LAURINBURG — Scotland County is one of the unhealthiest places in the state.
That was the finding of the Robert Wood Johnson Foundation’s recently released 2017 County Health Rankings & Roadmaps report for all 100 North Carolina counties. The New Jersey-based Foundation, a philanthropy dedicated solely to health, scored Scotland County’s overall health next last out of all of North Carolina’s 100 counties for the second straight year.
Robeson County was ranked at 100 by the report.
Compiled by the University of Wisconsin and the foundation, the County Health Rankings measure the health of county populations in all 50 states based on more than 30 factors, including obesity, tobacco use, premature death, physical inactivity and access to clinical care. The report was the foundation’s seventh annual study.
County Health Department Director Kristen Patterson said the numbers in the report are misleading because Scotland small county is being compared with larger counties.
“With a small population the number of anything like STDs, for example, is going to be higher than a larger area, so the per capita rank will be different,” Patterson said.
Kate Konkle, associate researcher with the University of Wisconsin, said a number of variables go into determining where counties rank statistically.
Health outcomes are assessed based on the number of premature deaths. A premature death is considered to be death before 75. The county had 646 premature deaths between 2010 and 2015, the years the data was collected. When that number is adjusted to per 100 thousand, the county had almost double the number of premature deaths than the state at 7,200 in 100 thousand.
Other factors used in the report include infant mortality rates, smoking rates, obesity, physical inactivity, percentage of children in poverty, number of health providers, access to exercise opportunities, and violent crime.
About 26 percent of adults in the county smoke compared with 19 percent statewide.
Thirty-six percent of adults are obese with a body-mass index of 30 or more, while the state average is 30 percent.
The report said 25 percent of the county is physically active with more that 66 percent reporting a lack of access to opportunities for exercise.
The report also looked at the county’s rate ofsexually transmitted diseases. The rate was judged based on the number of testing for chlamydia because that is the most commonly tested disease, according to Konkle. Scotland County reports almost double the cases as the state average. Scotland County saw 288 cases during the survey time out of a total population of 36,025 as of 2010.
One place the county does better is access to insurance and primary care providers. Sixteen percent of the county is uninsured compared to 15 percent statewide. Access to primary health care providers is 1,480 residents per provider. The state average is 1,410:1.
The numbers for dental care are not as promising at 3,950:1 — more than double the state average.
The loss of jobs in recent years is a major contributor to many of the health issues, according to Patterson. The county’s latest unemployment rate for February was 8.6 percent. The state average was 5.1 percent.
The bottom 10 are among the state’s most economically distressed counties and suffer with higher unemployment rates, higher tax rates, and struggling school systems.
“This used to be a town with a lot of jobs. You’re going to have problems with socio-economic factors when there are not a lot of jobs,” Patterson said. “That does affect living standards and health.”
Rankings for adjacent counties were Hoke, 60th; Cumberland, 79th; Bladen, 91st; and Columbus, 97th. Columbus ranked last in life expectancy.
Reach Beth Lawrence 910-506-3169