County Health Rankings: A Breath of Fresh Air
By Donald F. Schwarz
About the Author: Donald F. Schwarz, MD, MPH, MBA is Director, Catalyzing Demand for Healthy Places and Practices at the Robert Wood Johnson Foundation.
Air pollution has long moved on from being a concern reserved for proactive environmentalists. Today, it has become a more visible personal health issue for millions of families and a major and growing public health concern for communities who live in close proximity to pollution sources.
The quality of air that we breathe determines, in part, how long and how well we live. Unfortunately, for residents of predominantly low-income and/or minority counties across the country, the impact of polluted air leads to the biggest concerns. Because many mobile and stationary sources of air pollution tend to be concentrated around the residential areas of low-income and minority communities, certain geographies have a greater threat of damaged health.
That’s why the County Health Rankings, an online tool which uses a variety of indicators to rank public health for almost every county in the nation, includes air pollution as an indicator to measure the health conditions of a county. It recognizes that an important aspect of the health of a community includes factors beyond the control of an individual person. The tool highlights regions by their health quality to help focus local government action.
Air pollution is not a health concern that exists in a bubble — it has impacts on human health in several realms. For example, we know the links between polluted air and asthma. According to the U.S. Centers for Disease Control and Prevention, about nine people die from asthma in the U.S. every day. The toll on lives is acute, as is the effect on how well people in impacted regions live. Air pollution also causes decreased lung function, chronic bronchitis, and other adverse pulmonary effects. The impact does not end with individual homes and families but over time affects our communities and our economy. In fact, asthma costs us about $56 billion in medical costs, lost workdays, and early deaths each year. These are not expenses that people who are already struggling to make a living are able to comfortably “take on,” nor should they have to.
There are also correlations between air pollution and the quality of life for children, many of whom are low-income or minority, who live, learn, and play in close proximity to pollution sources. There is a strong correlation between birth defect rates and proximity to air pollution, likely because pregnant mothers are a more susceptible population to environmental hazards. For older children, education is a concern based on the fact that more than 10.5 million school days each year are lost among 5- to 17-year-olds due to asthma complications.
Our hopes are that by using the county ranking tool, state and local governments can find ways which to share ideas to improve public health from place to place. For example, a recent study from our home state of New Jersey found that programs like the E-Z Pass open-road tolling (which result in fewer cars idling around toll plazas) have been connected to lower premature birth rate among moms who live nearby. By indicating within states those counties with similar pollution control problems, there is an opportunity for increased collaboration between governments and decision-makers. We hope that knowledge like this can contribute to improved public health for all.
We can hope for brighter futures for marginalized communities by taking direct action in the right areas. Want to know if you are breathing clean air in your county? Check out the 2015 County Health Rankings to see where your county stands in your state for air pollution.
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