Southern, rural portions of Georgia are home to the state’s least healthy counties, though Bulloch ranks in the top 25 percent, according to a comprehensive report released recently.
Bulloch County appeared 30th and 49th on County Health Rankings lists provided by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation. The institute assesses wellness in counties throughout the United States.
The health institute ranked 156 Georgia counties based on various factors that include: health behaviors – smoking, drinking and obesity rates; clinical care – access and quality; social and economic factors – education, employment and income; and the environment – air quality and health-related facilities.
“What they do is collaborate with the Centers for Disease Control and the National Association of County and City Health Officials to put together this list that evaluates health factors and outcomes within the community,” said Roger Naylor, director of Public Relations for the Southeast Health District, which is made up of 16 counties, including Bulloch, Evans and Candler. “There are varying reasons that lead to a county’s ranking. Income, education, graduation rates, resources and assets within the region are all factors in developing these rankings.”

Bulloch rankings
Bulloch ranked number 49 on the health factors list and 30th on the health outcomes list, which are based on premature deaths, birth weight figures and patients’ perceived, reported health.
The county’s health outcomes ranking improved from 38th one year ago, and moved into the top 30 thanks to community efforts in and around Statesboro focused on improving health, according to Cindi Hart, district nursing clinical cCoordinator for the Southeast Health District.
“I think the obvious reason is resources,” said Hart. “You can look at the community collaborations within Bulloch County, like the farmers market and all of the programs and opportunities provided by parks and rRecreation, as to why the county ranks so high.”
Surrounding counties did not fare as well, mirroring a trend seen throughout the state – that poorer counties are not as healthy as more affluent regions.
“There is a common theme when you look at health at this level; it doesn’t matter if it is in Georgia, Connecticut or Wisconsin. There seems to be a very strong relationship between socio-economic factors and health,” said Stuart Tedders, associate professor of Epidemiology at Georgia Southern University’s Jiann-Ping Hsu College of Public Health. “What we see in these rankings is more of an indication of the differences in socio-economic status of the population as opposed to anything else.”

Neighboring counties
Jenkins, Emanuel and Evans counties lagged behind their wealthier, more populated neighbor, and appeared on the bottom 15 percent of the rankings.
Jenkins Country ranked 134 in health outcomes and 149 in health factors; Emanuel County ranked 131 in the outcomes list and 139 in health factors; and Evans County ranked 138 in health outcomes, 120 in health factors.
Various factors contribute to the low marks, said Naylor, including poverty rates and teen birth rates.
“There is no doubt, and we have known this for years, that income levels and education play a factor in overall health,” he said. “Folks that are struggling financially tend to not go to the doctor as much because they do not have the finances to do that.”
“If I had to guess what separates [Bulloch County] from the others, I would attribute it to the fact that the county has a much more affluent, highly educated population than some of the surrounding regions,” Tedders said. “Anytime you couple higher education with higher affluence and income, you are going to have better health outcomes; because people are more acutely aware of what it means to live a healthier lifestyle.”
Each of the healthiest Georgia counties are located in the Metro-Atlanta area and home to affluent populations – Fayette ranks number one, Oconee is second, followed by Forsyth, Gwinnett and Cobb.
Calhoun County in southwest Georgia ranks as the state’s least healthy.

An opportunity
According to Naylor, the rankings provide an opportunity for counties to assess their health standing and take steps to improve.
“What we like to do with these rankings is take the information to the community and to the board of health to explain to them things we see that can be improved,” he said. “We can then work on bringing these numbers down.”
“The health rankings really are a call to action for communities,” Hart said. “They provide the perfect opportunity to look at what we can do locally to really make a difference and make our health numbers better.”
Georgia Southern is already making an effort to improve health of students and faculty, Tedders said. The school operates wellness programs that he would like to see expanded to include the public.
“Within the university, they have a very effective wellness program where they promote well-being,” he said. “I would like to see a more obvious partnership between the university and community in addressing wellness issues. I think that would be mutually beneficial. I believe Georgia Southern is a resource to Bulloch and any other county in Southeast Georgia.”
Improving health and wellness – and moving up in next year’s rankings – can be done with some effort, said Naylor.
“We need to work together in our communities,” he said. “It is extremely important for groups to collaborate and join forces to carry out healthy initiatives.”

Jeff Harrison can be reached at (912) 489-9454.