County Health Rankings 2012
April 4, 2012
Tim Cowan, MSPH, Director, Health Index Initiative
County Health Rankings 2012
1. Publically Released Tuesday, April 3, 2012
2. Following slides provide select information
about CHR 2012
• 2012 Rankings of Maine’s 16 counties
• Comparison of Health Outcomes from CHR 2010- 2012
• Change in county rates for premature mortality, which carries
50% weight in the overall Health Outcomes Rank.
• Change in county rates for four other metrics in Health
Outcomes Rank.
• Change in county rates for Tobacco use, Obesity and
Preventable Hospitalizations (Health Index Priorities) that
contribute to the Health Factors Rank.
County Health Rankings model © 2012 UWPHI
Health Outcomes
Mortality (length of life): 50%
Morbidity (quality of life): 50%
Tobacco use
Health behaviors
(30%)
Diet & exercise
Alcohol use
Unsafe sex
Clinical care
(20%)
Health Factors
Access to care
Quality of care
Education
Social & economic
factors
(40%)
Employment
Income
Family & social support
Community safety
Programs and
Policies
Physical environment
(10%)
Environmental quality
Built environment
Highlights: County Health Rankings 2012
1. For both the Health Outcomes and the Health
Factors Rankings, eight of the ten healthiest
counties in Maine are in the MaineHealth service
area. (See next two slides.)
2. Comparing data from the County Health Rankings
in 2010, 2011, & 2012, five counties experienced a
decrease in premature death rates. Four of these
counties are in the MaineHealth Service Area:
Cumberland, Oxford, Sagadahoc, and Waldo
Counties
2012 County Health Rankings
www.countyhealthrankings.org
Rank Health Outcomes
Rank Health Factors
1
Sagadahoc
1
Cumberland
2
Hancock
2
Sagadahoc
3
Cumberland
3
York
4
York
4
Lincoln
5
Knox
5
Hancock
6
Waldo
6
Knox
7
Lincoln
7
Kennebec
8
Franklin
8
Franklin
9
Kennebec
9
Penobscot
10
Penobscot
10
Waldo
11
Androscoggin
11
Aroostook
12
Aroostook
12
Androscoggin
13
Piscataquis
13
Oxford
14
Somerset
14
Piscataquis
15
Oxford
15
Somerset
16
Washington
16
Washington
For both the Rankings
of Health Outcomes &
Health Factors,
eight of the ten
healthiest counties in
Maine are in the
MaineHealth Service
Area (indicated by
counties in red font).
Health Outcomes Rankings- Change Over Time
Biggest contributor to a
change in a county’s
health outcomes rank was
a change in the premature
death rate.
 Premature death is the
single mortality measure
in the County Health
Rankings.
 It contributes 50% to the
overall Health Outcomes
Ranking.
 Four morbidity measures
contribute the remaining
50%. Is less variation
across counties for
these measures.
Sorted by 2012
Rankings
MaineHealth Service Area
Sagadahoc
Cumberland
York
Knox
Waldo
Lincoln
Franklin
Kennebec
Androscoggin
Somerset
Oxford
Northern Maine Counties
Hancock
Penobscot
Aroostook
Piscataquis
Washington
Overall Rankings
2010
2011
2012
7
3
5
6
9
4
1
8
11
14
16
4
3
6
7
8
5
2
9
12
14
16
1
3
4
5
6
7
8
9
11
14
15
2
10
13
12
15
1
11
13
10
15
2
10
12
13
16
More About Premature Mortality
Given the large influence that premature mortality has on
the Health Outcomes Ranking, I’ve provided a number of
slides describing what that mortality measure is, and then
the trend data for the Maine Counties.
Next three slides describe what the metric represents.
Then, two slides address county-level changes over time.
Premature Mortality (length of life)


Makes up 50% of Health Outcomes Ranking
Metric used= Years of Potential Life Lost before
age 75 (YPLL-75)

Every death before age 75 contributes to the
TOTAL number years of potential life lost.
 Examples
• Person dies lung cancer age 62=
• 25 yr old dies in car crash=
• Person dies heart attach at 73=

13 yrs into total
50 yrs into total
2 yrs into total
Rates are adjusted for age differences populationsfor fair comparisons across counties.
Premature Mortality (length of life)
The bar graph on the next slide presents two things:
 Shows how much the major health
issues/conditions contribute to the premature
mortality rate.
• Cancer mortality # 1.
• Cardiovascular Mortality # 3.
 Comparison of Maine’s rate to US overall, and to
Minnesota (had the lowest rate in the US in
2011 America’s Health Rankings®
Premature Mortality (length of life)

The next slide presents county-level changes in the
premature mortality rates over the three time periods
used in the three County Health Rankings
 CHR 2010
2004-2006
 CHR 2011
2005-2007
 CHR 2012
2006-2008

Five counties had a decrease in mortality. Four of
these are located in the MaineHealth Service Area.

Sagadahoc had a rate below the national benchmark.
Morbidity (quality of life)
 Graphs on the next four slides present changes in
county-level rates for the four metrics included in the
Morbidity component of Health Outcomes Ranking
 % adults rating health as fair or poor
 Average number of poor physical health days in past 30 days
 Average number of poor mental health days in past 30 days
 Percent live births that are low birth weight (<2500 grams)
 Little change over time for these measures.
Health Factors: Health Index Priorities
Graphs on the next few slides present changes in countylevel rates for:
tobacco use,
obesity, and
preventable hospital stays.
There is no county –level data for immunizations.
Visit County Health Rankings website!!
www.countyhealthrankings.org
Major enhancements to County Health
Roadmaps component of site. This
component guides and informs about
tools and resources to help make
communities more healthy.
Comments and Questions
Timothy Cowan, MSPH
Director, Health Index Initiative
cowant@mainehealth.org