Clark County saw slight decreases in adult smoking and obesity and a marked decline in the number of uninsured over the past year, according to the annual County Health Rankings and Roadmaps report released last week. 

The report, which was conducted by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, provides two rankings — for health factors and health outcomes.

Clark County ranks 24th out of Kentucky’s 120 counties in health factors, and 53rd in health outcomes, showing only slight movement since last year’s report.

In 2016, Clark County ranked 29th in health factors and 52nd in health outcomes.

Health factors include health behaviors, clinical care, social and economic factors, and physical environment. These factors include smoking rates, access to care, the number of children under 18 living in poverty and workforce health. 

Health outcomes include information on length of life and quality of life, with details on premature death, poor or fair health, poor physical health days, poor mental health days and low birthweight.

Compared to surrounding counties, Clark ranks lower than Bourbon (45), Fayette (7) and Madison (27) in health outcomes and higher than Estill (95), Montgomery (63) and Powell (101).

In health outcomes rankings, OIdham County ranked first, followed by Boone, Spencer, Shelby and Woodford counties. Breathitt County ranked last, with Wolfe, Owsley, Knott and Harlan county also in the bottom five.

Clark County has a higher rate of premature deaths (9,700) than the state (8,900). Premature death rates are calculated by the years of potential life lost before 75 per 100,000 population. Clark ranks 65th in the state for estimated length of life.

Other figures contributing to the outcomes ranking are

— 19 percent of adults in Clark report being in poor or fair health;

— The average number of poor physical health days reported in the last 30 days is 4.5;

— The average number of poor mental health days reported in the last 30 days is 4.

In health factors, Clark ranks higher than all surrounding counties except Fayette and Madison counties, which rank 15th and 19th respectively.

For health factors, Oldham County ranked highest in the state, with Boone, Spencer, Woodford and Anderson counties also in the top five. Clay County ranked last, with Harlan, Martin, Bell and Wolfe counties also in the bottom five.

In Clark County, 21 percent of adults are current smokers, a decrease of 2 percent from last year’s report and 5 percent less than the state. In surrounding counties, only Fayette has a lower adult smoking percentage (20 percent).

The adult obesity rate also declined by 1 percent from last year to 31 percent. In Kentucky, 33 percent of adults are obese. Again, only Fayette County had a lower rate of adult obesity in surrounding counties (27 percent).

Likewise, Clark County saw a more than 10 percent drop in alcohol-imparied driving deaths to 7 percent in 2017. Statewide, 28 percent of driving death involved alcohol.

The percent of Clark Countians who are uninsured dropped to 10 percent in 2017, down 5 percent from the previous year.

Clark also has a higher graduation rate (95 percent) than the state and surrounding counties.

Analyzing the data 

Clark County Health Department Director Scott Lockard said while the health rankings data is a good tool for some general data about overall health, he cautions reading into the information blindly.

“As with any data, you have to look at the sources,” he said. “One of the challenges with this particular data is that we were underrepresented through some surveys in the past which skews some of the data. However, they did some over-counting in Clark County this year to compensate, so we’re seeing some numbers that are more accurate for us now and that makes this data more beneficial.”

One statistic Lockard pointed out was a previously reported 40 percent smoking rate in Clark County. He believes the 2017 rate of 21 percent is much more accurate.

“All around this information is going to be more indicative of our true health status,” he said. “However, some of the data is two or three years old, so there are some really good things happening in Clark County to improve health that will not be reflected in the data for a couple years.”

Lockard said one of Clark County’s greatest strengths is a number of groups working together to address various health concerns in the community, and a willingness of elected officials to involve the health care sector in planning discussions.

“We have lots of groups that are coming together now,” he said. “We’ve been very pleased that, as a health department, we facilitate the MAPP process and we’ve seen first-hand these groups coming together to address these challenges and issues.”

He noted the Clark County Activity Coalition’s annual wellness challenge, the Bicycle Pedestrian Advisory Committee’s walk-bike pedestrian master transportation plan, which was approved by the city and county government; and the Chamber of Commerce’s health committee.

“There’s a lot of positive things going on in the community with a great health focus,” he said. “These groups are making opportunities for physical activity more accessible.”

Lockard said Clark County has  its challenges, though.

Some of the pressing health concerns are lack of physical activity, high obesity and smoking rates, and substance abuse, he said.

“One of the biggest issues facing our community is the opioid crisis,” he said. “We have a needle exchange program, but there are many other entities working together to address this epidemic. There is a primary, secondary and tertiary level of intervention that is very complex in addressing the substance abuse problem.

“From a health department perspective, Kentucky leads the nation in Hepatitis C cases. A 21 percent smoking rate is still way too high. If we could even cut that number in half, we would see a substantial improvement in the rates of cancer and heart disease. Obesity is still a challenge and we need to educate people on taking advantage of opportunities for physical activity and health eating.”

Lockard said one benefit has been the increased access to health care via the Affordable Care Act.

“With the ACA, there are a number of individuals who have access now that didn’t before,” he said. “That expansion of Medicaid and the ACA has been important to our community. People are now able to get screenings and preventative care they couldn’t before. We have moved up in the rankings as a big part of that has been access to care. Upcoming changes could discourage that in the future.”

When comparing health status with other counties, Lockard said he hopes people will avoid thinking one county is better or worse the others based on these rankings.

“We have to remember in Kentucky, it’s not truly a competition of who is the best county,” he said. “The best county in Kentucky has its challenges. We’re truly competing with ourselves. We need to look at these rankings and ask ourselves how we can improve in our community.

“Clark County is a great community, but we still have our challenges. We have to address those and be able to openly talk about them, to put them out on the table and have some honest conversations about these challenges.”