ST. GEORGE — Utah has long been known for ranking as one of the top 10 healthiest states in America. But within the state itself, some counties tend to have better health than others.

County Health Rankings are compiled every year by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The survey looks at the overall quality of life, health behaviors, physical environment and clinical care for each county.

The five counties represented by the Southwest Utah Public Health Department saw mixed results. Washington County ranked seventh, Kane 11th, Iron 18th, Beaver 20th and Garfield 24th.

The data used to determine how each county ranks comes from a variety of sources including the Centers for Disease Control and Prevention, the Behavioral Risk Factor Surveillance System, the National Center for Health Statistics and the Bureau of Labor Statistics and is intended to give residents, communities and health departments a better understanding of how to improve their health locally.

“Part of our role is to evaluate all data sources so that we have a good feel for the factors that contribute to life expectancy and quality of life, and this is one source that we can look at,” David Blodgett, director of the Southwest Utah Public Health Department, said. “Each county has unique characteristics in population, demographics and economy, and differences in how they approach various aspects of community living. We find that most are very engaged with us in the quest for better health.”

Length of life and premature death rates were a factor in the report, measuring the number of deaths under the age of 75 per 100,000 people. All five counties saw a higher number of premature deaths than Utah overall, which averages 6,100 for every 100,000 people. Washington County’s rates were just above the state average, seeing 6,200 premature deaths while the other counties were up more significantly, with Beaver County having the most of the five with 9,100, and Garfield County just behind with 8,700.

This higher number of premature deaths in Beaver and Garfield counties may be related to their higher rates of injury deaths. Beaver County had an average of 109 injury deaths per 100,000 people and Garfield had 127, while other counties, such as Washington and Iron, with lower premature deaths, also had lower injury deaths. Washington County only had 79 injury deaths per 100,000 people and Iron County had 69.

Injury deaths include any kind of planned deaths including homicide or suicide as well as unplanned deaths such as car crashes and falls.

For health behaviors, the study looked at adult smoking, obesity, the food environment index, physical inactivity, access to exercise opportunities, excessive drinking, alcohol-impaired driving deaths, sexually transmitted infections and teen births.

Washington County ranked sixth for health behaviors overall in Utah, while Kane ranked eighth, Beaver 11th, Iron 16th and Garfield 17th.

Health factors, including premature deaths and obesity, are correlated with the community’s access to healthy foods, according to the study. That factor is measured by the distance that people live from a grocery store, as well as the number of people facing food insecurity due to cost. In Washington County, 9 percent of residents have limited access to healthy food and 14 percent struggle with food insecurity.

The results of the report were fairly consistent with the health department’s current evaluations, Blodgett said. Part of the department’s responsibilities include identifying areas of concern and working to address them. A few of the areas that they have been working on and have seen improvement in are in smoking and obesity rates in the district.

Obesity rates have either remained the same or declined by one or two percentage points across all five counties since 2018. All but Garfield County, where 29 percent of the population is obese, had lower rates of obesity than the state average of 26 percent.

In all five counties, an estimated 10 percent of the population are smokers.

“Utah enjoys some of the lowest rates in the nation but we keep working on it, as smoking contributes to most of the top causes of death,” Blodgett said.

Clinical care statistics were also included in the report, which looked at the number of primary care physicians, dentists and mental health providers, as well as the number of uninsured residents, preventable hospital stays, mammography screenings and flu vaccinations.

Overall, Washington County ranked number 12 in the state for clinical care while Kane County ranked 15, Iron 17, Beaver 22 and Garfield 25.

Washington County has a 87 primary care physicians and a ratio of 1,840 residents per doctor, which was fairly consistent with Kane, Garfield and Beaver counties. Iron County did not fare as well, having only 20 primary care physicians, which comes out to 2,500 residents per doctor.

Social and economic factors also affect a county’s health ranking, including high school graduation rates, the number of people who have some college, rates of unemployment, children in poverty, income inequality, children in single-parent households, violent crime, injury deaths and social associations. For these factors, Kane County ranked eighth, Washington 11th, Beaver 16th, Iron 18th and Garfield 24th.

All five counties did well in regard to education. Kane County had a 98 percent high school graduation rate, while the lowest of the five, Beaver County, had an 85 percent graduation rate. And in all five counties, over 50 percent of the population had at least some college.

Having higher rates of educational success in a community is important because adults with more education are less likely to smoke and are more likely to exercise, according to the report. They are also more likely to be employed and earn more than those with less education.

The rates of children living in poverty were all above the state average of 11 percent. Beaver County had a 13 percent child poverty rate while Iron County had 18 percent. Washington County was just above Beaver with 14 percent while Garfield and Kane counties had a 15 percent child poverty rate.

The number of violent crimes in a community can affect the community’s health in more ways than physically or psychologically harming the victims of the crimes. It can also reduce the number of people exercising outdoors and can raise their stress levels, causing hypertension and other stress-related disorders which can even lead to obesity, according to the study.

The number of reported violent crime incidents per 100,000 people were mixed. The state average is 229, and Washington County saw less with 154 per 100,000 people. Beaver County only had 54, while Iron had 278, Kane was had 311 and there was no data available for Garfield.

The final category that the report looked at was the physical environment, which includes air pollution, drinking water violations, severe housing problems, long commutes and driving alone to work.

Beaver was the only one of the five counties that did not have a drinking water violation. The report drew this information from the Utah Department of Environmental Quality, which indicates only whether the county has a violation, but does not list what that violation was.

“We have many water systems, so some are bound to have occasional violations. … To our knowledge there have been no consistent violations related to the systems that serve our towns and cities,” Blodgett said.

The length of the average person’s commute to work, and whether they make that commute alone, can have an impact on both an individual’s health and the community’s health as a whole.

According to a 2012 study in the American Journal of Preventive Medicine, the farther that a person commutes by vehicle, the higher their blood pressure and body mass index are likely to be, and the less physical activity they are likely to participate in. They found that each additional hour that is spent in a vehicle per day increases that person’s likelihood of obesity by 6 percent.

Additionally, when a person drives a vehicle to work alone instead of carpooling or using public transportation, they contribute to air pollution, which puts the entire community at risk for health consequences including chronic bronchitis, asthma and decreased lung function.

Over 70 percent of the working population in all five counties drive alone to work, though less than 20 percent have a commute of over 30 minutes in Southern Utah.

To view the full County Health Rankings report, click here.

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