In this paper, the health outcomes and factors for different counties within California are identified and compared. The rankings are the most recent (2021). Some states rank high in these two health aspects, while some perform very poorly in these two components. Marin County is the healthiest county in California. It ranks the highest in both health outcomes and health factors. Other counties that make the top three healthiest areas in the state are Placer and San Mateo counties. They rank second and third consecutively. Trinity County ranks last in the health outcomes category. Other counties with the poorest health outcomes in the state of California are Lake and Siskiyou, which rank 56 and 57, respectively. Counties at the lowest bottom in the health factors category include Imperial, Kern, and Tulare.
Trinity County Health Outcomes and Factors
The selected county is Trinity. Compared to Marin County, which ranks the highest in health factors and outcomes, Trinity performs poorly in the two health dimensions. The difference in the number of premature deaths in the two counties is significantly different. In Marin County, premature deaths were 3,200 compared to 13,200 for Trinity County (County Health Rankings, 2021). A difference of 10,000 exists between these two figures. The numbers indicate that for every premature death in Marin County, Trinity County records approximately four.
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Moreover, Trinity County's number of premature deaths is higher than the state average, 5,300. These figures show that a significant number of people in Trinity County die at an early age. The quality of life in Trinity County is below the state average in most measurements. For example, the state population with poor or fair health percentage is 18 percent, while that of Trinity County is 20% (County Health Rankings, 2021). Marin County has 12 percent of its entire population with poor or fair health. However, the rates of low birth weight are 65 in both counties. This is 1% below the state rate.
Health behaviors such as adult smoking, adult obesity, and physical activity are of concern in Trinity County. For example, 19 percent of the adult population in Trinity smoke, and 29 percent are obese. Marin County, which scores highest in health factors, has an adult obesity rate of 18%, and 10% of its population smokes cigarettes. The state adult smoking rate is 11 percent, and obesity is 24 percent. Therefore, the rates of these health factors in Trinity County is high than those of California. The obesity rate in Trinity County is high despite reasonable access to exercise opportunities throughout the county. Although accessibility to exercise options is adequate in the county, the rate is lower than the state average of 93 percent. Marin County has a rate of 97 percent. Therefore, more people can access exercise. However, accessibility of exercise opportunities does not always translate to engagement in physical activity, as indicated by low physical activity levels in Marin County and California. Only 13 percent of the population in California engages in physical activity compared to 22% in Trinity County, where accessibility to physical activity opportunities is 8 percent (County Health Rankings, 2021). Therefore, it is likely that increasing physical activity opportunities in Trinity County would improve physical activity levels, hence reducing obesity. Other health behaviors related to substance misuse are slightly above the state figures. Sexually transmitted infections are significantly low in Trinity, but the number of teen births (25) is higher than the state average (17) and Marin county figure (6).
Clinical care components such as the number of uninsured people and healthcare practitioners' ratio in the county are not suitable compared to state and the best county averages. For example, the number of people without health insurance in Trinity County is 95 compared to only 5 percent in Marin County and 8 percent in the entire state. Trinity County has a severe shortage of primary care physicians. The physician to patient ratio is 1:4,180 (County Health Rankings, 2021). This means that each primary care doctor is supposed to attend to 4,180 patients. In Marin County, the ratio is 1:690 and the state figure is 1:1250. The number of mental healthcare professionals available in the county is also not sufficient to meet the population's mental health needs. However, the number of preventable hospital days is lower (2,132) than the state figure (3358). The high doctor-to-patient ratio indicates that Trinity County requires more healthcare professionals, especially primary care doctors, to meet the population's health needs. When health care needs are not met adequately, health outcomes are poor or below average.
Social determinants of health such as education attainment are considered fair in Trinity County. For example, 92% of the county's population has a high school diploma, and 60 percent have completed college. Unemployment is higher (5.5%) than the state rate (4.0%). Counties such as Marin have an unemployment rate as low as 2.3 percent. Violent crime is lower (380) than the state figure of (421) (County Health Rankings, 2021). However, compared to other counties such as Marin, which has a violent crime figure of 178, Trinity County's crime rate is high. Therefore, security, which is a social determinant of health, is low in the county. Air pollution in Trinity County is lower than the state average, and severe housing issues are within the rate witnessed in most counties across California. Water violations occur in Trinity County, and this puts the health of community members at risk.
Priority Areas and Proposed Interventions
Based on the described indicators for health outcomes and factors, the priority issues in Trinity County are access to healthcare and premature deaths. There exists an urgent need to address health behaviors causing premature deaths in the county. The most suitable strategy to improve primary care access is to increase the number of primary care physicians in the county. According to Wang et al. (2020), existing evidence indicates that most problems in the United States healthcare system can be eliminated if patients readily access primary care. When care is accessible, utilization and costs improve. Besides, access to primary care reduces urgent and costly healthcare services. A shortage in primary care providers is associated with poor patient and health outcomes because there are no adequate doctors to meet the health needs of patients (Bodenheimer, 2018). In addition, the number of emergency cases and preventable hospitalizations escalate. Therefore, by increasing the number of primary care physicians, issues such as hospitalizations would reduce significantly.
Healthy lifestyle promotion activities in the community can help reduce the number of premature deaths in the county. Lifestyle behaviors such as smoking, alcohol and substance abuse, lack of physical activity, and poor diet contribute to premature deaths. According to Wang et al. (2020), sticking to a healthy lifestyle provides significant early death prevention benefits. A healthy lifestyle is vital for people who use preventive medicines and those who do not. These interventions require collaboration within the entire health system and the community. Effective community change requires the involvement of community members in input during community health assessment, planning, and execution.
Conclusively, Trinity County lags in most health indicators when compared to other counties in California. Outcomes such as premature deaths, unhealthy lifestyle behaviors including smoking and drinking, and lack of access to primary care demonstrate a worrying trend in the county. Priority health areas of the county are access to primary care and prevention of premature deaths. The proposed interventions to address these needs include hiring more primary care doctors and healthy lifestyle promotion activities.
References
Bodenheimer, T. (2018). Improving access to primary care. Medical Care , 56 (10), 815-817. https://doi.org/10.1097/mlr.0000000000000971
County Health Rankings. (2021). Explore health rankings . County Health Rankings & Roadmaps. https://www.countyhealthrankings.org/explore-health-rankings
Glass, D. P., Kanter, M. H., Jacobsen, S. J., & Minardi, P. M. (2017). The impact of improving access to primary care. Journal of Evaluation in Clinical Practice , 23 (6), 1451-1458. https://doi.org/10.1111/jep.12821
Wang, K., Li, Y., Liu, G., Rimm, E., Chan, A., Giovannucci, E., & Song, M. (2020). Healthy lifestyle for prevention of premature death among users and nonusers of common preventive medications: A prospective study in two US cohorts. Current Developments in Nutrition , 4 (Supplement_2), 85-85. https://doi.org/10.1093/cdn/nzaa040_085
