Despite high state ranking, some leaders say it's time to 'double down' on health in Howard County

Bikers finish their 16-mile bike ride to start the last leg of an Iron Girl Triathlon in Columbia in 2016. Access to biking and walking throughout the county is one of the focus areas for local health advocates.

Howard County helped lead the pack for the fifth straight year as the second healthiest county in the state, according to an annual study by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Howard came in first the first three years of the survey from 2011 through 2013, but has fallen second to Montgomery County the last five years. The survey showed wealth as one of the biggest determinants of community health; in 2017 the U.S. Census Bureau ranked Howard County as the fourth wealthiest county in the nation based on median household income, while Montgomery County ranked 19th.


“Really Howard County should be beating the pants off of Montgomery and we’re not, so the message is we really need to double down on health in the community,” said Nikki Vernick, CEO of Columbia-based community health nonprofit the Horizon Foundation. “In many ways because of our wealth and affluence and educational status, we should be doing better than the rest of the state.”

The survey looked at 30 factors that contribute to overall community health, including access to clinical care, physical exercise, air pollution, poverty levels and obesity.


Elizabeth Kromm, vice president of Population Health and Advancement at Howard County General Hospital, called the survey a “playbook” to show counties what they’re doing well and how they can improve.

“Do we have that foundation in place for people to achieve healthy lives?” Kromm said.

While the county has done well at investing in public health infrastructures such as access to clinical care, Kromm said more is needed to improve access to other factors that influence overall health, such as affordable housing. It’s a problem that she said plagues both younger families in the county and the elderly who may not be able to afford necessary modifications to their homes to make them safe.

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Fourteen percent of county residents suffer from “severe housing problems” according to the survey, which includes overcrowding, high housing costs or lack of kitchen or plumbing facilities. Both Montgomery County and the state average is 17 percent.

“When housing isn’t affordable and there are multiple families living in a single family unit, that is not great for good health,” Kromm said. “If you’re spending more of your income on housing, then you have less left in terms of savings, maybe some other things to make healthier choices.”

The County Council approved legislation in February that makes it easier to build affordable housing units in otherwise crowded areas of the county.

Deputy Health Officer for Howard County Antigone Vickery said while the department is pleased by the county’s high ranking, it is consistently working to roll out new programs that tackle some of the community’s pressing health needs, one of the most serious being the opioid crisis. This month the department is launching a “guiding good choices” program for parents to help steer children away from substance abuse; this summer it will launch a holistic pain management program.

Another area in which Vernick said she’d like to see improvement is easy access to physical exercise throughout the county, including greater investment in the county’s fledgling bike path network. Use of the network, she said, could be a way to bring down the county’s 23 percent adult obesity rate; Montgomery County’s is 21 percent.


When looking at Howard County compared to counties nationwide, Vernick said the county isn’t yet at the most forefront of community health.

“We need to be looking at health in all policies, in transportation, housing,” she said. “We need to be looking at ways to design a community that promotes walking and biking, looking at ways to think about our healthy food access.”