This week, the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute released its annual county-by-county health rankings in all 50 states. Today, we’re going to take a deep dive into—you guessed it—Essex County, Massachusetts, to analyze for trends, identify problems, and find solutions.
Essex County is ranked the 6th healthiest county (of 14) in Massachusetts. The good news is that Massachusetts is one of the healthiest states in the country on a wide variety of metrics, from having the lowest percentage of uninsured residents to one of the highest immunization rates in the U.S. (on the other hand, Massachusetts has one of the worst records on binge drinking and health disparity based on level of educational attainment).
The bad news is that we still have a ways to go to root out preventable health dangers, provide all people have access to quality, affordable, preventive care, and arm Bay Staters with the skills and tools they need to keep their families strong.
The North Shore continues to suffer from high rates of impaired/drunk driving. Nearly 1 in 3 driving deaths involve alcohol, above the Massachusetts average of 28 percent and far higher than the national leaders at 14 percent.
Essex County also suffers from:
· the third highest Chlamydia rate in the Commonwealth
· a well-below average ratio of primary care physicians per capita
· a high rate of single-parent households (nearly 1/3)
· the most severe housing problems (overcrowding, high housing costs, or lack of kitchen or plumbing facilities) outside of Boston and the islands
· long commutes (39 percent of commuters who drive themselves to work commute for longer than 30 minutes each way)
There are a number of steps policymakers should take to address these concerns. First, while only 3.1 percent of residents in the 6th Congressional District (roughly continuous with Essex County) are uninsured, further outreach is needed to communities that remain underinsured.
In Lynn, over 11 percent of residents 18-64 are uninsured, the sixth highest rate in the state. In Salem, nearly 7 percent of 18-64 year-olds are uninsured. In Beverly, 4.6 percent of children are uninsured, the fourth highest rate in the Commonwealth. Furthermore, according to the Census Bureau, over one-third of all uninsured residents of Essex County are immigrants.
Getting these neighbors quality insurance is critical since Blue Cross has found that a significant percentage of the uninsured face a variety of unmet medical needs, from dentists and preventive care to prescription drugs.
Making the Bay State healthier goes beyond insurance, though. It also involves changing habits and encouraging beneficial behavior. Cities and towns in Northeast Mass. should canvass the country for pioneering public health initiatives. In New York City, calorie counts at restaurants have provided transparency to consumers about nutrition information. While evidence is mixed as to their effects, simply making people aware of the choices they are making is a step in the right direction.
In Chicago, Mayor Rahm Emanuel has banned the sale of tobacco products marketed to children in school zones and has taken concrete steps to keep e-cigarettes out of the hands of kids.
Closer to home, on the South Shore, the Southcoast Hospitals Group has invested in a health van that serves community organizations at sites throughout Greater Fall River, New Bedford and Wareham and surrounding communities, providing free education and screenings to the community. Hospitals in Essex County should work together with local governments to sponsor a similar program.
The Bay State already provides a wellness tax credit for businesses. But Beacon Hill should do more to nudge people toward better health outcomes.
In particular, our sales tax is a mess. For instance, while running sneakers are exempt, cleated sneakers are not. We should exempt cleats, along with condoms and approved weight loss aids to encourage healthy behavior.
Lastly, our schools should be on the cutting edge of nutrition—going beyond was is required by the Mass. School Nutrition Standards, to help reduce childhood obesity that can lead to diabetes. While come students have complained about the lack of cookies, the benefits of healthy lunch in school far outweigh the costs.
Massachusetts has been a leader in public health for generations, ever since the Supreme Court upheld the Commonwealth’s mandatory vaccination law in the landmark case of Jacobson v. Massachusetts, 197 U.S. 11 (1905). It is our responsibility to remain a model for others to follow and, in the process, ensure a better life for our citizens.