County near bottom of health rankings

Mille Lacs County ranks 85th in health outcomes and 83rd in health factors among the state’s 87 counties, according to the latest of the five annual health-ranking studies from the University of Wisconsin Population Health Institute.

The institute ranks counties according to a standard formula to measure the health status of their residents and how long they live.

The highest health outcome rank went to Carver, which lies southwest of Minneapolis and which was in first place in last year’s study. Sherburne County, which was ranked 41st last time has now moved up to 26th place. Isanti County which was 45th, moved up to 42nd, and Benton which was 64th, moved up to 56th. Mille Lacs’s health outcome ranking remains unchanged from last year.

The study ranks Mille Lacs as being 85th for length of life and 61st for quality of life. In the health factors overall category, Mille Lacs County ranks 84th for health behaviors, 75th for clinical care, 80th in social and economic factors, and 77th in physical environment.

Quality of life is broken down to days of poor or fair health, poor physical health days, poor mental health days and low birth weights.

Health behaviors include adult smoking (25 percent vs. the state average of 16 percent), adult obesity, food environment index, physical activity, access to exercise opportunities (40 percent vs. state’s 80 percent), excessive drinking, alcohol-impaired driving deaths (41 percent vs. state’s 32 percent), sexually transmitted infections (208 vs. state’s 316, and teen births (41 vs. state’s 25).

The clinical care category has to do with insured, primary care physicians, dentists, mental health providers, preventable hospital stays and diabetic and mammography screenings.

Social and economic factors relate to high school graduation (81 percent vs. the state’s 77 percent), some college (61 percent vs. state’s 73 percent), unemployment, children in poverty (18 percent vs. state’s 15 percent), children in single parent households, violent crime (130 vs. state’s 234), and injury deaths (87 vs. state’s 54).

Physical environment includes air pollution (particulate matter), drinking water violations, severe housing problems, driving alone to work and long commutes. Driving alone came in at 42 percent for Mille Lacs County vs. the state average of 29 percent.


Janelle Schroeder, who left her job as Mille Lacs County Community Health director last week, wasn’t available for comment on this year’s study. The county’s health-outcomes ranking is unchanged from the previous year, when Schroeder said she was not so surprised by Mille Lacs’ low ranking because of Mille Lacs being among the top five to 10 poorest counties in the state.

“Something very interesting is that the zip code (or where you live) can affect your health,” she said.

One factor that can contribute to poorer health, she said, is whether residents have sufficient access to grocery stores to buy fresh fruit and vegetables. Also, if the tax base is low, the jurisdiction may not have high-quality academic options nor enough sidewalks, she said.

Many things are in the environment that contribute to the health of residents, she said. For instance, on the north end of Mille Lacs County, the Mille Lacs Band of Ojibwe have “historical trauma,” Schroeder said.

Schroeder noted too that Minnesota is not ranked as high in health as it once was, and said the Minnesota Department of Health is focusing on reducing health inequities.

But getting back to Mille Lacs County, Schroeder said: “We know that we have social and economic factors and health behaviors that contribute to poor health.”

Schroeder pointed out that adult men in Mille Lacs County have double the lung cancer rate than the state.

What to do

Schroeder noted that all Minnesota counties every five years must report to the Minnesota Department of Health their county’s health assessment and create an action plan to improve it, utilizing the health factors.

The entire community needs to be involved in addressing health issues, including pollution and the choice of healthy lifestyle habits, Schroeder added. “There is a great deal of individual choice. I hope we have healthy choices.”

The ideal would be for healthy choices to be easy to make and the unhealthy ones difficult to choose, Schroeder said.

Instead, the opposite is often the case, she indicated, giving the example of a parent with children at a grocery store. By the time they get to the checkout counter, the parent is weary, and there sits all that candy displayed for the children to want, Schroeder said.

The County Board also has a role, and the commissioners are trying to create more jobs in the county to provide a more livable wage, Schroeder added.

“When you are stressed financially, it is difficult to parent well,” she explained.

The southern end of Mille Lac County has an advantage in that it offers a shorter commute to metro jobs compared to the north end, Schroeder said. Also, the north end’s tourism economy fluctuates more, she said.

Minnesota Health Commissioner Dr. Ed Ehlinger said that research shows that among the factors contributing to health, 40 percent are related to social and economic, 30 percent are tied to health behaviors, 10 percent relate to physical environment, 10 percent to genes and biology, and 10 percent involve clinical care.

One more challenge in improving healthy outcomes is that it may take as much as 25 years, or even a lifetime to see the results of action plans, Schroeder said.