Kimberly McRae

HPEB 511
October 22, 2016
Community Ranking Assignment

The county that I will be evaluating is Richland County in central South

Carolina. This county ranks 7th overall in the state. We rank extremely well in
Clinical Care (2nd in the state) however we scored the worst in Social and Economic
Factors (15th in the state) and Quality of Life (13th in the state). Within the clinical
care criterion, several factors seem to influence such a ranking. Compared to the
state average (19%), 16% of the Richland County population is uninsured. The
health care costs for Richland county is also lower than the state average; $8,756 to
$9,283 respectively. Also, the prevalence of primary care physicians and dentists in
Richland County is greater than the state average; 1200:1, 1230:1 and
1500:1,1950:1 respectively.
Although this county has a high ranking for clinical care, social & economic
factors and quality of life rankings are not as stellar. Within the social and economic
factors category, high school graduation was only at 65% and violent crime
statistics were also higher than the state average (947 compared to 577). Within
the quality of life category, Richland Countys low birthweight percentage was
higher than the state average (11% compared to 10%), however infant mortality is
slightly lower than the state average (7 compared to 8). Also, the HIV prevalence is
more than twice the state average.
From these statistics I gathered that although clinical care in Richland County
is the second best in the state, social and economic factors (ranking 15) cause the
quality of life in this county to be not as great (ranking 13). Although this county
has necessary access quality physicians, dentists, and preventative screenings,
social and economic factors such as income inequality, increased high school
graduation rates, and high unemployment rates (when compared to the average of
top national performers) all speak to the discordance between health care and
health outcomes.
My recommendation to improve our countys social and economic ranking,
and in turn improve the quality of life ranking, coincides with the findings of Liu Y
et.al. They studied if there was an association between education and the
occurrence of low birthweight. They found that there was a negative association in
the education level of Chinese women and the birthweight of the newborn. They
concluded that strategies to address and monitor inequalities in a childs health
should be implemented before the child is delivered (Liu, et al., 2008). In Richland
County, since the dropout rate in high school is relatively higher than the state and
US average, implementing programs to improve that statistic might also decrease
low birthweight in the county and decrease infant mortality. Also, improving the
condition of poverty in this county and especially the state as a whole might reduce
the prevalence of mental health. For Richland County, the number of poor mental
health days per month was 3.9 and the percentage of children in poverty was 22%
and the unemployment rate is 6%. According to a study done by Franziska Reiss in
2013, there is a negative correlation between poverty and mental health in children
and adolescents. Children and adolescents were two to three more times more
likely to develop mental health if they were socioeconomically disadvantaged. It is
possible that once we do something to decrease systematic poverty in our county,
the rate of mental health will decrease as well (Reiss, 2013).

Works Cited
Liu, Y., Jianmeng, L., Rongwei, Y., Aiguo, R., Song, L., & Zhu, L. (2008). Association of
Education and the occurrence of low birthweight in rural southern China
during the early and late 1990s. American Journal of Public Health, 5.
Reiss, F. (2013). Socioeconomic inequalities and mental health problems in childrean
and adolecents: A systematic review. Social Science and Medicine, 8.