Mind the Gap: Colorado’s Health Differences by County

What if Colorado could avoid 4,800 premature deaths? What if 247,000 Coloradans could cut back on their problem drinking? And what if 149,000 households could find a safe and reasonably priced place to live?

“What if” often gets a bad rap, but such questions can be the starting point in addressing helath disparities among regions in the same state.

The newly released 2015 Health Gaps Reports, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, identifies gaps in opportunities for good health among counties in Colorado as well as other states.

The Colorado Health Gaps Report looks at how much better Coloradans would fare if every community did as well when it comes to factors that affect health as the communities with high marks. It’s meant to suggest ways state leaders can even the playing field.

Health gaps refer to the measurable differences among counties in promoting opportunities for better health. Simply put, location matters.

The data reveal significant differences in health outcomes based on where we live, work, learn and play.  Residents of some Colorado communities have a better chance to stay healthy because they have access to health care services and providers, live in well-built neighborhoods with safe parks and other amenities, and enjoy good schools.

If every county did as well as the highest performing counties, 4,800 Coloradans would not die prematurely due to poor health, 66,000 fewer children would live in poverty and 160,000 fewer adult would be obese, the report estimates.

Disparities are measured on several indicators of health.

For example, the report cites a 45-point gap between counties with the lowest and highest rates of teen births (15 births per 1,000 on the low end and 60 births per 1,000 on the high end.) Looking at data used to calculate health gaps, Pitkin, Douglas and Park counties report the lowest teen birth rates in the state while Denver, Rio Grande and Bent counties report the highest.

There’s a 25 percentage point difference between the best and worst performing counties on mammography screenings. Saguache, Prowers and Lincoln counties hover around 40 percent of women receiving recommended mammography screening, while Eagle, Jackson and Summit counties report more than 70 percent of women receive mammography screenings.

Data from the 2015 Colorado Health Access Survey, which is not part of the Health Gaps Report, also finds regional differences. There is a 10.6 percentage-point gap between the best and worst-performing regions on uninsurance. Douglas County has the lowest uninsurance rate in the state at 2.4 percent, while the northwest corner of the state (including Moffat, Rio Blanco, Routt and Jackson counties) has the highest uninsurance rate at 13.0 percent.

These differences illuminate regional disparities in access to care and obstacles to care in underserved areas of the state.

But there’s more to health than health care. Socioeconomic factors, health behaviors, and the built environment also come into play, the Health Gaps Report says. It cites “meaningful gaps” that Colorado policymakers and leaders may want to examine more closely to improve health. Among the suggestions: promote anti-smoking initiatives, support and improve education and reduce unemployment.

The Colorado Health Gaps Report, the CHAS and the latest Colorado Access to Care Index are powerful tools that can guide policies and programs to create a healthier state.