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Study: Despite overall fitness, Blaine County set back by alcohol use, mental health


A 2021 study by the Robert Wood Johnson Foundation found that Blaine County ranked No. 5 in overall health outcomes in Idaho, while Valley County—which includes McCall—ranked No. 1.

Though Blaine ranked among the fittest and longest-lived counties, limited mental health services and heavy drinking weighed it down in the annual rankings.

Teton, Ada and Latah counties clocked in at second, third and fourth, respectively, in the rankings, which are compiled each year by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The assessment—published every year since 2011 as the “County Health Rankings & Roadmaps” report—ranks more than 3,100 counties nationwide based on a range of weighted factors, including longevity, quality of life and health-related behaviors, such as smoking, drinking and exercising. The 2021 report reflects conditions in 2019 due to about two years of lag time.

“We anticipate the 2022 rankings will include mortality data from the year 2020 and will reflect deaths attributed to COVID-19 in that year,” it states.

The annual report looks at a county’s overall health using two categories: “Health Outcomes,” a more current snapshot which represents “how long people live and how healthy people feel while alive,” and “Health Factors,” a look at “how healthy a county might be in the future” based on health behaviors, access to clinical care, social and economic wellbeing and physical environment factors.

“When a single ranking of the ‘healthiest’ counties is desired, we use the Health Outcomes rank,” the report states.

In the past decade, Blaine County has generally found a spot among the top three “healthiest” counties in the state, never falling below fifth place of 42 tallied counties on the County Health Rankings & Roadmaps dashboard.

This year, Blaine fell one place from 2020 in the study’s “Health Outcomes” category, from fourth to fifth, and fell three places in the study’s “Health Factors” category, from second to fifth.

The County Health Rankings & Roadmaps report comes with detailed suggestions of “how to create opportunities for a healthier community,” highlighting areas of strength and weakness in two shades.

According to the 2021 report, strong points in Blaine County included a relatively long lifespan—85.3 years compared to Idaho’s average of 79.4 and the nationwide average of 77.3—and an adult obesity rate of 17%, much lower than Idaho’s 29% and the nation’s 42%. Blaine also ranked low in diabetes prevalence at 6%, compared to Idaho’s average of 9% and the country’s average of 10.2%.

The county additionally excelled with its access to recreational activities, as measured by the percentage of adults over age 20 with limited access to leisure-time physical activity. (Only 14% of adults in Blaine County had limited access to recreational activity, compared to the state’s 20% and the nation’s average of 25%, according to data sourced from the U.S. Diabetes Surveillance System.)

In addition, Blaine County had a lower number of preventable hospital stays (1,400) compared to Idaho’s average (2,469); a strong flu vaccination rate (54%) compared to the state average (43%); and good access to primary care (980 patients per physician) and dental care (1,210 patients per provider), as measured against Idaho’s average of 1,530 patients per physician and 1,510 per dentist.

On the food index, which rates access to healthy foods on a scale of 0 (worst) to 10 (best), Blaine County scored 8.2, well above Idaho’s average of 7.7 and the nationwide average of 7.6.

Erin Pfaeffle, director of community engagement at St. Luke’s Wood River, largely attributed the county’s food-access score to the work of the Bellevue-based Hunger Coalition.

“What you’re seeing is really the critical work of The Hunger Coalition, and why we’re stronger in that area,” she said. “They’re a tremendous asset.”

Weak points reported in Blaine County this year were primarily associated with alcohol and substance abuse, mental health difficulties and limited access to mental health providers. Blaine County saw a higher than average percentage of driving deaths associated with alcohol involvement (42%) compared to Idaho’s average (31%) and the country’s average (26.5%), and a high percentage of adults reporting binge or heavy drinking (21%), compared to the state average of 17% and nationwide average of 16%.

“We’ve always been above the national average for alcohol use, specifically binge drinking, as well as marijuana use,” Pfaeffle noted. “What I find fascinating is that this [county ranking] is based on self-reporting, yet we’re still higher than average.

“While we have a very strong AA community, we also have lots of access to alcohol here, which has played a significant negative role in our community health in the past 20 years.”

The ratio of mental health providers per patient in Blaine County (510 to 1) was also higher than Idaho’s average (460 to 1), making it harder to find necessary care.

Pfaeffle said St. Luke’s Center for Community Health is addressing those challenges by strengthening partnerships with the Suicide Prevention Alliance, providing counseling scholarships and building a culture of more awareness around mental health struggles. But there simply aren’t enough skilled providers to keep up with the demand, she said, producing extended wait times.

“I can tell you with 100% confidence that we do not have enough therapists, psychiatrists and providers who are specifically trained in substance use and alcohol use disorders, especially since substance abuse often coincides with mental health issues,” she said. “Intensive outpatient services are limited. And wait times to get appointments has significantly increased since the pandemic.”

Pfaeffle said that could partly be attributed to limited supply of affordable housing.

“Housing access and the cost of living is absolutely a factor in recruiting mental health practitioners. There’s no doubt in my mind that the general cost of living and availability of reasonably priced housing has an impact on our ability to recruit not only trained staff, but staff in general,” she said.

According to the 2021 report, Blaine County had a higher percentage of “severe housing problems,” as defined by overcrowding, high housing costs and lack of kitchen and plumbing facilities (18%, compared to 14% of Idahoans and 14% of all Americans). It also had a higher-than-average percentage of uninsured citizens (18% compared to 13% of Idahoans and 11% of all Americans).

In the 2021 County Health Rankings & Roadmaps report, neighboring counties Camas and Lincoln ranked 28h and 30th in overall health outcomes, showing higher smoking rates, greater physical inactivity and less access to healthy foods.


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