Montgomery County Leads State In Health, Life Expectancy

BETHESDA, MD — Montgomery County is the healthiest county in Maryland. That's according to County Health Rankings and Roadmaps, which published its annual report Tuesday morning.

The rankings represent a health snapshot of nearly every county in America. The data shows that where you live plays a significant role in how well you live. And how long.

Residents in Montgomery County can expect to live 84 years, according to the report. The national average is 79.1 years.

Here are the complete rankings for Montgomery County, out of 24 counties statewide.

• Overall rank: 1
• Length of life: 1
• Quality of life: 1
• Health factors: 2
• Health behaviors: 1
• Clinical care: 2
• Social and economic factors: 4
• Physical environment: 14

"Montgomery County has been at the forefront in implementing a plethora of health-related initiatives in our region," said Council President Nancy Navarro. "I am pleased to see that our efforts keep paying dividends in our goal of fostering a healthy society. I look forward to building on this work and continuing to promote good health for all our constituents."

County Health Rankings is a program collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin's Population Health Institute. The rankings look at a variety of measures that impact a community's health, including high school graduation rates and access to healthy foods. Rates for smoking, obesity, and teen births are also incorporated.

The Rankings State Reports call attention to key drivers in health such as severe housing cost burden and its connection to other factors like children in poverty. Among Maryland's children living in poverty, 64 percent were living in a household that spends more than half of its income on housing. High housing costs make it difficult for families to afford other essentials that contribute to good health, such as healthy food, medicine, or transportation to work or school, a news release says.

In Maryland, 15 percent of households spend more than half of their income on housing costs but when we look by race—even deeper differences emerge with households headed by Hispanic residents most burdened by severe housing costs at 20 percent compared to White resident households at 12 percent, the report said. County by county, severe housing cost burden ranges from 10 percent to 24 percent of households.

"Maryland's local health departments work daily to achieve health equity and overall community wellness. To succeed in this, we must address the social determinants of health that impact our population health goals," said Maura Rossman, MD, president, Maryland Association of County Health Officers and health officer for the Howard County Health Department.

This year, the program looked closely at the effect housing costs have on a person's health. The researchers found that 11 percent of households nationwide spend more than half their income on housing. That means people often don't have the money for high-quality food or access to health care. It can also mean having trouble securing transportation to get to work or school.

The housing cost burden, which is "substantially higher" among renters than owners, is closely tied to things like high rates of poverty, food insecurity, and self-rated poor health.

"Our homes are inextricably tied to our health," said Richard Besser, MD, RWJF president and CEO. "It's unacceptable that so many individuals and families face barriers to health because of what they have to spend on housing. This leaves them with fewer dollars to keep their families healthy. Imagine the stress and pain that come with unplanned moves. We are all healthier and stronger together when everyone has access to safe and affordable housing, regardless of the color of their skin or how much money they make."

"We know there's a severe housing cost burden that is a national issue," Justin Rivas, a network strategist with County Health Rankings, told Patch. "When families spend more than 50 percent of their income on their housing, whether it's rent or mortgage, it leaves less money and opportunities to pursue health."

It's easier to get a quality education when you live close to good schools. It's easier to earn a living wage when you live near well-paying jobs. It's easier to eat healthy when you live near grocery stores with affordable, nutritious food. And it's easier to keep active when you live near green spaces and parks, the report said.

But there are large, persistent gaps and disparities in healthy outcomes, particularly along racial lines. That stuck out to Rivas this year. And those gaps are linked to issues like housing.

While about 11 percent of households nationwide are burdened by severe housing costs, that number is about 25 percent for black households, Rivas said. For Latino households, it's about 16 percent.

"These kinds of large gaps do exist," said Rivas. "And data around the issue of housing can help us lead to maybe closing some gaps in terms of opportunity and communities."

Community Health Rankings doesn't take a position on measures such as a $15 minimum wage or rent-control, but the program does support a "comprehensive approach toward improving housing," Rivas said. Any possible solution should be tailored to each community's needs, and that starts with community engagement and getting residents involved in the process, he said.

County Health Rankings offers hundreds of scientifically-backed strategies to improve health factors, including income, housing, transit, employment, and diet and exercise. Three of the featured strategies are the "Earned Income Tax Credit," or EITC; mixed-use development; and adult vocational training.

The EITC is a refundable income tax credit for low- to moderate-income workers and families. They're offered by the federal government and many state governments. The value changes each year, but in 2017 a person who had no custodial children and earned less than $15,010 could receive up to $510. Meanwhile, a married couple with three or more children who earned less than $53,930 could've received up to $6,318. The program highlighted that there is "strong evidence" the EITC increases employment and income for participating families. It also improves birth outcomes.

Mixed-use development refers to using land for multiple purposes rather than for single-use. Recently, there’s been a surge in such development with many neighborhoods seeing apartments and condos built on top of coffee shops, grocery stores and fitness centers. These new developments often include retail space, restaurants, walking paths and green space. There is strong evidence that design and land-use policies, including mixed-use development, increase physical activity. This type of development also reduces transportation costs, increases economic opportunity, grows household wealth and enhances neighborhood-level cultural diversity, the program stated.

Adult vocational training means just that — helping people develop skills specific for a certain job through education and certification programs. This includes job-search assistance, personal development resources and other support services, including child care, during training. These programs typically benefit people with little job experience or education, as well as unemployed individuals or dislocated workers.The program said there is strong evidence that adult vocational training increases employment and paychecks among those who participate.

Patch national staffer Dan Hampton contributed to this report.