth of American Hospital Association (AHA) data and found that distressed communities had seen a 16 percent reduction in the number of hospital beds between 2006 and 2017.  This report doesn’t offer a state- or county-level breakdown, but rural Georgia has almost certainly suffered that level of loss of beds over the past decade or so.

 

 

 

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).

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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.

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

 

© Trouble in God’s Country 2019