Child poverty, obesity muddy Davidson's health report

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Davidson County is in the midst of an economic boom and, in many ways, a cultural renaissance, but the state's capital lags its neighbors in several important health factors, according to a county health rankings report.

In Davidson County, 29 percent of children — nearly one in three — live in poverty, according to a new county health rankings report from Robert Wood Johnson Foundation. The state average is 27 percent while the counties surrounding Davidson come in at less than 20 percent. Williamson County has the lowest incidence of child poverty in the state with 7 percent.

Davidson's child poverty level has ticked up 5 percentage points since 2010, raising concerns about the county's long-term health outlook. And Davidson County's percentage of obesity increased to 31 percent from 30 percent, where it had held steady since 2010, according to the report.

"The irony in Davidson County is that the economy has really exploded in many ways, but the divide continues to grow," said Michele Johnson, executive director of the Tennessee Justice Center.

Socioeconomic factors, such as education, economy and social connectedness, impact communities' health. A county, such as Davidson, may have a rosy overall picture of health — it ranked sixth in the state for quality of life — but indicators such as child poverty, obesity and physical inactivity point to challenges in changing the culture.

"What's the full story of your county and does everyone have the same opportunity, or do some have more opportunities to live a fuller, healthier life?" asked Kate Konkle, associate researcher at the University of Wisconsin Population Health Institute, which teamed with the Robert Wood Johnson Foundation on the annual county health report.

Tennessee ranks 45th overall in health, according to the UnitedHealth Foundation, but the report compiles data from many sources, including the U.S. Census and Centers for Disease Control, to dig into how individual counties are performing.

The county rankings paint a portrait of health around the state that won't surprise political leaders or medical providers. Thirty-two percent of adult Tennesseans are obese — a figure that jumps to 70 percent to include those who are overweight — and 16 percent are uninsured. Nearly one in three people is physically inactive.

Gov. Bill Haslam is challenging counties, municipalities and neighborhoods to start grassroots efforts to change the culture of health. Participants in the Healthier Tennessee Communities initiative must hold at least nine events in a year and find a way to measure results.

"Change takes time, and the data that we collect takes time to catch up with that change. This is not a short-term commitment. If you really want to make change and build a culture of health, that's a long-term commitment," Konkle said.

Williamson County, perhaps unsurprisingly given its affluence, took the top slot in both health outcomes and factors, meaning its residents have the highest quality of life, the best access to making healthy choices and the socioeconomic infrastructure for leading a healthy life.

A wealthy environment alone doesn't impact health, but it brings with it a wider range of choices and programs, said Konkle, adding that the more affluence in an area brings with it more parks and usually safer neighborhoods and better access to clinical care.

Williamson is one of the most affluent in the nation and should be comparing itself to similar areas rather than using its neighbors as a measure, said Dr. Melinda Buntin, chair of Vanderbilt University School of Medicine's department of health policy. Franklin is part of Haslam's initiative and will act as a role model for other communities looking to start programs.

"You might be doing well compared to counties in a state that is not keeping pace with the rest of the nation," said Buntin.

The same can be said for the counties surrounding Davidson, which have better health profiles than most of the state, in large part because bedroom communities bring increased education and economic opportunities, said Konkle.

Rankings are "imperfect but useful," said Buntin, who will be using the data for evidence of where progress has occurred as well as the areas in which health indicators may have gotten worse.

"We can and must do better if we want the next generation to be healthier. Finding the will to do better is vital, but Tennesseans can do anything if we set our mind to it. Our future depends upon it," Johnson said.

Top Overall Health Outcomes

1. Williamson

2. Rutherford

3. Putnam

4. Wilson

5. Sumner

6. Davidson

7. Montgomery

8. Blount

9. Fayette

10. Robertson

Worst Overall Health Outcomes

1. Grundy

2. Clay

3. Hancock

4. Scott

5. Meigs

6. Van Buren

7. Claiborne

8. Cocke

9. Polk

10. Trousdale

Davidson County By The Numbers

29 percent: Children under the age of 18 who live in poverty

5 percent: Increase in children living in poverty since 2010

31 percent: Adults who are obese

26 percent: Don't engage in leisure-time activity

Source for all: County Health Rankings 2015, Robert Wood Johnson Foundation