Tarrant County is the 24th-healthiest county overall in Texas but ranks worse than the state average in several specific areas that affect health, including air pollution and sexually transmitted infections, according to a new report.
The county has double the state average for unhealthy-air-quality days, and almost one-third of children live in single-parent households, the study found.
Still, Tarrant has risen in the rankings for health outcomes from 37th in 2010 and 32nd in 2011, according to the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
The rankings released today offer snapshots of the overall health in communities, officials say. The report studied 221 of Texas' 254 counties.
"These snapshots look at how long people are living and how well they are living," said Julie Willems Van Dijk, associate scientist at the population health institute. "Certainly Tarrant County is doing fairly well, ranking 24th out of 221 counties for health outcomes."
Tarrant County Public Health Director Lou Brewer said that while the county has improved in the rankings, "there is always more work that can be done to improve the health of Tarrant County residents."
Van Dijk noted that Tarrant ranked 64th in health factors and lower in social, economic and physical environment factors, she said.
"To me, that is a bit of a wake-up call to say that [Tarrant] is lagging a little bit in things that will drive tomorrow's health outcomes," Van Dijk said.
The report ranks the health of most U.S. counties using the rate of people dying before age 75, the percentage of people who report being in fair or poor health, the number of days people report being in poor physical or mental health, and the rate of low-birth-weight infants.
It also considered other health factors ranging from health behavior -- excessive drinking, inactivity, smoking -- to access to recreational facilities.
Dallas County ranked 51st in health outcomes; Parker County, 32nd; and Denton County, fifth.
Smoking, obesity rates
Van Dijk cautioned that a county's rise or fall is attributed to activities not only in that county, but also health factors in other counties, she said.
Researchers flagged the adult smoking and obesity rates, as well as children living in poverty, because those factors can have a strong impact on premature deaths or poor health outcomes, Van Dijk said.
In Tarrant County, 28 percent of adults are obese and 18 percent smoke, both 1 percentage point below state rates, according to the report. Its chlamydia rate and percentage of fast food restaurants were above the state rate.
Brewer said that Tarrant has improved its mortality indicator and morbidity rankings since 2010. Of the five most populous counties in Texas, Tarrant had the second-best rankings for health outcomes and health factors, he said.
Tarrant ranked the poorest in physical environment factors, coming in 217th of 221 counties. Brewer noted that four of the five most-populous counties were also at the bottom in that category.
Tarrant County Public Health recently launched Mobilizing for Action through Planning and Partnerships, a community-driven process to prioritize public-health issues and identify resources to address them, Brewer said.
The process will result in a community health improvement plan, he said.
Denton ranks high
In Texas, the healthiest county was Collin County, followed by Williamson, Rockwall, Denton and Gillespie, the report found. The five least-healthy counties were Marion, Polk, Brooks, Red River, Trinity and Orange.
For example, Marion County, in East Texas, has three times as many premature deaths as Collin County, researchers said.
"The county health rankings show us that much of what influences our health happens outside of the doctor's office," said Risa Lavizzo-Mourey, president and CEO of the Wood Johnson Foundation. "In fact, where we live, learn, work and play has a big role in determining how healthy we are and how long we live."
Where does Tarrant County rank in the state?
(Out of 221 counties studied)
Health outcomes: 24
Clinical care: 38
Health factors: 64
Social and economic factors: 104
Physical environment: 217 Tarrant and the state compared
Tarrant County: 18%
Tarrant County: 28%
Sexually transmitted disease
(Chlamydia infections per 100,000 people)
Tarrant County: 448
Tarrant County: 25%
Children in poverty
Tarrant County: 21%
Children in single-parent households
Tarrant County: 31%
(Days with high levels of ozone)
Tarrant County: 39
(Violent crimes per 100,000 people)
Tarrant County: 501