ADDISON COUNTY — An annual county-by-county study on the nation’s health ranks Addison County as Vermont’s second healthiest county — Addison County trails only its larger neighbor to the north, Chittenden.
The 2013 County Health Rankings report — released late last month and prepared by The Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute (UWPHI) — ranks counties according to health outcomes and factors, including mortality and morbidity rates, health behaviors, clinical care, social and economic factors, and the physical environment.
By some measures in the County Health Rankings report, Addison County also stacks up well to what the report calls “national benchmarks.” It defines those benchmarks as scores in the top 10 percent in health categories.
Addison County lands in the top 10 percent among counties nationally in having favorable rates of premature deaths, teen motherhood and low birthweights; comparatively few residents who are uninsured or reporting poor health, obesity or physical inactivity; relatively fewer children living in poverty; and better than average access to primary care physicians and recreation facilities.
The county is notably out of the top 10 percent in excessive drinking, access to dentists, and percentage of fast-food restaurants.
Full data and an explanation of the study’s design may be found at www.countyhealthrankings.org/rankings/data.
According to the website, “The rankings illustrate what we know when it comes to making people sick or healthy. The County Health Rankings confirm the critical role that factors such as education, jobs, income and the environment play in how healthy people are and how long we live.”
The study comes in conjunction with what RWJF and UWPHI call “County Health Roadmaps,” which the website states, “show what we can do to create healthier places to live, learn, work and play” and offer grants and “guidance on developing strategies and advocacy efforts to advance pro?health policies, opportunities for ongoing learning, and a searchable database of evidence?informed policies and programs focused on health improvement.”
Although the RWJF and UWPHI rankings do not attempt to compare individual counties on a national basis except to that benchmark standard, another study released in December claimed Vermont overall was the nation’s healthiest state.
United Health Foundation, which has conducted health rankings for the last 23 years, made that claim late last year and said that Vermont has stood atop its rankings for four straight years. Those findings may be found at www.americashealthrankings.org/Rankings.
According to the foundation’s website, the state scores well for a high rate of high school graduation, a low violent crime rate, a low incidence of infectious disease, a low prevalence of low birthweights, high per capita public health funding, a low rate of uninsured residents, and ready availability of primary care physicians.
But that study also notes some weak points: Vermont has “a high prevalence of binge drinking at 18.5 percent of the adult population, a moderate occupational fatalities rate at 3.9 deaths per 100,000 workers, and a moderately high cancer death rate at 185.0 deaths per 100,000 population.”
COUNTY STUDY DETAILS
The RWJF/UWPHI rankings are based on what the study calls “health outcomes” and “health factors.”  
Addison County leads Vermont in health outcomes according to the report, in which “mortality” (life span) and “morbidity” (general illness) are weighted equally.
The study measures mortality by looking at premature death, defining it by years lost per 100,000 people for those who perish before the age of 75. Addison County’s number is below both the state average and national benchmark.
Morbidity is measured by a survey of those who report poor or fair health (10 percent in Addison County), poor physical health days (2.9 per month on average) and mental health days (3.2 per month), and low birthweight (5.4 percent of county infants).
Those percentages are lower than the state average and national benchmark, while the physical and mental health day numbers are better than the state average, but a little higher than the 10 percent or better national benchmark.
The county is third in the state in “Health Factors,” and within that category is second in “Health Behaviors,” sixth in “Clinical Care,” third in “Social & Economic Factors” and 12th in “Physical Environment.”
Notable within “Health Behaviors” are:
•  An adult smoking rate (16 percent) that is about the same as the state average (17 percent), but short of the national 10 percent or better benchmark (13 percent smoking rate).
•  A physical inactivity rate (19 percent) that equals the state rate and betters the national benchmark (21 percent).
•  An excessive drinking rate (18 percent) that roughly equals the state rate (19) but more than doubles the benchmark (7 percent).
•  A teen birth rate of 12 per 1,000, compared to 19 per 1,000 in Vermont and the national benchmark of 21 per 1,000.
In “Clinical Care,” the county scores well in the numbers of uninsured residents (10 percent), of Medicare patients who receive health screenings in two categories, and of primary care doctors (944-1, compared to 931-1 statewide and 1,067-1 for the benchmark).
But Addison County scores less well in preventable hospital stays (55 per 1,000 Medicare patients) compared to the state average (51) and the national benchmark (47), and in a high ratio of dentists to residents (2,643-1) compared to the state (1,727) and the benchmark (1,516-1).
In “Social & Economic Factors,” Addison:
•  Equals the benchmark in unemployment percentage (5 percent) and beats the state number in that category (5.6 percent).
•  Equals the benchmark in children living in poverty (14 percent) and beats the benchmark in that category (16 percent).
•  Roughly equals the state (17 percent) and benchmark (14 percent) in the “inadequate social support” category (15 percent), which measures seniors living without family support.
County results are mixed in the “children in single parent households” category, which the study says it measures because statistically both parents and children in such homes face more health issues. Addison’s rate is 27 percent, better than the state’s percentage (30), but higher than the benchmark (20).
In “Physical Environment,” where Addison is 12th out of 14 counties, the county gets high marks for access to healthy foods and recreation facilities and its air quality.
But the county gets demerits for “drinking water safety,” apparently because of testing problems for municipal water systems, and for the percentage of its restaurants that serve fast food (41 percent, per the study), compared to 31 percent statewide and a 27 percent benchmark.
Andy Kirkaldy may be reached at [email protected].