Lewis and Clark and Jefferson counties rank among the top 10 healthiest of Montana’s 56 counties, a national report released early Wednesday found. Jefferson came in at No. 5 and Lewis and Clark at No. 9.
But the state of Montana needs to do a better job on child care and wages, the study’s authors claim, noting that on average, 31% of household income goes to finding someone to take care of the kids while parents work.
The study, aided by funding from the Robert Wood Johnson Foundation, which states it is the country’s largest public health philanthropy, said it reached its conclusions using data on more than 90 health-influencing factors such as housing, education, jobs, and access to quality health care.
The report looks at health outcomes and health factors.
Health outcomes are how healthy a county is right now. They reflect the physical and mental well-being of residents within a community through measures representing not only the length of life, but quality of life as well.
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In that category, Broadwater County was ranked No. 11, Powell was 24th, Cascade was 27th, Teton was 35th and Flathead was 7th.
Health factors represent what can be done to improve the length and quality of life for residents and are predictors of how healthy communities can be in the future.
In that category, Lewis and Clark County ranked No. 3, Jefferson was fourth, Cascade was 25th, Flathead was 20th, Powell was 34th and Teton was 17th. Rounding out the top 10 was Beaverhead at No. 2, then Missoula at No. 5. Madison was sixth, Custer was Seventh, Sweet Grass was eighth, Yellowstone was ninth and Fallon was 10th.
Gallatin County ranked No. 1 in both categories.
In terms of health outcomes, 13% of Lewis and Clark County residents are in poor health, compared to 14% for the state. There are 16% in the county who are smokers, compared to 18% in the state. The report stated 28% of county and state residents are obese, and 25% of county and state residents are excessive drinkers.
Drenda Niemann, health officer with Lewis and Clark Public Health, said she was aware of the new health ranking report, but had not had time to review it.
She said her agency works with several community stakeholders to update its Community Health Report every three years. This report provides the latest data on the health of residents in Lewis and Clark County.
Niemann said the report helps outline how the community can work collaboratively to improve health conditions. She said the 2022 plan should be complete by the end of June.
She said the task force has identified chronic diseases, housing and behavioral health, with the undercutting issue of early childhood and access to care, as priorities.
Niemann said in the past 10 years, researchers found that conditions where people are born, live, learn, work, play, worship and age — called social determinants of health — affect a wide range of health, functioning, and quality of life outcomes and risks and contribute to why some of people are healthier than others.
“As a community, we have the opportunity to address some of these social determinants which contribute to improved health outcomes through the Community Health Improvement Plan,” she said.
Authors of the Wisconsin report said this year’s rankings look at what it takes to rebuild after a COVID-19 pandemic in ways that ensure economic security and health.
“Working together, we can transform public goods such as affordable and accessible child care, quality public schools, and jobs that treat people with the dignity they deserve and the wages that will support their families,” Marjory Givens, co-director of the County Health Rankings & Roadmaps, said in a news release. “This would not only ensure a just recovery from the pandemic for families and communities today but greater economic security, better health and well-being for generations to come.”
The Wisconsin study claims the average living wage is $35.80 an hour for a household with one adult and two children, noting many people fall way below that bar.
“Jobs must lift workers out of poverty, not keep them in it,” states the 2022 County Health Rankings data from the University of Wisconsin Population Health Institute (UWPHI). “Living wages cover basic needs and are essential to live a healthy life.”
The report finds that depending on location, the living wage dips to a minimum of $29.81 an hour and rises to a high of $65.45 an hour.
Gallatin ranks as the healthiest in Montana, and Roosevelt is the least healthy county in the state. However, the report said that due to insufficient data there were no rankings for Carter, Daniels, Garfield, Golden Valley, Liberty, Powder River, Treasure and Wibaux counties.
Others filling out the top 10 are Carbon at No. 2, then Madison, Beaverhead, Jefferson, Missoula, Flathead, Richland, Lewis and Clark and Dawson at No. 10.
The Montana report states that for a family with two children, on average, 31% of household income goes to child care. When a single expense consumes the majority of a paycheck – especially one as essential as child care – families are unable to afford other necessities, the study’s authors note.
“… in nearly all U.S. counties, a typical worker’s wage is less than what would be considered a living wage for one adult with two children for the area. Among these counties, a more than 73% wage increase would be necessary to make a living wage, while some counties need as much as a 229% increase.
The impact of child care costs is even more stark when exploring differences in household income by race and ethnicity, the study found.
It said an American Indian and Alaska Native family in Montana has a median household income of $35,859, while a white family’s median household income is $58,291.
“These income disparities demonstrate how economic security is not equally accessible to all people living in Montana,” the study’s author said. “The pandemic was hard on working families, revealing gaps across the nation in child care affordability.”
The U.S. Department of Health and Human Services’ benchmark suggests that child care is no longer affordable if it exceeds 7% of a household’s income.
Montana was awarded more than $110 million through the American Rescue Plan for one-time-only funding to support stabilization grants to child care providers. The funds are to be used to cover their operating expenses as they face less revenue and higher expenses during the pandemic. It was to also expand and support child care infrastructure throughout Montana, including support for emergency and essential workers.
A report by the state Department of Labor and Industry last August found 60% of Montana’s counties are child care deserts, meaning the amount of care available meets less than a third of the potential demand. There were six counties of the state’s 56 without a single licensed provider, according to the report.
Tori Sproles of Child Care Connections, a nonprofit that is one of seven child care resource and referral agencies in Montana, agreed with the study’s findings.
She said in Gallatin County alone, families with two children under 3 are paying 28% of their income for child care. She said in smaller communities it is 30-35%. Montana’s statewide average is 16.5%.
Sproles, whose agency serves Gallatin, Park, Meagher, Lewis and Clark, Jefferson, and Broadwater counties, said not being able to access appropriate support and services has taken a toll on a lot of things, such as preventing some families from reentering the workforce.
“In a roundabout way it impacts mental health and wellness in general,” she said.
The rankings are available at www.countyhealthrankings.org.
Assistant editor Phil Drake can be reached at 406-231-9021.