Survey numbers can mean various things to different people. The county health rankings are in the same boat, Franklin County Health Department officials said.

Franklin County’s overall health outcomes ranking out of 102 counties rose to 26 in 2018, but other factors remained unchanged or lowered.

“It is always interesting in our county that we seem to do well with outcomes,” Midge Ransom, county health director said. “We do well with length of life (21st) and other quality of life measures. While that is very high, our health factors are not so good, being ranked down in the 79-80.

“I always consider the county health rankings as informative. They give us an idea of the issues we potentially have. I am cautious in the rankings because in Kansas, we have such a disparity between the size of counties.”

Ransom said an example is Pottawatomie County, which has 3,000 people, shows they are relatively close to grocery stores, but only half of the Franklin County population is inside Ottawa.

“You look at access to healthy foods, Pottawatomie County had a measure of zero, which means their people are close to a full-service grocery store,” Ransom said. “In Franklin County, we have half our population living outside of city of Ottawa and they are in excess distance per income levels from the only full-service grocery stores in Ottawa. That tells us we need to improve access to healthy food. It helps you understand why the ranking is what it is. Some of those measures in a state are not easily remedied.”

The rankings showed Johnson County as the healthiest county and Chautauqua County as the least healthiest.

Ransom said a couple of issues that are a concern is the smoking and obesity rates. Franklin County ranks among the highest in tobacco use at 20 percent and the obesity rate is 34 percent.

“We are worse than most of the state,” Ransom said of the smoking. “Vaping is a huge concern among young people.”

Franklin County’s health behavior ranking is 95th out of 102, which comes from factors such as smoking, obesity, physical inactivity (26 percent), and alcohol-impaired driving deaths (27 percent).

Ransom said the county obesity rate is similar to a lot of other counties, but the physical activity, drinking and results from drinking are a concern.

“Impaired driving, vehicle accidents and crime, all those things impact that section,” she said. “A fourth of our population is not active enough. It does not have to be difficult. The hardest step is the first step out your door. Thirty minutes a day does wonders for your mental health and physical health. We would like to see that increased.

“We advocated with Wildlife and Parks to make those trails free. People used to tell us in Princeton and Richmond that they could not use the trail. That is not true anymore. We are looking at programs to get bicycles in people’s hands. We are trying to increase that access.”

Ransom said a big impact on the health numbers is the economic and social factors. She said income inequality is growing. Kansas has 46 percent of households spending half or more of their income on housing. according to the rankings.

“It has a very definite impact on living conditions,” Ransom said. “How much stress do you have in your life, which may lead to some of the less than desirable behaviors. Education is not the issue. It does not solve the problem of income inequality and poor housing. The more research that has been done about quality of housing, the neighborhood you live in, the more we see how critical that is to a person’s well-being and health.”

She said once a person’s health declines, then it effects other factors such as holding down a job.

Ransom said there are no easy answers to many of the issues that effect the health rankings.

“Some people want a quick turnaround,” she said. “What can you do about the obesity rate today that will make us better next year. What we know is behaviors and socio-economic factors take 20 to 30 years down the road [to improve]. The policies we put into place today, efforts we make to increase the physical activity venues — such as the trails — will make a difference down the road. It slowly changes the social context of what is acceptable and what people desire to do. Those are things we are most concerned about. Even though, they take a long time, they are more impactful in the long run.”