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Northland’s health rankings still unhealthy

You’re not as healthy as you could be, Northland.

You’re fatter, smoke more and die younger than people in counties downstate, whether that’s in Minnesota or Wisconsin.

So says an annual County Health Rankings report compiled by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.

And that’s proven to be the case for all five years the survey has been in


“What it does highlight are the same things that we know,” said Louise Anderson, director of the Carlton-Cook-Lake-St. Louis Community Health Board.

The report uses a variety of data to rank each county in the country in two general areas: health outcomes and health factors. The former essentially measures the county’s current health, with data such as premature deaths and low birth weight, said Julie Willems Van Dijk, the study’s deputy director. The latter compiles factors that could affect the population’s health down the road, such as prevalence of obesity and smoking.

For the most part, Northeastern Minnesota and Northwestern Wisconsin counties fall in the bottom half of their states. St. Louis County, for example, ranks 75th of the 87 Minnesota counties in health outcomes and 53rd in health factors. A year ago, it ranked 72nd and 59th in the two categories.

Douglas County ranked 48th among Wisconsin’s 72 counties in health outcomes and 47th in health factors. That was an improvement in both areas, from 53rd and 55th.

But don’t focus too much on rankings, said Patrick Remington, associate dean of the University of Wisconsin School of Medicine and Public Health. Those results depend, after all, on how other counties are progressing.  

Instead, he said, this year’s report includes trend lines in certain categories to show whether a given county is improving, declining or staying about the same.

In St. Louis County, for example, positive trends show up in the areas of preventable hospital stays and diabetic screening. But negative trends included unemployment, children in poverty, adult obesity and physical inactivity.

It’s nothing the county and the region didn’t know, said Amy Westbrook, St. Louis County’s public health director. A community health assessment for the region in 2012 saw tobacco, mental health and poverty among problems to be solved.

“And the top health issue that rose to No. 1 was obesity,” she said.

St. Louis County’s obesity rate — the percentage of adults with a body mass index of 30 or greater — was 27 percent, according to County Health Rankings, which was released on Wednesday. That was only 1 percentage point higher than the state’s average, and if the county had a 25 percent obesity rate it would be in the top 10 percent nationally.

But 22 percent of St. Louis County residents smoke, compared with 16 percent statewide, Area health officials point out that northern counties would rank higher, if they weren’t in such healthy states.

“Minnesota is high compared to the rest of the states, so we’re lower in a high state,” said Dave Lee, Carlton County’s public health director.

Moreover, some of the data may be misleading when applied to rural counties, both Lee and Anderson said.

“They use a data set that not only under-represents rural counties, but it’s sort of a misuse of the data,” Anderson said.

Because significant numbers aren’t surveyed in small counties, the analysts look at seven years’ worth of data. The numbers still are small and the information dated, she said.

Lee said the data are more reliable in some categories, such as premature death. That’s the area that most hurt Carlton County, which ranked 78th in health outcomes this year. He’s optimistic the Affordable Care Act will make a difference by changing the emphasis from treating ill health to maintaining good health.

“We can start moving to be much more creative and collaborative in looking at how do we impact people’s health,” Lee said. “We are forced … to look at how do we work together to change those clinical outcomes.”

The region knows about its problems, Anderson said, but it has “amazing partnerships” among schools, food shelves, health plans, hospitals and public health agencies to tackle them.

“We’re still at a point where some of the health indicators are worse in Northeastern Minnesota, (but) we’re beautifully poised and already have strong partnerships for moving forward,” she said.

See for yourself

The County Health Rankings 2014 report is available at