Who's on top? County health rankings released

By Darla Carter

Getting high off various drugs had become so commonplace to Emilee Ward that when a friend offered her heroin, she accepted it, thinking, "I do everything else. I will be fine."

The drug sent the Louisville teen on a downward spiral that would eventually lead her to lose almost everything, including an infant son – conceived while she was addicted – who's now in the temporary custody of her parents.

"At the worst part of my addiction, I was 75 pounds. I was homeless," said Ward, who's now 21 and recovering at Freedom House, a Louisville program for drug- or alcohol-dependent women and their children. "I didn't have any money ever. I was having to steal food just to eat every couple of days or so."

A national report on county-by-county health illuminates the state of America's young adults, many of whom are struggling under the weight of the country's heroin and opioid epidemic and other problems, such as being jobless and disconnected from school.

The report released Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute also gives insight into which counties are the healthiest within each state, with Oldham County earning bragging rights over Jefferson County – and many others – in Kentucky in multiple categories

In the two major categories, Health Outcomes and Health Factors, Oldham County ranks No. 1, and it's No. 2 behind Boone County in the Quality of Life category.

Oldham County's public health director, Teresa Gamsky, said, "We value being No. 1 (in Kentucky) and we work at it very hard," but because the state as a whole is one of the unhealthiest in the country, there's still room for improvement "as far as stopping smoking, increasing our physical activity and making healthy food choices."

Jefferson County ranks 28th in Health Outcomes, which is based on length and quality of life. It's 57th in the Health Factors category, which includes behaviors like adult smoking, adult obesity and teen births as well as other areas like clinical care.

Dr. Sarah Moyer, medical director of the Louisville Metro Department of Public Health and Wellness, released a statement, saying in part, "We are pleased that our community remains in the top 25 percent of Kentucky counties in overall Health Outcomes, but we know there's work to do, and we remain focused on specific areas of need, like boosting healthy behaviors."

Moyer also noted that the department is taking steps to address the community's drug crisis. She cited the new Office of Addiction Services and the Louisville Metro Syringe Exchange Program as well as a focus on data.

The national report laments that too many young people are dying from drug overdoses and other preventable causes.

"In 2015, more than 1.2 million people died prematurely – this was 39,700 more people than in the previous year," the report notes.

And 85 percent of the increase was due to more deaths among youth and young adults from ages 15 to 44.

"We found that younger generations are losing their lives too soon and the largest contributor was an increase in injury deaths," which can be intentional deaths like homicides and suicides or unplanned events like drug overdoses, falls and car crashes, the report notes.

"While myriad issues contributed to the rise, the drug overdose epidemic is the leading cause of death among 25- to 44-year-olds and is a clear driver of this trend," according to a news release from the foundation.

Though drug deaths are accelerating among 15- to 24-year-olds, nearly three times as many people in that age group die as a result of homicide, suicide or motor vehicle crashes, the foundation notes.

Jefferson County is ranked 42nd out of 120 counties for length of life, which is based on the premature death rate or YPLL: years of potential life lost before age 75 per 100,000 population. As part of the formula that's used, someone who dies at age 20 contributes 55 years of potential life lost, but someone who dies at 70 contributes just five.

The best Kentucky performer was Oldham County, which had a premature death rate of 5,300 (years of potential life lost per 100,000), which was comparable to the rate of top U.S. performers (5,200). Jefferson County's premature death rate was 8,800 (years of potential life lost per 100,000) compared to the state's rate of 8,900. The rates for this measure were based on 2012-2014 data.

Volunteers of America Mid-States, which operates Freedom House and provides many other addiction services, has three expansion projects in the works to try to save young lives in Louisville.

"It is heartbreaking to see every single day young men and women who are sons and daughters and parents who are dying from this disease and that is all the more reason why we have an urgency to respond to this crisis," said Jennifer Hancock, the organization's president and chief executive officer. "… I see this as a public health crisis."

Ben Chandler, president and chief executive officer of the Foundation for a Healthy Kentucky, said there's no doubt that more needs to be done to save young people, though "it's tremendously expensive."

"The drug epidemic that we've got - particularly the opioid problem - is intractable in many ways," he said. "It's a problem that's statewide in magnitude."

In analyzing county health, the Robert Wood Johnson Foundation and the Wisconsin institute consider more than 30 factors. For the most part, counties that performed the most poorly in the commonwealth were in eastern Kentucky. For example, Breathitt was ranked dead last (120) in Health Outcomes and Clay was ranked last in Health Factors.

"The eastern Kentucky counties have a lot of problems that they have to overcome, starting with high poverty levels," Chandler said. ". ... We've got a lot of work to do in the eastern part of the state."

Reporter Darla Carter can be reached at (502) 582-7068 or dcarter@courier-journal.com.