Imagine living in a place where air and water are relatively free of pollution. Work commutes are short, and traffic’s not bad, either. It’s a healthy place to live.

That place, according to a study by County Health Rankings and Roadmaps, is here, in Dolores and Montezuma counties, which ranked first and second for a healthy physical environment in an annual report on health in Colorado.

And that’s where a paradox begins to take shape.

Despite the high rankings for physical environment, the counties were ranked in the bottom quarter for overall health among 60 ranked Colorado counties.

Montezuma County ranked 46th for overall health in 2015, according to the study released by the Robert Wood Johnson Foundation and the University of Wisconsin. Dolores County was ranked 44th for overall health. Four counties – San Juan, Jackson, Mineral and Hinsdale – were not rated.

County Health Rankings and Roadmaps compiles demographic data on a variety of quality of life factors for communities as a way to highlight where improvement is needed.

“It’s a snapshot of the state of health in specific counties, and includes almost all counties in the United States,” said associate researcher Kate Konkle, of the University of Wisconsin. “The goal is to identify problems, then look into what barriers are preventing residents from getting the care they need.”

Data utilized ranged from 2002-2015 and was derived from a variety of sources, including the census, the Centers for Disease Control, and the American Community Survey. The rankings measure vital health factors, including high school graduation rates, obesity, smoking, unemployment, access to healthy foods, the quality of air and water, income, and teen births in nearly every county in America.

The center also provides Roadmaps that provide guidance and tools to understand the data, and strategies that communities can use to move from education to action.

For health behaviors Montezuma County showed higher levels of smoking, obesity, physical inactivity, premature deaths, and sexually transmitted infections, compared with state averages.

The rate of teen births is also high in the county, with 54 births per 1,000 female teenagers, compared with a rate of 33 births per 1,000 female teenagers statewide.

For clinical care, the rate of uninsured residents in the county is 23 percent, compared with 16 percent statewide. There is a lack of mental health providers and dentists, compared with state averages, and low preventative care such as mammogram screenings.

Among social and economic factors, child poverty is a serious issue, the study shows, with 27 percent of children living in poverty in Montezuma County, compared with 16 percent statewide. And the number of children in single-parent households is 37 percent in the county, compared with 29 percent statewide.

Also, graduation rates fell below the state rate, with 64 percent of county ninth-graders making it through to high school graduation, compared with a 77 percent graduation rate statewide.

Childhood poverty stands out in the study; it is higher than the state average, and more than double than the top performing counties in the country.

“Poverty and lack of education has a significant impact on health, so the question locally is how to address that,” Konkle said.

One solution is an education campaign directing low-income parents to subsidized health programs.

On the plus side, the study shows Montezuma County has a low crime rate, is improving along with the state and nation on unemployment rates, and has a good record of monitoring for diabetes, jumping from 67 percent of diabetics getting tested in 2008 to 79 percent getting tested in 2013.

Then there is the impressive No. 2 spot for physical environment. Konkle explained that many rural counties score high in that category, a result of clean water and air, safe and affordable housing, minimal overcrowding, and good transportation.

“That is a good strength, but it does not impact overall health as much as health behaviors, clinical care, education, and economic factors,” Konkle said.

For more information go to www.countyhealthrankings.org

jmimiaga@the-journal.com

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