Looks at a variety of public health data, along with socioeconomic and demographic data, to provide a context for health.Health involves so much more than just the care we receive. Socioeconomics and demographics drive health outcomes in powerful ways. Research is focused on the recently released 2013 County Health Rankings.

1. Georgia Statewide
County Health Rankings
Atlanta Regional Commission
Regional Snapshot: June 2013
For more information contact:
mcarnathan@atlantaregional.com

2. Health Factors & Outcomes Z-Scores
Factors Z-Score Outcomes Z-Score
Health Factors are what influence the
health of a county. Such measures
include tobacco use, diet and exercise,
education, employment, community
safety or physical environment quality.
Health Outcomes represent how healthy
a county is. The two components of
health outcomes are how long people live
(mortality) and how healthy people feel
while alive (morbidity).
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau
* Negative Z-scores indicate relatively healthier counties

3. Statewide County Rankings: Health Factors
Top 10 Rankings
1. Fayette 6. Harris
2. Oconee 7. Cobb
3. Forsyth 8. Gwinnett
4. Columbia 9. Union
5. Cherokee 10. Bryan
These are the 10 healthiest
counties based on health
factors.
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau

4. Statewide County Rankings: Health Outcomes
Top 10 Rankings
1. Forsyth 6. Cobb
2. Fayette 7. Columbia
3. Oconee 8. Morgan
4. Gwinnett 9. Coweta
5. Cherokee 10. Rockdale
These are the 10 healthiest
counties based on health
outcomes.
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau

5. Health Factors Z-Scores: Variables
Income
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau
Z-Scores
Z-Scores measure how far a
particular county deviates from the
state average on a selected
measure. Here we are looking at
overall health factor z-scores.
Negative z-scores mean that
counties are relatively healthier
than the state average.
• This scatter plot shows that
income and the overall ranking
on health factors are related –
i.e. the higher the income, the
lower the z-scores, thus the
healthier the counties.
• Subsequent slides shows
several of these scatterplots
that tracks the relationships
between socioeconomics and
demographics to overall health.

6. Health Factors Z-Scores: Variables
Income
Population Age 65 and over
Non-White Population
Education
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau

7. Health Outcomes Z-Scores: Variables
Income
Population Age 65 and over
Non-White Population
Education
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau

8. Counties with Highest Access to Primary
Care Physicians (per 100,000)
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau
• Floyd County, with
Rome as the county
seat, has the highest
number of primary care
physicians per 100,000
at 117.
• Fulton County has the
highest population in
the state, and ranks No.
5 in Primary Physician
rate.
• Of the top 20 counties
listed, only four are
located in the 20-County
Metro area.
• Seminole County ranks
No. 3 in primary
physician rate, but has
170 preventable
hospital stays per 1,000
Medicare enrollees.
Primary Physician Rate
Preventable Hospital Stays
2012 County
Population Estimates

9. Counties with Lowest Access to Primary
Care Physicians (per 100,000)
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau
• Macon County has the
lowest rate of primary
care physicians in the
state.
• Paulding County, one of
the 20-County Metro
area counties, ranks 148
on primary care
physician rate with a
relatively high
population at 144,800.
• Rural counties have a
significantly lower rate
of primary care
physicians . However,
this does not necessarily
translate into higher
numbers of preventable
hospital stays.
2012 County
Population
Estimates
Primary Physician Rate
Preventable Hospital Stays

10. Preventable Hospital Stays and People
Without Health Insurance
Source: Small Area Health Insurance Estimates, 2010, U.S. Census Bureau
• Dark purple
indicates counties
with high
numbers of
preventable
hospital stays.
• There is a strong
correlation
between
uninsured
children and
adults.
• Counties with the
highest numbers
of preventable
hospital stays also
have the highest
rates of uninsured
people.

11. Healthcare Costs Per Person and
Household Income
Source: Behavioral Risk Factor Surveillance System, 2005-2011, U.S. Census Bureau
• Dark red indicates
counties with higher
cost of health care
per person.
• Southeastern
counties have a
dense concentration
of high health care
costs in the state.
• Of these counties,
the percentage of
households with
income less than
$35,000 is 30% or
greater.
• There is little
connection between
people who cannot
access a doctor due
to cost, household
income, or average
health care cost per
person.

12. Obesity Rates and Educational
Attainment
Source: National Center for Chronic Disease Prevention and Health Promotion 2009, U.S. Census Bureau
• Dark brown
counties have the
highest obesity
rates.
• There exists a
strong
correlation
between obesity
rate and income.
• The lowest
statewide obesity
rates are found in
the Northeastern
and Metro-
Atlanta counties.

13. Smoking in Relation to Cancer and
Respiratory Deaths
Source: Behavioral Risk Factor Surveillance System, 2005-2011, U.S. Census Bureau
• Counties with no
records have
populations of
30,000 or less.
• Counties with the
highest rate of
smokers tend to be
rural and less
populated.
• Counties with high
rates of respiratory
deaths (over 150,
per 100,000
population) tend to
have high rates of
cancer as well (200
or more, per
100,000
population).

14. STD Rate, Income and Non-White
Population
Source: Georgia Department of Public Health, STD Program, 2009-2011, U.S. Census Bureau
• Dark purple
indicates counties
with higher STD
rates.
• Counties with a
non-white
population of 50%
or greater tend to
have the highest
rates of STDs in
Georgia.
• Low-income
counties do not
show a significant
correlation
between STDs or
non-white
population.

15. YPLL 75 Rate, Education and Income
Source: Georgia Department of Public Health, 2009-2011, U.S. Census Bureau
• Dark brown
indicates areas
with high Years of
Potential Life Lost
after Age 75 (YPLL
75), which is a
measure of
premature death.
• Rural counties
experience high
rates (per
100,000)
population) of
YPLL 75.
• Higher YPLL 75
rates can be found
in counties with
lower educational
attainment and
lower income.

16. 20-County Metro Atlanta: Income,
Death Rate and Primary Care Access
• Dark green
represents the
wealthiest
counties in terms
of median
household
income.
• The graph shows
that there is little
correlation
between death
rate and primary
care physician
rates.
• County death
rates are more
closely correlated
with levels of
income and
education.
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau

17. 0
50
100
150
200
250
300
350 Cancer
External Causes
Repiratory
Cardiovascular
20-County Metro Atlanta Death Rates
RateofDeath(per100,000)
Source: Georgia Department of Public Health, 2009-2011

18. 20-County Metro Atlanta: Teen Birth
Rates
• Dark red
represents the
percent of births
that are to
women ages 10-
19.
• Counties with high
percentages of
people 25 and
older with no high
school diploma
and mothers who
did not complete
high school also
have the highest
rates of teen
pregnancy.
• Poorer counties
have higher rates
of teen pregnancy.
Source: Georgia Department of Public Health, Maternal Child Health (MCH) Statistics, 2009-2011, U.S. Census Bureau

19. • Dark blue represents
higher median
household income.
• Single fathers bring
home a bigger
paycheck than single
mothers in every
county except for
Rockdale: here,
single mothers earn
$4,459 more
annually than single
fathers.
• Both single mothers
and fathers are
below the median
household income,
highlighting a
significant economic
disadvantage.
20-County Metro Atlanta: Income for
Single Mothers and Fathers
Source: U.S. Census Bureau

20. 10-County Atlanta Area: Health Behaviors
0
5
10
15
20
25
30
35
40
Smoking
Physical Inactivity
Obesity
Excessive Drinking
PercentageofPopulation
Source: HRSA Area Resource File, 2011-2012, U.S. Census Bureau