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MASON CITY | Cerro Gordo County is the least county healthy in North Iowa.

That’s what the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute’s 10th annual County Health Rankings released Tuesday show.

“The point is not to shame anybody or to call anybody out, but to look at where they can take action,” said Ericka Burroughs-Girardi, County Health Rankings and Roadmaps action learning coach.

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Among Iowa’s 99 counties, Cerro Gordo County ranks 78th, a six-point drop from last year and its lowest position since 2012.

But it’s not the only county to slip in the health rankings this year. Its neighbors — Butler, Franklin, Winnebago and Worth counties — also did. However, Floyd, Hancock, Mitchell and Wright counties improved.

Mitchell County ranks ninth, followed by Butler County (22nd), Hancock County (27th), Floyd County (33rd), Winnebago County (39th), Worth County (67th), Wright County (72nd) and Franklin County (75th).

“One thing about Iowa to note is it has relatively small counties in terms of population, so it really only takes a couple of factors to result in what we would think of as a major fluctuation,” Burroughs-Girardi said.

The annual rankings position counties in two areas: health outcomes and health factors based on the most up-to-date national and state data.

Health outcomes refer to length of life, which Cerro Gordo County ranks No. 86, and quality of life, which the county ranks No. 62. Health factors look at a variety of things that indicate a person’s health, like health behaviors (Cerro Gordo ranked No. 18); clinical care (No. 2); social and economic factors (No. 55); and physical environment (No. 49).

Cerro Gordo County’s highest health outcomes ranking, No. 49, came in 2015, but since then, its ranking has continually slipped in the area.

“It’s concerning,” said Kara Vogelson, Cerro Gordo County Public Health organizational development and research manager, referring to the county’s premature death statistic, or years of potential life lost before age 75 per 100,000 population.

Since 2016, the premature death statistic in Cerro Gordo County has increased from 6,000 to 8,000, including a 700 jump from last year.

The leading causes of death in Cerro Gordo County among those under 75, in order of prevalence, are cancer, heart disease, unintentional injuries, chronic lower respiratory diseases and chronic liver disease and cirrhosis, the report said.

“Health behaviors are the things that we strongly focus on promoting, so we can positively impact the health outcomes,” Vogelson said. “They’ll start evening out in the near future, I hope.”

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That focus on “health behaviors, upstream initiatives and social determinants,” is reflected in Cerro Gordo County’s health factors, which have improved since 2015.

This year it moved up one spot to No. 22. Its best ranking, No. 14, was in 2011, which was the first year of the report, and its worst, No. 43, was in 2015.

According to the rankings, the county’s areas to explore in the health factors category are adult obesity, adult smoking, excessive drinking and injury deaths — most of which showed data above the state and national average.

“This data is here as a conversation-starter and determine who has the resources to make it happen,” Burroughs-Girardi said.

Adult obesity in Cerro Gordo County, which refers to the percentage of individuals with body mass index of 30 or more, fell to 32 percent from last year, while the percentage of adults reporting binge or heavy drinking remained at 22 percent.

Vogelson said Public Health focuses resources on tobacco prevention and cessation and adult obesity through programming.

Cerro Gordo County showed better results than Iowa and the U.S. in access to exercise opportunities, 93 percent; as well as ratio of population to primary care physicians, 630-to-1, and mental health providers, 410-to-1.

Vogelson said the County Health Rankings is just one resource Public Health uses to gauge the health of the county and effectiveness of its programming. Cerro Gordo County Public Health, in collaboration with Prairie Ridge, United Way of North Central Iowa and MercyOne North Iowa Medical Center, creates an annual Community Health Needs Assessment.

“I look forward to this every year,” she said. "The rankings aren’t as important as the actual data."

The Iowa State Report called attention to key drivers of health, such as severe housing burden and its connection to other factors like children in poverty. Among Iowa’s children living in poverty 44 percent were living in a household that spends more than half of its income on housing.

In Cerro Gordo County, 10 percent of households have at least one of four housing problems: overcrowding, high housing costs, lack of kitchen facilities or lack of plumbing facilities, which is tied with the state.

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“When people are spending that much to keep a roof on their head, they’re not able to maintain the other essentials,” Burroughs-Girardi said. “We all know we need healthy food to eat, but can we afford it? You’re going to do what you have to do to keep a roof over your head, so that may mean choosing junk food over healthy food.”

Vogelson said the housing issue in Cerro Gordo County, and North Iowa, is compounded because of its “really old housing stock,” which isn’t always the healthiest.

Burroughs-Girardi hopes this year’s County Health Rankings data will encourage counties to talk about the housing needs within their communities, especially “affordable housing for people with lower income.”

Iowa counties deemed the healthiest are, starting with No. 1, Cedar County, which received that ranking for the first time, followed by Dallas, Bremer, Sioux and Winneshiek counties. Iowa’s least healthy counties in descending order are Appanoose, Lee, Wayne, Wapello and Audubon.

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Reach Reporter Ashley Stewart at 641-421-0533. Follow her on Twitter at GGastewart.

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