Midlands counties’ rankings in health study vary widely

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No Midlands counties ranked in the healthiest or most unhealthy in the state, according to a new report, but that doesn’t mean the area doesn’t have its share of challenges or residents living better-than-average healthy lives.

A series of annual statewide and county-by-county reports covering the United States was released this week by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The reports analyzed two main areas: health factors and health outcomes.

Health factors include areas that drive how long and how well people live, including behaviors such as tobacco use, eating habits, exercise, alcohol and drug use; access to and quality of clinical care; social and economic factors such as education, employment, income, and family support; and physical environment, including air and water quality, housing and transit.

Health outcomes represent measures of how long people live and how healthy people feel, such as length of life and premature death (years of potential life lost before 75), self-reported health status and percentage of low birth weight newborns.

Of the 46 counties in South Carolina, Midlands counties did not appear in either the top healthiest or least healthy counties statewide.

The state’s healthiest county was Beaufort, followed by York, Charleston, Edgefield and Greenville. The state’s least healthiest counties were Lee, Dillon, Marlboro, Marion and Williamsburg.

In the Midlands, Lexington ranked sixth, Saluda 10th, Richland 12th, Kershaw 17th, Sumter 21st, Calhoun 23th, Orangeburg 37th and Fairfield 39th.

Midlands counties saw a wide range in quality-of-life rankings. Lexington ranked fourth and Richland 17th, while Orangeburg came in at 40th.

In general, Saluda, Lexington and Richland residents enjoy longer lives than others in the Midlands, ranking second, ninth and 10th for length of life, respectively. Saluda and Lexington ranked among the state’s best counties in physical environment at fourth and sixth.

Richland County ranked first in clinical care, with just 9% of residents uninsured and comparably high rates of mammography screening and flu vaccinations.

Lexington ranked second in social and economic factors, with a low unemployment rate and the lowest percentage of children in poverty among Midlands counties at 17%.

When compared with the rest of the state, most Midlands counties see more premature deaths, more days, lower birth rates and more poor mental health days.

Except in Orangeburg, Midlands counties have a lower rate of adult smoking than the state average, but all have a higher or the same rate of obesity as the state average and most are less physically active.

Except in Lexington, Midlands counties ranked below state average for excessive drinking, but all ranked higher than the state average for alcohol-impaired driving deaths.

The report drew a connection between housing problems and health.

“Housing is part of the foundation for living long and well,” a news release on the report said. “High housing costs can force some families to live in unsafe or overcrowded housing, or even into homelessness. This year’s rankings state reports show stark differences across and within counties in the opportunity to afford a home, especially for those with low incomes and people of color. This year’s analyses show that a lack of opportunity for a safe, secure and affordable home is tied to poor health.”

The state average for people dealing with severe housing problems, such as overcrowding, high cost, lack of kitchens or lack of plumbing, was 15%. In Richland County, 18% of the population dealt with such problems, while 12% did in Kershaw and 13% did in Lexington.

“Among South Carolina’s children living in poverty, 49% were living in a household that spends more than half of its income on housing,” the report said. “High housing costs make it difficult for families to afford other essentials that contribute to good health, such as healthy food, medicine, or transportation to work or school.”

When race is accounted for, the differences are even more stark. While 13% of all households in South Carolina spend more than half of their income on housing, 20% of black residents are burdened by severe housing costs compared to 10% of white residents.

“When we talk about the overall picture of health and wellness in South Carolina, it is important to remember that it’s not only about access to clinical care, but a collaborative, community-based approach to a healthier state for all residents,” S.C. Institute of Medicine and Public Health senior director of strategic engagement Megan Weis said in a statement in the report. “That’s why our communities, state agencies, businesses, health care providers, policy makers and other partners are working together on initiatives including Live Healthy South Carolina — a united effort supporting the state health improvement plan that outlines priorities and spurs action to improve overall well-being in the Palmetto State.”