Click this photo to visit the 2015 County Health Rankings and find out how healthy your county is. Photo by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The 2015 County Health Rankings & Roadmaps measures the health of nearly all counties in the nation and ranks them within states, using county-level indicators from a variety of national and state data sources. The rankings, put together by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, measure vital health factors including high school graduation rates, obesity, smoking, unemployment, access to healthy foods, the quality of air and water, income and teen births in nearly every county in America.

Public Health Newswire caught up with APHA member and RWJF Interim Vice President of Program Portfolios Michelle A. Larkin, JD, MS, RN, to discuss this year’s rankings and how they can help us build a national “culture of health.”

Want to find out your community’s health rankings? Visit and see how your health is affected.

What are your greatest takeaways this year’s rankings?

Certainly one of them is that premature death rates are dropping. The reasons for the drops in premature death rates vary from county to county. For example, in Baltimore City death due to assault has fallen by a quarter and death by HIV/AIDS has dropped by almost 60 percent since 2004. Those are big numbers. We know that Baltimore City has made a concerted effort to address violence prevention in the last decade and it has an active needle program that is really making a difference in HIV/AIDS prevention and treatment. Another thing I’d say is that there is a real role for health departments and the public health community to explore the question of ‘Why are, or are not, premature deaths in our county declining?’ Being a member of APHA, we’re focused on how to create change. I’d love to see APHA membership take a key role in stimulating conversation in their communities. We are seeing reductions in cardiovascular disease and injury-related deaths but there’s something specific you need in each community.

We’re seeing that the healthiest counties share certain qualities, such as higher college attendance, fewer preventable hospital stays and greater access to places to be physically active, like parks and gyms. We’re really thinking about how we can do a better job spreading these qualities across the nation. Also, we’re looking at how to be able to provide some coaching assistance to communities that want to dig into rankings and lay out a plan to improve.

How can APHA and our members maximize our ability to create change, as you say?

We do it in a number of ways already. Often times we’re the conveners in their communities. Getting people together in public health agencies, social services providers and other sectors like early-childhood where we’re thinking about how to ensure that people and families have safe places to be active. Often times it’s the public health community that’s bringing these people together providing connection and understanding in how public health impacts our lives in so many ways, and we’re also  keepers of large amounts of data in the community.

The County Health Rankings are a great data tool to allow you to go in, compare how you stack up against other counties for 30-plus measures. Then to take it a step further, public health professionals have data at the local level that can drill into a deeper conversation and explore solutions. Data in and of itself is not enough. We need to be able to tee up solutions.

Michelle A. Larkin, JD, MS, RN, is assistant vice president for the Robert Wood Johnson Foundation’s Program Portfolios. Photo by RWJF

The rankings also has an “Action Center” that gives county health leaders the tools to make their communities healthier. How does it work?

The Action Center allows you to go in and click on any sectors you’re from, whether in public health or community development or education, and talk about key activities we can embark on — or simply explore data. One of the beautiful things about the rankings is that they allow people from across sectors to see how they can contribute to building a culture of health in your community.

How can workplace wellness provide benefit to employees? It’s also looking at the community employees go back to and how to foster economic development, workforce employment opportunities. How does a business leader connect with a community college system, or network in their location to talk about skills needed for someone coming out of academic institutions to get employment? How do we have that conversation?

This is really an incredible resource because there’s a tab you can click on what you, personally, can do. But there’s also a tab that relates to policies and programs with scientifically supported evidence that describes effective or ineffective policy. You can click on any of the health factors you’re interested in, such as employment policies or community safety, and it takes you through policies and programs that work.

This year’s rankings also include the RWJF Culture of Health prize that “recognizes communities that are creating powerful partnerships and deep commitments to enable all in our diverse society to lead healthy lives now and for generations to come.” How do these stories complement your data?

Part of what we’ve learned through the ranking process is that stories of how we’ve made progress are really valuable. We’re in the process of site visiting 15 finalists for this year from 343 applicantsthis year. They’ve got great stories in how they come together as a community to determine a path forward to build that culture of health. They brought together partners, focused on long sustainable changes, and policy change and systems change that are going to last beyond any one particular program intervention.

A good example is Spokane, Washington, which was focused on closing its achievement gap. They were able to bring together their leadership, business education, public health leadership, to expand education opportunities for kids, implement full-day kindergarten, skill-building training sessions for young students and a real-time system to monitor student attendance and grades. The system alerted them earlier to kids who were at risk for dropout and leaders were able to target dropout prevention efforts to support children — not just in terms of academic achievement, but also in terms of what was causing the children to miss school and not do well academically, whether that was housing insecurity, employment instability for parents or something else happening. And they’ve been able to turn it around. Spokane has had remarkable improvement in high school graduation rates. That was led by a combination of business, (the community vitality collaborative) Priority Spokane and public health leaders.

There’s also the economic return on investment. Spokane is doing a great job of recruiting businesses to come into the Spokane area and recognized that if high school dropout rates continued the way they were trending, they wouldn’t have had the workers that the employers they were recruiting needed. It’s not just about having a physically healthy individual; they recognized the need for a healthy community including skilled young people, places for people to age and access to good jobs.