Do Healthy Counties Make Healthy People? Or Vice Versa?

Originally posted at CSAC.
By Gregg Fishman.

There’s a story recently circulating on the MSN news site that lists the 10 counties across the country where people live longer on average than elsewhere. Three of them, Marin, Santa Clara and San Mateo are here in California.  These are not necessarily the places where individual people live to be the oldest—rather, these are the counties where the median age at death is the highest—in other words, more people are living longer there.

The story points out that most of the counties that made the list—including the three from California — generally have better access to health care — but the article points out another factor too. All 10 of the counties on the list tend to be places where people are active and have a lot of opportunity for outdoor recreation. Certainly Marin, Santa Clara and San Mateo fit that description. The weather is mild, there are ample parks and other amenities conducive to outdoor activity and while many people work hard, many also have the means and the time that allows them to take advantage of those opportunities.

The story also points out—if somewhat obliquely, that it’s hard to tell which comes first—the park or the person who wants to use it?  It’s a more complex set of questions really. Did those counties proactively develop the amenities that then attracted healthier people? Or did the people already live there, and the local jurisdictions are reacting to their priorities? Or did they become more interested in an active lifestyle because the local governments made it easier to for them to do so?

From a purely fiscal perspective, this opens up an interesting question: Does a healthier population reduce health care costs because people are, well, healthier? Or does it increase costs because people live longer and presumably use more healthcare services over time? I’m sure there are economists and public health specialist who could answer that question—but please, remember to factor in a better quality of life, longer productivity, and other positives related to living longer.

And finally, the story reminds me that the theme this year’s CSAC Annual Meeting is “Healthy Counties, Healthy California” and notably, the meeting is in San Jose, Santa Clara County—one of the places where people seem to live longer. Hopefully that setting will be even more conducive to learning a few things about how to foster healthier counties, healthier residents and a healthier state in the long run.