Harford County isn't quite so healthy as it was a year ago, according to a widely circulated and quoted national survey that tracks a variety of public health and quality of life factors in local jurisdictions.
Harford slipped from fifth in overall health to ninth among Maryland's 23 counties and Baltimore City, according to the Robert Wood Johnson Foundation's 2017 County Health Rankings & Roadmaps.
That ranking is based on multiple health metrics, and one of the big factors was that Harford's overall quality of life declined relative to other Maryland counties, as measured by such things as smoking, obesity, exercise, the quality of the local health care system, as well as dental and mental health providers, the economy, social mobility and the environment, according to one of the report's authors.
The foundation, a private philanthropic organization headquartered in Princeton, N.J., has published county-by-county rankings of the healthiest communities across the nation for the past eight years. It works with the University of Wisconsin Population Health Institute in Madison, Wis., to create the report.
"The primary reason for the change this year is really those quality of life measures," Kate Konkle, an associate researcher with the UW Population Health Institute, said of a key component of the "health outcomes" ranking, which measures a community's overall health through the length and quality of residents' lives.
Despite the drop in the overall rankings after finishing in the top five last year, local health officials were quick to put a spin on the latest report, citing county residents living longer, having more access to health insurance and smoking less.
"We have not regressed," William Wiseman, a Harford County Health Department spokesperson, said Monday. "In point of fact, there are many areas in which we continue to improve."
Prior to the 2016 report, which covered a 2015 calendar year survey, Harford's yearly rankings typically fell between ninth and 10th place, primarily because of the percentage of county residents who were obese or who smoked.
In the most recent report, Harford ranked eighth in what are termed "health factors," such as smoking, obesity, exercise. The county placed ninth in those factors in 2016.
Harford residents don't exercise a much as they could, despite having an abundance of exercise opportunities available, according to the report, and they consume alcohol in excessive amounts at a rate greater than the state average.
"Assessing our rates and ranking against state averages and those of other Maryland counties, the findings reflect health status in Harford remains stable and that Harford is relatively healthy by comparison," Harford Health Officer Susan Kelly said in a recent statement following the 2017 report's release.
Harford ranked ninth out of 24 Maryland jurisdictions in "health outcomes," a compilation of factors that illustrate the length and quality of residents' lives. The eight counties ahead of Harford are Montgomery, at number one, followed by Howard, Carroll, Frederick, Talbot, Calvert, Queen Anne's and St. Mary's, according to the report, which can be viewed online at harfordcountyhealth.com.
Under the health outcomes heading, Harford ranked fifth in the state in premature death, with 2,532 deaths before age 75, or a rate of 5,900 years of potential life lost, according to the data. The statewide rate was 6,400 years of potential life lost.
The county ranked 10th in the state in quality of life, with factors such as 12 percent of adults reporting they were in poor or fair health, versus 13 percent of Maryland adults in poor or fair health.
Kelly noted that "much depends on the health decisions and behaviors of Harford County residents."
"The information contained in these annual reports is only as meaningful as the actions they inspire," she stated.
The data is useful for local officials as they develop strategic plans to counter health issues identified in the report, according to Kelly.
"We continue to have a very active and very aggressive health needs assessment process," Wiseman said. "The work of the Local Heath Improvement Coalition and its work groups remains an important tool in improving things."
Harford ranks fourth in overall health behaviors; 14 percent of adults are smokers and 28 percent are obese, compared to 15 and 29 percent statewide, respectively.
The county ranks at 8.8 on the "food environment index," which measures from zero to 10 the factors that give Harford residents "a healthy food environment," according to the study. The statewide food environment index is 8.4, according to the data.
The data show 21 percent of adults age 20 and older do not engage in physical activity during their leisure time, compared to 19 percent statewide, although 94 percent of the population has access to opportunities for exercise, compared to 91 percent of the statewide population.
Seventeen percent of Harford County adults report drinking excessive amounts of alcohol, compared to 12 percent of Maryland residents, plus 24 percent of the fatal traffic accidents involved alcohol. That figure is well above the state rate of 13 percent.
Harford County is well below statewide rates for sexually-transmitted infections and teen pregnancies. The data show 189.8 new cases of chlamydia per 100,000 people and 15 teen births per 1,000 girls and women ages 15 to 19, compared to respective rates of 462.6 cases of chlamydia and 25 teen births statewide.
Harford ranks ninth on the clinical care scale, with only 6 percent of the population age 65 and younger that does not have health insurance, versus 9 percent uninsured statewide.
The county has a ratio of one primary care physician per 1,630 residents and the same ratio for dentists, compared to a statewide ratio of one primary care provider per 1,130 residents and one dentist for every 1,350 residents.
There is one mental health provider per 740 Harford residents, while the statewide ratio is one provider for 490 residents, according to the data.
Harford had 50 preventable hospital stays for every 1,000 people enrolled in Medicare versus 46 statewide, according to the report.
Harford's air quality is worse than the statewide average, with an average daily density of 10.9 micrograms of fine particulate matter per cubic meter, versus 9.5 micrograms for the state, plus it has recorded drinking water violations.
The county was one of 13 out of 24 Maryland jurisdictions that had a drinking water violation, according to the report, although such findings in previous reports have been disputed by public water supply officials.
Thirteen percent of the county's households have at least one of four "severe housing problems," which include overcrowding, a high cost of house, lack of a kitchen or lack of plumbing facilities, according to the report; 17 percent of households statewide report such problems.
The report indicates 83 percent of Harford's workforce drives to work alone, versus 74 percent of the statewide population, and 50 percent of people report driving to work alone for at least 30 minutes, compared to 48 percent of the statewide workforce.
Wiseman, of the health department, stressed that many factors, such as the quality of the environment, are outside his agency's control.
"The primary objective here is to use [the report] as another tool, another set of data that we can utilize to try to address some of these issues more effectively," he said.