Tale of two counties

February 19, 2010

Marin and Lake counties are two counties in Northern California, not very far apart. Marin is on the coast, Lake is inland. Marin has a heavily populated corridor along Highway 101 and some rural areas elsewhere. Lake is mostly rural. When it comes to health, the contrasts grow even more stark.

Marin was recently named the healthiest county in California in a national study by researchers at the University of Wisconsin. Babies are born healthier, or at least heavier, people live longer, and residents report being sick relatively rarely.
Lake County was near the bottom of California counties on all of those measures.

What causes those disparities? No one knows for sure. But an increasing amount of research shows that where you live has a relationship to how healthy you are.

It’s not only geography. Lake County has cleaner air than Marin, and its residents have greater access to fresh fruits and vegetables, at least in theory. The counties have an equal proportion of adults — 17 percent — without health insurance. But Lake County’s residents are still far less healthy than Marin’s, and they score low on several factors that contribute to or are connected to good health.

The people of Lake County are more likely to smoke cigarettes, to be obese, and to have children while they are still teen-agers. Far more kids live in poverty in Lake County, more students drop out of school, and a smaller proportion of the population has graduated from college. In Lake County, families are more likely to be headed by a single parent, and residents are more likely to be a victim of violent crime. All of these things — some within the control of individuals, some not — contribute to the lifestyle.

The data for the study comes from the California Department of Public Health and was crunched by researchers at the University of Wisconsin’s Population Health Institute. The study ranked counties by health outcomes and health “factors” — or conditions believed to contribute to those outcomes.

Here is a point-by-point the comparison between Marin and Lake counties:

Smoking rate. Twenty two percent of Lake County adults report smoking cigarettes. In Marin County, 7 percent of adults smoke.


Smoking rate. Twenty two percent of Lake County adults report smoking cigarettes. In Marin County, 7 percent of adults smoke.

Obesity In Lake County, the obesity rate is 24 percent. In Marin it is 17 percent.

Binge drinking. Here’s one where Lake comes out ahead of Marin. In Lake County, 15 percent of adults admit to binge drinking in the 30 days before they were surveyed. In Marin it was 18 percent.

Motor vehicle death rate. I’m not sure why there is such a big difference here, but Lake had 27 deaths per 100,000 population while Marin had just 6.

Sexual activity. Another one where Marin looks worse. Marin had 213 cases of chlamydia per 100,000 population while Lake had 167. Maybe it was all the binge drinking.

Teen birth rate. A huge difference here. Marin had 13 births among every 1,000 girls aged 15 to 19. Lake had 46.

Insurance. Perhaps a surprise: both counties had 17 percent of adults without insurance. I suspect Lake has a lot more on public insurance while Marin has more on private insurance. But this does show that access to coverage is not necessarily the driving factor in health outcomes.

Access to doctors. Finding a doctor can be another matter. In Marin there are 191 primary care doctors per 100,000 people. In Lake County, just 91.

Preventable hospital stays. Per 1,000 Medi-care enrollees: Lake, 59, Marin, 41.

Diabetic screening. Lake is on the ball here. Or maybe Marin just falls short. In Lake, 78 percent of diabetics in Medi-Care had received a key screening test. In Marin it was 77 percent.

Education. Uh-oh. Marin reports graduating more seniors than the county has entering as high school freshman. Possible, maybe, but that might also be bad data. Lake reports a graduation rate of 64 percent, which sounds accurate. Also, in Marin, 54 percent of people older than 25 have 4-year college degrees. In Lake County, just 15 percent do.

Unemployment. When the data were gathered, Lake County’s unemployment rate (11 percent) was more than double Marin’s (5 percent).

Child Poverty. Ouch. In Lake County, 27 percent of kids live in poverty. In Marin, just 7 percent.

Family. In Lake County, 11 percent of households are headed by single parents. In Marin, it’s 7 percent.

Crime. In Lake County, there were 418 violent crimes per 100,000 people. In Marin, it was 245.

Healthy food. Usually a good indicator of health but not this time. In Marin, 49 percent of zipcodes had access to healthy foods, while in Lake it was 53 percent. Of course in Marin everyone has a car and it might not be much of a problem to drive to the next zipcode to shop.

Alcohol. Interesting measure, but it doesn’t contribute to the outcomes in this case. In Lake, there are .6 liquor stores per 10,000 people. In Marin there is 1 store for every 10,000 residents.

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  1. Pingback: Community Health and Collaborative Journalism on HealthyCal.org « The Media Optimist

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