Ozaukee County ranks healthiest in Wisconsin and Menominee County is the least healthy county in the state, again, according to the annual County Health Rankings, released today by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

An easy-to-use snapshot that compares counties within states, the Rankings State Report calls attention to key drivers in health such as severe housing-cost burden and its connection to other factors like children in poverty. High housing costs can force some families to live in unsafe or overcrowded housing or even become homeless. This year’s Rankings State Reports show stark differences across and within counties in the opportunity to afford a home, especially for people of color and those with low incomes. In addition, the analyses show that a lack of opportunity for a safe, secure and affordable home is tied to poor health.

Among Wisconsin’s children living in poverty, 49 percent were living in a household that spends more than half of its income on housing. High housing costs make it difficult for families to afford other essentials that contribute to good health, such as healthy food, medicine or transportation to work or school.

Link between housing and health

Looking at differences by place and race offers a more complete picture of health. While in Wisconsin, 13 percent of households spend more than half of their income on housing costs, when race is taken into account, even deeper differences emerge. Households headed by black residents are the most burdened by severe housing costs at 28 percent, compared to white resident households at 11 percent. County by county, severe housing-cost burden ranges from seven percent to 19 percent of households.

“This year’s report clearly shows the linkage between quality, affordable housing and health. Policies such as the expansion of Medicaid not only expand access to health care, but can link people with resources to keep them healthy, such as safe housing,” said Julie Willems Van Dijk, now deputy secretary, Department of Health Services. (Van Dijk helped put together the report.)

“These rankings continue to frame the importance of focusing on factors that may not be traditionally seen as impacting health. Social determinants such as healthy housing, income and education are crucial to influencing how healthy we are as a state. The shared understanding and collective voice that public health organizations across the state have about rankings and these factors are key to establish better health outcomes,” said Lieske Giese, Wisconsin Public Health Association president and Eau Claire City-County Health Department Health director.

According to the 2019 Rankings, the five healthiest counties in Wisconsin, starting with the most healthy, are:

  • Ozaukee
  • Washington
  • St. Croix
  • Waukesha
  • Calumet

The five Wisconsin counties in the poorest health, starting with the least healthy, are:

  • Menominee
  • Milwaukee
  • Sawyer
  • Forest
  • Vilas

“Our homes are inextricably tied to our health,” said Dr. Richard Besser, Robert Wood Johnson Foundation president and CEO. “It’s unacceptable that so many individuals and families face barriers to health because of what they have to spend on housing. This leaves them with fewer dollars to keep their families healthy. Imagine the stress and pain that come with unplanned moves. We are all healthier and stronger together when everyone has access to safe and affordable housing, regardless of the color of their skin or how much money they make.”

Strategies aimed at reducing health disparities

In addition to the county-level data, the rankings also feature What Works for Health, a database of more than 400 evidence-informed strategies to support local changemakers as they take steps toward expanding opportunities. Each strategy is rated for its evidence of effectiveness and likely impact on health disparities. The Take Action Center also provides valuable guidance for communities who want to move with data to action.

“All communities have the potential to be places where everyone enjoys full and equal opportunity. But the data show that’s not happening in most communities yet. Children of color face a greater likelihood of growing up in poverty, and low-income families struggle to pay rent and get enough to eat,” said Sheri Johnson, acting director of County Health Rankings & Roadmaps. “It is time to do the difficult work of coming together to undo policies and practices that create barriers to opportunity. The rankings can help communities ground these important conversations in data, evidence, guidance and stories about challenges and success.”