"Over the last 10 years, Georgia's public health has declined."
Nathan Deal on Wednesday, April 13th, 2011 in a speech
Governor says Georgia health declining
Put down that Krispy Kreme, fellow Georgian. And quit smoking. You’re ruining our state’s reputation.
Georgians eat all the wrong things. We don’t exercise enough. Our children are plump.
It’s only getting worse, Gov. Nathan Deal said in a recent speech to the Georgia Public Health Association.
"Over the last 10 years, Georgia's public health has declined," Deal said.
This statement made the PolitiFact Georgia team curious. Yes, we’re chubbier than we once were. But are we sliding in other areas?
Deal made the claim after the passage of House Bill 214, which would create a new Georgia Department of Public Health. The legislation elevates public health to a Cabinet-level position, which supporters think will give the health of Georgians the attention it needs.
To back up the claim, Deal’s office sent us an essay from Atlanta Hospital News and Healthcare Report, an industry trade newspaper.
"Ten years ago . . . Georgia ranked 34th in health determinants in the United Health Foundation’s annual ranking of American states," it read. "Today we’re 47th."
We looked at the rankings ourselves.
United Health Foundation’s America’s Health Rankings is a yearly initiative that has scored states’ overall health since 1990. The ranking is based on a wide range of measures such as the infant mortality rate, the prevalence of smoking, violent crime, the percent of children in poverty and cancer deaths.
We found that the figures in the trade newspaper article were slightly off target and don’t reflect the broader picture presented by the rankings.
But first, a little about measuring the health of large populations.
Assessing the health of communities is an art as well as a science, experts told us. Thousands of pieces of health data are available. Those who use them to publish rankings make judgment calls on what measures to use, what sources to consider, and how to weigh their importance.
Those measures aren’t always directly about health. They also can include high school graduation, poverty and crime rates. People who have lower incomes can have stress problems and poor access to health care and healthy food, said Dr. Georges Benjamin, executive director of the American Public Health Association. These all hurt their well-being.
"There is a correlation between health and wealth," Benjamin said.
Now, back to America’s Health Rankings.
In 2010, Georgia’s overall ranking was 36. This was a major improvement from 2009, when the state ranked 43.
The survey included rankings in subcategories that included the "health determinants" that the trade industry publication cited. They are circumstances and environmental factors that have a major impact on your health. Another subcategory was health outcomes, a measure based on mortality and other markers that show whether the population is healthy.
Georgia’s health determinants rank sank two notches from 35 to 37 between 2001 and 2010. But outcomes improved by five places from 40 to 35.
(America’s Health Rankings for 2010 came out after the Atlanta Hospital News and Healthcare Report essay was published. The 2009 data showed the health determinants rank declined from 36 in 2000 to 47, which is slightly different from the figures in the article. Outcomes ticked downward from 40 to 41.)
Georgia’s 2010 ranking was unusually good. The state peaked in 1996 at 32, then sank to the low 40s by 2001. It stayed there until last year.
Overall, however, America’s Health Rankings showed health in Georgia improved in some areas and declined in others.
The rankings’ authors consider obesity and smoking to be the two most important health factors because they cause a host of other problems. Obesity rose in the past decade, but smoking declined.
Other measures showed mixed outcomes. There were declines in some health factors such as the percentage of children in poverty, people without health insurance, and adults with high cholesterol. They all increased in the past decade.
But other measures showed improvement. Cancer deaths, violent crime, infant mortality and rates of infectious disease all declined.
We looked for other sources of information to see if they showed different results. We consulted the Annie E. Casey Foundation’s Kids Count report, a well-regarded state-by-state measure of children’s health, and data from the Georgia Division of Public Health.
Between 2002 and 2010, Georgia’s Kids Count ranking mostly hovered in the low to mid-40s out of 50 states. That’s well below average, but not a clear decline. The percentage of low birth weight babies, obese children, and children in poverty increased, but other measures such as teen births, infant mortality and child deaths showed improvements.
Georgia Division of Public Health figures paint a mixed picture as well.
All sources we consulted found that the health of Georgians improved in some important categories and declined in others.
Overall, Georgia’s health hasn’t truly "declined" in the past decade as Deal said. It’s consistently low compared with other states, and during the past 10 years, our record has been mixed.
We rate Deal’s claim Half True.
Published: Monday, April 25th, 2011 at 6:00 a.m.
Subjects: Public Health
E-mail interview, Stephanie Mayfield, spokeswoman, Gov. Nathan Deal, April 15, 2011
The Atlanta Journal-Constitution, "Governor aims to aid residents' well-being," April 14, 2011
Atlanta Hospital News and Healthcare Report, "Losing Control of the Public Health Brand: Costs and Consequences," December 2010
America’s Health Rankings, Georgia data, accessed April 21, 2011
The Annie E. Casey Foundation, Kids Count Data Center, accessed April 21, 2011
Interview, Dr. Georges Benjamin, executive director, American Public Health Association, April 19, 2011
Interview, Laura Speer, associate director for policy reform and data,
the Annie E. Casey Foundation, April 20, 2011
Interview, Dr. Manuel A. Selva Jr., senior medical director, Southeast region, United Healthcare, April 21, 2011
Georgia Division of Public Health, Online Analytical Statistical Information System, accessed April 19, 2011
PolitiFact Georgia, "Hospital says Georgia's kids second fattest in nation," Nov. 8, 2010
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