County Health Rankings

Every year, the independent "County Health Rankings" research project ranks counties in the 50 states by health status and publishes the results online. Using composite scores informed by health outcomes (morbidity and mortality) and health factors (health behaviors, clinical care, social, economic, and physical environment factors), this project ranks most Florida counties by their overall quality of health and life. Data from the County Health Rankings project offer insight into important deficiencies in Florida's healthcare and health education resources that contribute to health disparities in the state.

Health Outcomes Ranking 2010

Source: http://www.countyhealthrankings.org/florida

Health Factors Ranking 2010

Source: http://www.countyhealthrankings.org/florida

The most important factor that emerges from examining this data is that geographic location of populations plays a critical role in determining health status. Counties that contain major metropolitan areas consistently perform well, while counties containing mostly rural areas perform relatively poorly. All counties containing major metropolitan areas rank within the top ten. These data support previous research that shows most of Florida's healthcare resources are clustered heavily in urban centers, making access to care a problem for individuals living in less populous areas. Moreover, many small-town providers do not accept public health insurance plans such as Medicaid, despite the fact that Florida's lower-income populations are disproportionately located in these rural areas. Consequently, many low-income individuals living in Florida find themselves faced with the choice of traveling long distances to procure medical care, or not receiving care at all. Also, it is important to recognize that county level data can mask tremendous health disparities within urban areas where pockets of poverty and other socioeconomic factors contribute to poor health outcomes.

Florida counties exhibit tremendous diversity in the composition of their populations by race and ethnicity. These demographics do correlate somewhat with county-level performance on key health indicators and resultant rankings. For example, Gadsden County, which has the highest percentage of African-American residents of any Florida county, ranks 62 out of 67. However, Citrus County, which has the highest percentage of Caucasian residents of any Florida county, ranks only 40 out of 67. Consequently, one can infer from the data that while ethnoracial composition of populations does impact county health status to some degree in Florida, it does not exert as strong an effect as the availability of healthcare resources. These county level data highlight the fact that "disparity" is a fundamentally ambiguous concept with multiple dimensions. On its face, the concept of a health disparity seems rather simple. In fact, when one attempts to formally define what constitutes a health disparity, difficulties emerge. FL CURED's purpose is not to focus on semantics but rather to illustrate the lack of clarity in health disparity definitions. Regardless of definition, health disparities, which are largely correlated with income levels and race, are an important area of concern for the state.

Florida has the second and third largest African-American and Latino populations, respectively, in the country. Within Florida, 16.1% of residents are African-American and 21.5% are of Hispanic descent. Certain diseases are more prevalent, more deadly, and in some cases, exclusive to certain populations. For many Floridians, research to improve these disparities observed among gender, race, and socioeconomic levels is crucial in reducing the economic burden of disease and creating a better quality of life.