S.C.'s healthiest counties: Greenville, Pickens among top 10

Greenville is the fourth healthiest county in the state, while Pickens ranks 10th and Anderson County comes in at 15th, a new national ranking of health shows.

Wealthy Beaufort County is the healthiest, while rural, impoverished Marlboro County is the least healthy, according to the annual County Health Rankings from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

This year’s rankings reveal gaps in health based on geography, race and ethnicity that are costly, preventable and could be narrowed by creating more equitable opportunities, such as improving education, the researchers said.

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Katy Smith, executive director of the Piedmont Health Foundation in Greenville, said the report shows that health is influenced by far more than the traditional health care system.

"Most of a community’s health is affected by social, economic and community factors, such as housing, transit, education, safety and more," she told The Greenville News. "To me, this is good news for community leaders who want citizens to be healthy."

Smith said the factors identified in the report are the same issues that Greenville County is discussing.

"There are things we can do to support our neighbors’ health," she said, "such as making sure we have adequate affordable housing, supporting growth in our transit systems to connect people to jobs and healthy foods, and making policies, as the city of Greenville did years ago, to ban tobacco use in public settings to reduce use.”

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And Kester Freeman, executive director of the South Carolina Institute of Medicine and Public Health, said the rankings illustrate that health policies must be tackled at the state and local levels.

“It is only by addressing the important drivers of health, including poverty and other gaps in opportunities as shown in this year’s report," he said, "that we can improve the health of all who live in South Carolina."

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Fewer opportunities

The report concludes that higher rates of educational achievement typically mean better jobs, higher incomes and longer lives, with college graduates living on average nine years longer than those who don’t complete high school.

Meanwhile, those who live in poverty typically have fewer opportunities and poorer health, with children in these circumstances generally having less access to well-resourced and quality schools and therefore fewer chances for living-wage jobs, upward economic mobility and good health as adults.

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People in the bottom-performing counties face higher rates of unemployment, lower rates of high school graduation, and lower median household incomes than people in the top performing counties, the researchers said.

Greenville County, which also ranked fourth last year, fared better in a number of categories than the rest of the state, according to the report.

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For example, there are fewer low birthweight babies here compared with the state average — 8 percent versus 10 percent; fewer smokers — 17 percent versus 20 percent; fewer teen births — 29 per 1,000 teens versus 33; and a lower rate of sexually transmitted diseases — 463 versus 570.

Anderson County has a low birthweight rate of 9 percent, a smoking rate of 19 percent, a teen birth rate of 40, and a rate of sexually transmitted diseases of 460.

Pickens County has a low birthweight rate of 8 percent, a smoking rate of 18 percent, a teen birth rate of 24, and a rate of sexually transmitted diseases of 333.

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And while 23 percent of the state’s children live in poverty, 15 percent live in poverty in Greenville County.

The percentage of children in poverty in Anderson County is 22 percent. It's 18 percent in Pickens County.

Education and employment

Compared with the state, Greenville County also has a higher high school graduation rate — 84 percent versus 80 percent; more people with a college education — 67 percent versus 62 percent; and a lower unemployment rate — 4.1 percent versus 4.8 percent, the study shows.

Anderson County has a high school graduation rate of 85 percent, a college education rate of 60 percent, and an unemployment rate of 4.4 percent.

Pickens County's high school graduation rate is is 82 percent, its college education rate is 59 percent and its unemployment rate is 4.8 percent.

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But though Upstate counties generally did well, South Carolina overall still ranks worse than the US median in many areas, including years of potential life lost before age 75 per 100,000 people — 8,300 compared with the national median of 6,700; high school graduation rate — 80 percent compared with 83 percent; violent crime — 521 compared with 380; sexually transmitted infections — 570 compared with 479; and children in poverty — 23 percent compared with 20 percent.

High school graduation and unemployment rates are worse among counties in the Southeast, Southwest, Appalachian, and Mississippi Delta regions, the report concluded.

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Lack of insurance also plays a role. Some 13 percent of South Carolinians — up to 30 percent of some racial groups — are uninsured, compared with 11 percent nationwide, according to the report.

'Structural racism'

And the gaps disproportionately affect people of color in South Carolina and around the nation.

The rate of children in poverty statewide, for example, ranges from 14 percent to 38 percent among different racial groups, with white children fairing best and Hispanic children worst.

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The researchers wrote that “structural racism in the form of unfair systems, policies and practices, such as residential segregation and inadequate access to quality clinical care," have created barriers to opportunity and good health in many communities of color.

“We can’t be a healthy, thriving nation if we continue to leave entire communities and populations behind,” said Dr. Richard Besser, Robert Wood Johnson Foundation CEO.

“"Every community should use their County Health Rankings data, work together, and find solutions so that all babies, kids, and adults — regardless of their race or ethnicity — have the same opportunities to be healthy.”

Nationwide, rural counties have the highest child poverty rates, 23.2 percent; followed by large urban metro, 21.2 percent; smaller metro, 20.5 percent; and suburban counties, 14.5 percent, the researchers said.

York and Charleston counties came in second and third in the county rankings, while Lexington County came in fifth.

In addition to Marlboro County, the least healthy counties are Marion, Dillon, Allendale and Williamsburg, the report showed.

"The time is now to address long-standing challenges like child poverty," said Julie Willems Van Dijk, director of County Health Rankings & Roadmaps.

"This year’s rankings are a call to action to see how these persistent health gaps play out locally, take an honest look at their root causes, and work together to give everyone a fair shot at a healthier life."

To read the full report, go to www.countyhealthrankings.org.