(Shelby, NC)--Each year, the University of Wisconsin Population Health Institute in partnership with the Robert Wood Johnson Foundation release the County Health Rankings. These rankings compare the overall health of nearly every county in the nation, with the goal of showing that where you live influences how well and how long you live. With a ranking of 1 indicating the healthiest county and a ranking of 100 indicating the least healthy county in North Carolina, Cleveland County received an overall ranking of 81 in Health Outcomes, a slight improvement from the ranking of 82 in 2017.
The rankings help to shed light on factors that are making our residents unhealthy and what issues we can work to address to help make Cleveland County a healthier place to live, learn, work and play. The rankings make it clear that good health is influenced by many factors beyond just medical care, and it takes a comprehensive community approach with engagement of partners from numerous sectors to address the many factors that can influence the health of our community.
One of the biggest areas of improvement in Cleveland County's health ranking from 2017 to 2018 is in the category of Length of Life, improving from a ranking of 89 in 2017, to 82 in 2018. This improvement is largely due to a decrease in the county's premature death rate, defined as years of potential life lost before age 75 per 100,000 population, decreasing from a rate of 10,200 in 2017 to 9,700 in 2018. This decrease in the county's premature death rate could be, at least in part, attributed to a decrease in the number of unintentional medication and drug overdose deaths. However, it should be noted that despite this decrease, drug overdose deaths remain the single leading cause of premature deaths among Americans ages 25 to 44, and continues to be an issue impacting Cleveland County.
Another notable area of improvement is in the category of Social and Economic Factors, improving from a ranking of 60 in 2017, to a ranking of 57 in 2018. This improvement in the ranking is marked by a slight increase in the percentage of adults ages 25-44 with some college education, a decrease in the unemployment rate and a decrease in the percentage of children living in poverty. Outcomes included in the Social and Economic Factors category are often referred to as the social determinants of health. Social determinants of health are the structural determinants and conditions in which people are born, grow, live, work and age. They include factors like socioeconomic status, education, the physical environment, employment, and social support networks. These conditions in which we live explain, in part, why some Americans are healthier than others and why Americans more generally are not as healthy as they could be. These environmental and social conditions are, often, some of the most difficult to change. Therefore, improvements in this category should be celebrated.
Although the county's overall health ranking improved, the rankings identify several areas in which attention is needed. In the category of Health Behaviors, adult smoking, adult obesity, excessive drinking, and sexually transmitted infections increased. These same health behaviors have already been identified as priority focus areas as a result of the Cleveland County Health Department's 2015 Community Health Assessment. Action plans to address substance abuse, physical activity and nutrition, and unintended pregnancies and sexually transmitted diseases have already been developed and much work has begun to help alleviate these issues in the county. Despite these increases in some undesired behaviors, there were some major improvements in health behaviors that should be mentioned. Although excessive drinking slightly increased from 15% in 2017 to 16% in 2018, alcohol-impaired driving deaths decreased significantly from 2017 to 2018, going down from 34% to 31%. Moreover, despite the increase in the rate of sexually transmitted infections, teen births went down considerably from 47/1,000 in 2017 to 39/1,000 in 2018.
To better understand the County Health Rankings, it is best to examine the individual measures, weights and scores that are used to develop rankings, rather than just looking at the overall ranking alone. There are many factors that can cause ranks to improve or worsen from year to year. It should also be noted that while scores and data are reported as 2018, often the source of data is actually from previous years, in some cases dating back as far as 2013. Furthermore, some data is reported as an average from a range of years over time. As a result, improvements in health factors within recent years or as of current are likely not yet reflected in the rankings. One of the key things to remember is, all counties can take action to improve, no matter how they rank. The rankings are not about a race to the top, but rather about identifying areas in which we can improve in order to make progress toward better health for our community.
The Rankings are available online at www.countyhealthrankings.org. For additional information on Cleveland County's health ranking, or for assistance in interpreting the data available on the County Health Rankings website, you may contact the Cleveland County Public Health Center at 980-484-5199.

Submitted by DeShay Oliver, PIO
Cleveland County Public Health Center
980-484-5199
Deshay.oliver@clevelandcounty.com