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Jan Lee headshot

Aetna Foundation Sponsored Series

Building Healthier Communities

Finding America’s Healthiest Communities

By Jan Lee


There has been a lot of discussion in recent years over what makes a healthy community. The United Nations’ Sustainable Development Goals highlights a few of the basic components: eradication of poverty and hunger; access to quality education and infrastructure that promotes healthy living, a strong economy and resilient communities.

But the extent to which those goals are reached often varies from country to country and community to community. Even the United States, arguably among the most affluent countries in the world, is characterized by disparity when it comes to how, and to what extent, communities meet those goals. In fact, the U.S. is often cited as having the lowest life expectancy rate among industrialized nations, despite the fact that we spend much more than our international peers on health care services - $3.2 trillion, according the Centers for Medicare and Medicaid Services.

To showcase the communities in America that are doing the best job of improving residents’ health through strategic partnerships, expanded public health assessments and education programs, the Aetna Foundation and U.S. News & World Report released the Healthiest Communities inaugural ranking in March 2018 - a detailed health report of U.S. communities. Healthiest Communities examines 3,000 counties across the country, offering a snapshot of just what those values look like at home: How well communities succeed in meeting health care needs; what education looks like in their neighborhoods; how well equity is addressed, the locality’s economic vitality and public safety record and so on.

Dr. Garth Graham, president of the Aetna Foundation and vice president of community health for Aetna said the point of the report was to provide comparative data that local residents and community leaders could use to analyze the health status of their community.

“We recognize the fact that most of health care occurs outside of doctor’s offices and that helps define how long people live,” said Graham. “We often say your zip code matters more than your genetic code – that’s why your community is so important.”

“Our collaboration with U.S. News is a way of defining, or helping to define, the national conversation – the factors within your community that help to make you healthy.”

The counties were evaluated according to ten categories that had been determined to drive health outcomes, including a community’s economic vitality and ability to guarantee intrinsic qualities like public safety and access to food and nutrition.

Take Madera County and Mono County, CA for example. Separated by Yosemite National Park, Madera County can be found to the west and Mono to the east. Although these counties are close in proximity, they are miles apart when it comes to health.

Mono County has a high-performing economy and easily outscores Madera, an urban town with an up-and-coming economy, in most of the ten categories used in the ranking. The most notable differences are environment, equity, infrastructure, public safety and population health – particularly mental health. Mono County ranks No. 42 nationally, while Madera is unranked.

The goal in creating the Healthiest Communities ranking is not just to recognize communities that are already making significant progress toward building healthy communities, but to inspire change in the way communities think about and pursue improvements in public health. While no two communities are the same, all communities can learn about best practices in their own backyard and across the country, then apply these lessons to improve the health of their residents.

Jan Lee headshot

Jan Lee is a former news editor and award-winning editorial writer whose non-fiction and fiction have been published in the U.S., Canada, Mexico, the U.K. and Australia. Her articles and posts can be found on TriplePundit, JustMeans, and her blog, The Multicultural Jew, as well as other publications. She currently splits her residence between the city of Vancouver, British Columbia and the rural farmlands of Idaho.

Read more stories by Jan Lee