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Introduction
Wherewelivematterstoourhealth.Thehealth ofacommunitydependsonmanydifferent factors,includingtheenvironment,education andjobs,accesstoandqualityofhealthcare, andindividualbehaviors.Wecanimprovea communityshealthbyimplementingeffective policiesandprograms.Forexample,people wholiveincommunitieswithsmokefreelaws arelesslikelytosmokeortobeexposedto secondhandsmoke,whichreduceslungcancer risk.Inaddition,peoplewholivein communitieswithsafeandaccessibleparkand recreationspacearemorelikelytoexercise, whichreducesheartdiseaserisk. However,healthvariesgreatlyacross communities,withsomeplacesbeingmuch healthierthanothers.And,untilnow,therehas beennostandardmethodtoillustratewhatwe knowaboutwhatmakespeoplesickorhealthy oracentralresourcetoidentifywhatwecando tocreatehealthierplacestolive,learn,work andplay. Weknowthatmuchofwhatinfluencesour healthhappensoutsideofthedoctorsoffice inourschools,workplacesandneighborhoods. TheCountyHealthRankings&Roadmaps programprovidesinformationontheoverall healthofyourcommunityandprovidesthe toolsnecessarytocreatecommunitybased, evidenceinformedsolutions.Rankingthe healthofnearlyeverycountyacrossthenation, theCountyHealthRankingsillustratewhatwe knowwhenitcomestowhatismaking communitiessickorhealthy.TheCountyHealth Roadmapsshowwhatwecandotocreate healthierplacestolive,learn,workandplay. TheRobertWoodJohnsonFoundation collaborateswiththeUniversityofWisconsin PopulationHealthInstitutetobringthis groundbreakingprogramtocountiesandstates acrossthenation. TheCountyHealthRankings&Roadmaps programincludestheCountyHealthRankings project,launchedin2010,andthenewer Roadmapsprojectthatmobilizeslocal communities,nationalpartnersandleaders acrossallsectorstoimprovehealth.The programisbasedonthismodelofpopulation healthimprovement:
Inthismodel,healthoutcomesaremeasures thatdescribethecurrenthealthstatusofa county.Thesehealthoutcomesareinfluenced byasetofhealthfactors.Countiescanimprove healthoutcomesbyaddressingallhealth factorswitheffective,evidenceinformed policiesandprograms. Everyonehasastakeincommunityhealth.We allneedtoworktogethertofindsolutions.The CountyHealthRankings&Roadmapsserveas bothacalltoactionandaneededtoolinthis effort. snapshots;orShareinformationwithothersvia Facebook,Twitter,orGoogle+.Tounderstand ourmethods,clickonLearnabouttheDataand Methods.Youcanalsotakeadvantageofthe UsingtheRankingsDataguidetohelpyou explorethedataandfigureoutmoreabout whatisdrivingyourcommunityshealth.To learnaboutwhatyoucandotoimprovehealth inyourcommunity,visittheRoadmapsto HealthActionCenter.Finally,youcanlearn whatothersaredoingbyreadingCommunities StoriesandvisitingtheProjectShowcase.
www.countyhealthrankings.org/oregon 1
GuidetoOurWebSite
TocompiletheRankings,weselectedmeasures thatreflectimportantaspectsofpopulation healththatcanbeimprovedandareavailable atthecountylevelacrossthenation.Visit www.countyhealthrankings.orgtolearnmore. Togetstartedandseedata,enteryourcounty orstatenameinthesearchbox.Clickonthe nameofacountyormeasuretoseemore details.Youcan:CompareCounties;Download dataforyourstate;Printoneormorecounty
CountyHealthRoadmaps
TheRankingsillustratewhatweknowwhenit comestomakingpeoplesickorhealthy.The CountyHealthRankingsconfirmthecriticalrole thatfactorssuchaseducation,jobs,incomeand theenvironmentplayinhowhealthypeopleare andhowlongwelive. TheCountyHealthRoadmapsmobilizeslocal communities,nationalpartnersandleaders acrossallsectorstoimprovehealth.TheCounty HealthRoadmapsshowwhatwecandoto createhealthierplacestolive,learn,workand play.TheRobertWoodJohnsonFoundation (RWJF)collaborateswiththeUniversityof WisconsinPopulationHealthInstitute(UWPHI) tobringthisgroundbreakingprojecttocities, countiesandstatesacrossthenation. TheRoadmapsprojectincludesgrantstolocal coalitionsandpartnershipsamong policymakers,business,education,public health,healthcare,andcommunity organizations;grantstonationalorganizations workingtoimprovehealth;recognitionof communitieswhosepromisingeffortshaveled tobetterhealth;andcustomizedguidanceon strategiestoimprovehealth. RoadmapstoHealthCommunityGrants TheRoadmapstoHealthCommunityGrants providefundingfor2yearstothirtystateand localeffortsamongpolicymakers,business, education,healthcare,publichealthand communityorganizationsworkingtocreate positivepolicyorsystemschangesthataddress thesocialandeconomicfactorsthatinfluence thehealthofpeopleintheircommunity. RoadmapstoHealthPartnerGrants RWJFisawardingRoadmapstoHealthPartner Grantstonationalorganizationsthatare experiencedatengaginglocalpartnersand leadersandareabletodeliverhighquality trainingandtechnicalassistance,and committedtomakingcommunitieshealthier placestolive,learn,workandplay.Partner granteesincreaseawarenessabouttheCounty HealthRankings&Roadmapstotheirmembers, affiliatesandallies.AsofFebruary2013,RWJF hasawardedpartnergrantstoUnitedWay Worldwide,NationalBusinessCoalitionon Health,andNationalAssociationofCounties.
RoadmapstoHealthActionCenter TheRoadmapstoHealthActionCenter,based atUWPHI,providestoolsandguidancetohelp groupsworkingtomaketheircommunities healthierplaces.TheActionCenterwebsite providesguidanceondevelopingstrategiesand advocacyeffortstoadvanceprohealthpolicies, opportunitiesforongoinglearning,anda searchabledatabaseofevidenceinformed policiesandprogramsfocusedonhealth improvement:WhatWorksforHealth.Action Centerstaffprovidecustomizedconsultation viaemailandtelephonetothoseseekingmore informationabouthowtoimprovehealth. Coaching,includingpossibleonsitevisits,is alsoavailableforcommunitieswhohave demonstratedthewillingnessandcapacityto addressfactorsthatweknowinfluencehow healthyapersonis,suchaseducation,income andfamilyconnectedness.
www.countyhealthrankings.org/oregon
CountyHealthRankings
The2013CountyHealthRankingsreportranks Oregoncountiesaccordingtotheirsummary measuresofhealthoutcomesandhealth factors.Countiesalsoreceivearankfor mortality,morbidity,healthbehaviors,clinical care,socialandeconomicfactors,andthe physicalenvironment.Thefigurebelowdepicts thestructureoftheRankingsmodel;those havinghighranks(e.g.,1or2)areestimatedto bethehealthiest.
Oursummaryhealthoutcomesrankingsare basedonanequalweightingofmortalityand morbiditymeasures.Thesummaryhealth factorsrankingsarebasedonweightedscores offourtypesoffactors:behavioral,clinical, socialandeconomic,andenvironmental.The weightsforthefactors(showninparenthesesin thefigure)arebaseduponareviewofthe literatureandexpertinput,butrepresentjust onewayofcombiningthesefactors.
www.countyhealthrankings.org/oregon 3
H E A L T H O UT CO M ES
County Baker Benton Clackamas Clatsop Columbia Coos Crook Curry Deschutes Rank County 33 2 5 12 19 28 8 26 7 Douglas Gilliam Grant Harney HoodRiver Jackson Jefferson Josephine Klamath Rank County 30 NR 1 20 3 13 32 29 31 Lake Lane Lincoln Linn Malheur Marion Morrow Multnomah Polk Rank County 22 17 24 23 10 14 16 15 9 Sherman Tillamook Umatilla Union Wallowa Wasco Washington Wheeler Yamhill
Rank NR 25 27 21 18 11 4 NR 6
www.countyhealthrankings.org/oregon
H E A L T H F A CT ORS
County Baker Benton Clackamas Clatsop Columbia Coos Crook Curry Deschutes
Rank County 17 1 4 15 12 30 27 24 5 Douglas Gilliam Grant Harney HoodRiver Jackson Jefferson Josephine Klamath
Rank County 28 NR 18 19 2 13 33 21 26 Lake Lane Lincoln Linn Malheur Marion Morrow Multnomah Polk
Rank County 29 10 23 22 32 20 25 9 6 Sherman Tillamook Umatilla Union Wallowa Wasco Washington Wheeler Yamhill
Rank NR 14 31 7 8 16 3 NR 11
www.countyhealthrankings.org/oregon
SummaryHealthOutcomes&HealthFactorsRankings
Countiesreceivetwosummaryranks: HealthOutcomes HealthFactors Eachoftheseranksrepresentsaweightedsummary ofanumberofmeasures.
Rank
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
HealthOutcomes
Grant Benton HoodRiver Washington Clackamas Yamhill Deschutes Crook Polk Malheur Wasco Clatsop Jackson Marion Multnomah Morrow Lane Wallowa Columbia Harney Union Lake Linn Lincoln Tillamook Curry Umatilla Coos Josephine Douglas Klamath Jefferson Baker
Rank
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
HealthFactors
Benton HoodRiver Washington Clackamas Deschutes Polk Union Wallowa Multnomah Lane Yamhill Columbia Jackson Tillamook Clatsop Wasco Baker Grant Harney Marion Josephine Linn Lincoln Curry Morrow Klamath Crook Douglas Lake Coos Umatilla Malheur Jefferson
NotRanked:Gilliam,Sherman,Wheeler
www.countyhealthrankings.org/oregon
2013CountyHealthRankings:Measures,DataSources,andYearsofData
HEALTHOUTCOMES Mortality Morbidity HEALTHFACTORS HEALTHBEHAVIORS TobaccoUse DietandExercise Adultsmoking Adultobesity Physicalinactivity Excessivedrinking Motorvehiclecrashdeathrate Sexuallytransmittedinfections Teenbirthrate CLINICALCARE AccesstoCare QualityofCare Education Employment Income FamilyandSocial Support CommunitySafety PHYSICALENVIRONMENT EnvironmentalQuality BuiltEnvironment
BehavioralRiskFactorSurveillanceSystem NationalCenterforChronicDiseasePrevention andHealthPromotion NationalCenterforChronicDiseasePrevention andHealthPromotion BehavioralRiskFactorSurveillanceSystem NationalCenterforHealthStatistics NationalCenterforHIV/AIDS,ViralHepatitis, STD,andTBprevention NationalCenterforHealthStatistics SmallAreaHealthInsuranceEstimates HRSAAreaResourceFile HRSAAreaResourceFile Medicare/DartmouthInstitute Medicare/DartmouthInstitute Medicare/DartmouthInstitute Primarilystatespecificsources,supplemented withNationalCenterforEducationStatistics AmericanCommunitySurvey BureauofLaborStatistics SmallAreaIncomeandPovertyEstimates BehavioralRiskFactorSurveillanceSystem AmericanCommunitySurvey FederalBureauofInvestigation CDCWONDEREnvironmentaldata SafeDrinkingWaterInformationSystem CensusCountyBusinessPatterns USDAFoodEnvironmentAtlas CensusCountyBusinessPatterns
20052011 2009 2009 20052011 20042010 2010 20042010 2010 20112012 20112012 2010 2010 2010 Statespecific 20072011 2011 2011 20052010 20072011 20082010 2008 FY2012 2010 2012 2010
AlcoholUse SexualActivity
Uninsured Primarycarephysicians Dentists Preventablehospitalstays Diabeticscreening Mammographyscreening Highschoolgraduation Somecollege Unemployment Childreninpoverty Inadequatesocialsupport Childreninsingleparenthouseholds Violentcrimerate Dailyfineparticulatematter1 Drinkingwatersafety Accesstorecreationalfacilities Limitedaccesstohealthyfoods Fastfoodrestaurants
SOCIALANDECONOMICFACTORS
www.countyhealthrankings.org/oregon
CREDITS
ReportAuthors UniversityofWisconsinMadison SchoolofMedicineandPublicHealth DepartmentofPopulationHealthSciences PopulationHealthInstitute BridgetBooskeCatlin,PhD,MHSA AmandaJovaag,MS PatrickRemington,MD,MPH Thispublicationwouldnothavebeenpossiblewithoutthefollowingcontributions: Data CentersforDiseaseControlandPrevention:NationalCenterforHealthStatisticsandDivisionofBehavioral Surveillance DartmouthInstituteforHealthPolicy&ClinicalPractice ResearchAssistance JenniferBuechner HyojunPark,MA ElizabethPollock JenniferRobinson MatthewRodock,MPH AnneRoubal,MS CommunicationsandOutreach BurnessCommunications AnnaGraupner,MPH KateKonkle,MPH KarenOdegaard,MPH JanONeill,MPA AngelaRussell,MS JulieWillemsVanDijk,PhD,RN Design ForumOne,Alexandria,VA RobertWoodJohnsonFoundation AbbeyCofsky,MPHSeniorProgramOfficer MichelleLarkin,JD,MS,RNAssistantVicePresidentandDeputyDirector,HealthGroup JamesS.Marks,MD,MPHSeniorVicePresidentandGroupDirector,HealthGroup JoeMarxSeniorCommunicationsOfficer Suggestedcitation:UniversityofWisconsinPopulationHealthInstitute.CountyHealthRankings2013.
www.countyhealthrankings.org/oregon
UniversityofWisconsinPopulationHealthInstitute 610WalnutSt,#524,Madison,WI53726 (608)2656370/info@countyhealthrankings.org