Tooele County ranks as the 17th healthiest out of 26 counties ranked in Utah, according to a report released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The report gave the county above-average marks for sexually transmitted infections contracted and the number of children in poverty, while citing obesity, substance abuse and a poor physical health environment as factors dragging down the county’s overall health.
The report ranks counties in all 50 states according to several different health factors. Morgan County was ranked as the healthiest county in Utah, with Carbon County ranked as the unhealthiest. Daggett, Piute and Rich counties were not ranked. Jeff Coombs, deputy director of the Tooele County Health Department, said the data collected from this report as well as the county’s own data has helped health officials create a community health improvement plan.
“Our community has gotten together and established priorities to work on in the next five years, and some of those are closely related to the rankings in the report,” he said. The five priorities that the community health improvement plan addresses are diabetes, obesity, physical activity, substance abuse and access to health care. A subcommittee has been created for each issue.
The report used mostly public data gathered from a number of national data sources and surveys over several years. County rankings were based on several criteria divided between two categories: factors and outcomes.
The county ranked No. 19 in the health factors category, which included subcategories such as health behaviors, clinical care, social and economic factors and physical environment.
In Tooele County, 15 percent of adults were reported as smokers. That is 5 percent more than the average for the state of Utah, but is only 1 percent more than the national benchmark — a standard of 90th percentile against which states and counties were compared to. Coombs said the adult smoking rate in Tooele County has steadily decreased over the past 10 years. “We’ve gone down from 23 percent a few years ago to 15 percent this year,” he said. “We’re higher than the state average, but we’re about at the national average.”
Ongoing efforts to reduce and prevent adult smoking are prevalent in Tooele County, according to Coombs. He said the health department has been working with the Tooele County Chamber of Commerce and local businesses to assess why adults smoke and if stricter smoking policies in the workplace would help them to decrease their usage.
“We’re just starting to see those results come in now, and now we have to look toward focusing on prevention and cessation efforts according to the results,” he said.
Tooele County residents also drink to excess more, with 13 percent of county residents reported as excessive drinkers compared to a state average of 9 percent and a national benchmark of 8 percent. Julie Spindler, prevention coordinator at Valley Mental Health, said traditionally both youth and adult alcohol usage has been higher than the rest of the state, but rates have trended down over the past 10 years. She said the higher binge drinking rates can be attributed to the county’s demographics.
“You have to look at our industrial population and our demographics,” she said. “We do have different demographics than the rest of state does in many aspects, but that has also changed in recent years with more people from other areas of Utah moving here.” Spindler said nationally the trend is that people are drinking less days per week, but when they do drink, they drink more in one sitting.
Thirty percent of Tooele County residents are considered obese. Obesity in Tooele County is 5 percent higher than in the state of Utah and the national benchmark. Coombs said this is another area of concern the health department is addressing.
“We have to start with behavioral changes, like the way we eat and the physical activity we do,” he said. “We’re looking at childhood obesity because all statistics show that if you’re obese as a child, you are at a higher risk to be obese as an adult. We need to change behaviors early on so that five, 10 and 20 years from now we’ll see improvements.”
The teen birth rate was also listed under the health behaviors category. In Tooele County and the state, the number of teen births was 35 for every 1,000 15 to 19-year-old teen. The national benchmark is 22. The teen birth rate in Tooele County has drastically declined in the past 10 years, according to Coombs.
“Ten years ago, we had the highest teen birth rate in the state, and now we’re right there with the state average,” he said. “We’ve seen a marked improvement within our own county.”
Bucky Whitehouse, community services supervisor for the health department, said this improvement is due to grant funding the health department was able to procure in 1998 to start a teen abstinence coalition.
“Through the funding we were able to dedicate the time of one of our nurses to start the coalition and do different activities throughout the schools teaching [abstinence] and working with students,” he said.
The abstinence grant was used from 1998 until 2009, and was renewed in 2010 and will be good until 2014.
Clinical care in Tooele County was ranked No. 14 in the state. The amount of primary care physicians available to county residents is one for every 2,106 people. Utah’s average is one doctor for every 1,072 people. The national benchmark is one for every 631 people. Tooele County’s physical environment was ranked at No. 21.
Access to recreational facilities is limited in Tooele County, according to the data. Measured by the rate of recreational facilities per 100,000 population, Tooele County has a total of three recreational facilities. In comparison, Utah has an average of eight facilities, and the national benchmark is 16 facilities. Whitehouse said the physical activity subcommittee is working on improving the amount of recreational facilities in the county.
“We need to improve on the number of facilities and the amount of outdoor recreational opportunities that our county provides,” he said. “What we’d like to help our citizens understand is that during the spring, summer and fall months, a lot of physical activities are available to them outside.”
Whitehouse said one thing the subcommittee plans to work on is outreach so residents know where they can go for recreation. The availability of fast food restaurants also lowered the county’s physical environment score. The fast food restaurants category measures the proportion of restaurants in a county that are fast food establishments. In Tooele County, that’s 62 percent while across the state it’s 58 percent and nationally, it’s 25 percent. Whitehouse said there’s a tendency to see more fast food restaurants in areas where commuter populations are highest.
“Tooele County has anywhere from 40 to 45 percent of its workforce driving out of the valley to work every day,” he said. “From that standpoint, you can see fast food restaurants thriving more than more formal restaurants do. Eating becomes a matter of convenience rather than choosing the healthiest option.”
In the health outcomes category, Tooele County ranked No. 17. This number was calculated through the county’s premature death rate — represented by the years of potential life lost before age 75 — number of self-reported poor or fair health days, poor mental health days, poor physical health days and low birth weight numbers. Tooele County ranked No. 14 in premature deaths and No. 17 in the morbidity, or quality of life, category. When it came to poor or fair health days, Tooele County residents ranked at 15 percent while the state’s average was 13 percent and the national benchmark was 10 percent. Tooele County residents also experienced an average of 3.6 poor mental health days, while the state average was 3.2 days and the national benchmark was 2.3.
The main area Tooele County needs to work on, according to Coombs, is the high obesity rate. “We have a young population in Tooele County,” he said. “The concern is that over time, if the younger population continues to have an unhealthy lifestyle, the coronary heart disease rate will skyrocket as they get older.”
Coombs said Tooele County has improved the most significantly in the past several years in the area of teen birth rates and adult smoking rates.
“Those are the two main areas that we’ve had successes,” he said. “Now the community has to come up with a strategy to address these larger issues [like obesity and physical inactivity], and then hopefully in 10 years we’ll start to see noticeable changes and outcomes.”