Rural vs. Urban Healthcare

Knoxville (WVLT) - Tennessee has ranked how healthy you and your neighbors are compared to residents in other counties in the state.

And in East Tennessee, it found a spectrum as diverse as its culture.

Knox was the highest ranking county in our region at six. Fentress and Hancock counties were the lowest at 92 and 93.

What is the reason for such a disparity?

Medical Reporter Jessa Goddard takes a closer look at the rankings and how rural areas compare to urban ones when it comes to the quality of health care.

The purpose of the ranking is to try to address specific health issues after Tennessee's overall health ranked 47th in the nation.

But where do East Tennessee health officials begin when local counties came in at the very top and the very bottom, and scattered in between?

To rank the counties, the state institute of public health used 34 variables. Determining factors include: availability and access to health care, socioeconomic factors, physical environment, such as air quality, and individual behaviors, like smoking.

East Tennessee Regional Health Doctor Paul Irwin says where you live is directly connected to how healthy you are.

"We know that access to healthcare is certainly tied to geographic isolation, so the farther out counties are from urban areas, the greater the access problems they have," Dr. Irwin.

But Irwin says it's at the individual household level where health happens or doesn't happen.

After all, 80 percent of the causes of death are related to individual behaviors.

That's why the regional health office is trying to target people early.

To combat low birth weight, officials began a smoking cessation program for low income, pregnant women.

And to fight the battle of the bulge, they've implemented nutrition programs in public schools.

Now, these rankings will help public health officials, at the local level, target more specific areas of improvement.

"We also know that health inequities exist between and amongst our counties and in that sense the report doesn't provide a new window in understanding why those health inequities exist," says Dr. Irwin.

State health officials say the rankings are a prescription for public health.

At the individual level, to make good decisions about your personal health.

And at the state level, to bring about changes in state law for the good of everyone.

The state institute of public health was formed this year to help build up the public health work force, which is expected to decline by 50 percent in the next five years, as current workers retire.

Though, public health officials say regardless of this county-by-county ranking, the bottom line is there's something every one of us can do to improve our health.

Here are the overall rankings, from first to last:

1. Williamson

2. Sumner

3. Rutherford

4. Franklin

5. Moore

6. Knox

7. Wilson

8. Bradley

9. Bledsoe

10. Montgomery

11. Chester

12. Putnam

13. Weakley

14. Giles

15. Anderson

16. Blount

17. Dickson

18. Loudon

19. Maury

20. Sullivan

21. Coffee

22. Meigs

23. Hamblen

24. Roane

25. Jefferson

26. Humphreys

27. Hawkins

28. Warren

29. Davidson

30. Cheatham

31. Robertson

32. Sevier

33. Crockett

34. Carter

35. Trousdale

36. Pickett

37. Perry

38. Hickman

39. Lawrence

40. Decatur

41. Monroe

42. Smith

43. McNairy

44. McMinn

45. Washington

46. Greene

47. Cumberland

48. Marshall

49. Rhea

50. Unicoi

51. Campbell

52. White

53. Bedford

54. Van Buren

55. Macon

56. Hamilton

57. Overton

58. Claiborne

59. Sequatchie

60. Dyer

61. Wayne

62. Gibson

63. Grainger

64. Cannon

65. Marion

66. Hardin

67. Morgan

68. Houston

69. Polk

70. Union

71. Madison

72. Carroll

73. Tipton

74. Obion

75. Clay

76. Jackson

77. Shelby

78. Stewart

79. Henry

80. Scott

81. Lincoln

82. Henderson

83. Johnson

84. Grundy

85. Fayette

86. Benton

87. Lewis

88. Cocke

89. Lauderdale

90. Dekalb

91. Haywood

92. Fentress

93. Hancock

94. Hardeman

95. Lake

Source: the Tennessee Institute of Public Health

Copyright 2006 by the Associated Press. All rights reserved.