2019 “March Madness” Health Rankings :: Marathon County #14 Seed in WI

Written by Joan M. Theurer & Brad Karger

During “NCAA March Madness,” the National Collegiate Athletic Association selects the 68 best Division I men’s college basketball teams (as determined by a complex ranking system) to play in a tournament to determine the national championship.

Also in March, the Robert Wood Johnson Foundation ranks the health of counties in all 50 states (using a standardized measurement of how healthy people are and how long they live) to determine the healthiest counties in the nation.


The stakes of the County Health Rankings are high — They provide insight about the health of our community, our family, and ourselves, and they predict future health success for us all.

Since both Wisconsin teams have already been eliminated from the NCAA tournament, maybe now you have a bit more time to check out a few quick highlights about Marathon County’s 2019 health rankings.

True, they’re presented with much less fanfare, but they can have a much bigger impact on your future!

Q. Why would I care how my county compares to other Wisconsin counties?

A. The County Health Rankings show community leaders — and the public — that where we live matters! Health is more than access to health care . . . Where we live, learn, work, and play impacts our health. It’s hard to have a healthy life if you don’t live in a healthy community. As Dr. Robert Ross, President and CEO of The California Endowment, made the claim:

“Tell me your zip code, and I will tell you your life expectancy.” 

Q. So, how did Marathon County rank for 2019?

A. We ranked 14th out of 72 for Health Factors and 19th out of 72 in Health Outcomes.

The good news?

Marathon County ranked in the top third of all Wisconsin counties.

Plenty to be happy about — but still plenty to be concerned about . . .

If this were the NCAA playoffs, we’d be in the tournament, but we’d be the underdog even in our first match-up!

Q. How is the health of a county measured?

A. The Health Outcomes score is a weighted composite of:

  • Length of Life (50%)
  • Quality of Life (50%)

 In HEALTH OUTCOMES, Marathon County ranked #19 of 72 counties in Wisconsin.

In addition, the Rankings rate Health Factors that look at:

  • Health Behaviors (30%)
  • Clinical Care (20%)
  • Social and Economic Factors (40%)
  • Physical Environment (10%)

In HEALTH FACTORS, Marathon County ranked #14 of 72 counties in Wisconsin.

Screen capture of 2019 Health Rankings for Marathon County.

HEALTH OUTCOMES were made up of the following:

  • Length of Life (ranked 18): Premature death, as defined as years of potential life lost before age 75 per 100,000 population (age-adjusted)
  • Quality of Life (ranked 31): Poor or fair health, poor physical health days, poor mental health days, low birthweight

HEALTH FACTORS were made up of the following:

  • Health Behaviors (ranked 25): Adult smoking, adult obesity, food environment index, physical inactivity, access to exercise opportunities, excessive drinking, alcohol-impaired driving deaths, sexually transmitted infections, teen births
  • Clinical Care (ranked 14): Percent of uninsured under the age of 65, primary care physicians, dentists, mental health providers, preventable hospital stays, diabetic monitoring, mammography screening
  • Social & Economic (15): High school graduation, some college, unemployment, children in poverty, income inequality, children in single-parent households, social associations, violent crime, and injury deaths
  • Physical Environment (49): Air pollution, drinking water violations, severe housing problems, driving alone to work, long commute-driving alone
Screen capture of County Health Rankings Interactive Model.

The Rankings utilize national data sources (and for Wisconsin, use data from their partner the University of Wisconsin Population Health Institute), analyzing data from a single year or multiple years.

Each measure is weighted — for example, adult smoking is weighted 10%, while excessive alcohol use is weighted 2.5%.

Marathon County data can be found here.

Q. Which Wisconsin counties are the “first seeds” — like Duke, North Carolina, Gonzaga, & Virginia are in the NCAA tournament?

A. Wisconsin’s healthiest county is Ozaukee — followed by Washington, St. Croix, Waukesha, and Calumet.

The counties in the poorest health are Menominee, Milwaukee, Sawyer, Forest, and Vilas.

Most people are surprised that social and economic conditions of a community contribute 40% to the health of a community and the healthiest counties. Ozaukee County is a wealthy county, and income is a predictor of health — but more goes into personal and community health. Marathon County residents often wonder why we don’t rank higher given that we’re a regional provider of health care. The answer is that access to health care is important, but community health is SO MUCH MORE than that. To be a healthy community involves building a culture of health and the infrastructure to support it.

To function at the highest level, it’s not the play of a few “star players.” It’s all of us — working as a team — supporting each other and reinforcing healthy behaviors and investments in our health infrastructure.

In Marathon County, we aspire to be healthy, safe, and prosperous. One thing we can learn from the 2019 County Health Rankings is that these desired outcomes are interrelated.

Q. What have we learned about Marathon County’s strengths and opportunities for improvement?

 A. As a county, we’ve improved our game in these key areas:

  • The number of residents under 65 with health insurance
  • The number of dentists
  • Mammography screening among women 65–74
  • Decreasing violent crime
  • Reduced air pollution

As a county, we seem to be losing ground in:

  • Adult obesity
  • Sexually transmitted diseases
  • Child poverty

The Rankings inform us where we need to focus our community efforts to be among the healthiest counties in Wisconsin.

LIFE_Report-coverThe findings support the 2017–2020 Marathon County Community Health Priorities and the 2017–2019 LIFE Report Calls to Action.

Community health priorities include:

  • Alcohol and other drug misuse and abuse
  • Behavioral health
  • Adverse childhood experiences
  • Healthy weight
  • Health needs of aging
  • Oral health
  • Social and economic factors that influence health

Creating healthy communities is everyone’s business.

Marathon County is fortunate to have strong partnerships across diverse sectors committed to help create a culture of health where ALL people enjoy the opportunities to live, learn, work, and play in a healthy community.

March Madness is now in full swing . . .

We’ve gone from 68 teams to 32 to a “Sweet 16” of active teams.

Wisconsin and Marquette didn’t make to the Sweet 16 this year, but 2020 is another year, and both those teams are determined to improve their talent level and their winning culture to advance all the way to the Final Four!

In Marathon County, we need to take a similar approach:

  • What are our strengths and weaknesses?
  • What can we learn from communities that have been more successful than we have?
  • Who are our team leaders going to be?
  • How can we get more people engaged?
  • What is our game plan?

The 2017–2020 Marathon County Community Health Improvement Plan aligns community efforts to address issues having the greatest impact on the health of Marathon County residents. To read more about what is being done in Marathon County to address community health priorities visit: http://MarathonCountyHealthPriorities.org/.



Come on, Marathon County . . .

We don’t need to take a backseat to Ozaukee County — or any county!

Like any winning team, first we must recognize that we’re a “team.”

It’s hard to be healthy in a community where health is not valued and investments haven’t been made to support health. When the people around you spend most of their free time in front of a screen or eating processed food or drinking too much alcohol, it’s hard to be individually healthy.

By contrast, a healthy community is one in which local groups — and individuals — work together to support healthy eating, regular exercise, and investments in healthy-living options.

If we adopt a winning attitude, we can improve our health ranking, all the way to the top of the list!

Look at all we have:

  • Granite Peak
  • Nine Mile County Forest and Recreation Area
  • Eastbay Sports Complex
  • Badger State Games
  • Walking and hiking trails
  • Whitewater kayaking
  • and the list goes on and on . . .

We have the potential for Marathon County to be a mecca of outdoor recreation!

But to develop a culture of health, we need to commit to using the roadmap the Robert Wood Johnson Foundation has given us with our current health rankings and make it a priority to address our weakness and to sustain our strengths.

You can start by taking the 2019 Active Family Challenge put on by the Marathon County Parks, Recreation, & Forestry Department . . . Learn more about this spring/summer county-wide activity in “Sign Up for Marathon County’s 2019 “Active Family Challenge.”

Active Family Challenge Poster - FINAL_000

Seek out other opportunities to get involved, and let GOOD HEALTH become YOUR priority!

*  *  *

If you’d like to get involved in community leadership in health promotion, there are a number of organizations that could use a helping hand, such as:

The best way to get connected with one of these groups is to contact the Marathon County Health Department and ask to speak with a Health Educator.

JoanTheurerJoan M. Theurer

Health Officer  |  Marathon County Health Department

Joan Theurer is a Health Officer with the Marathon County Health Department. Over the course of her career, Joan has been fortunate to work in a variety of community settings, from small rural communities in Clark County to urban communities in the Milwaukee area. She has an undergraduate degree in Child Development and Family Life, as well as Nursing, and a master’s degree in Community Health Nursing. Joan is a graduate of the National Public Health Leadership Institute, Chapel Hill, NC. She and her husband moved to the area over 20 years ago to be close to Nine Mile County Forest for skiing and the numerous great outdoor recreational opportunities the area affords.  Email Joan Theurer.

Brad Karger - Marathon County Administrator

Brad Karger

Marathon County Administrator

In his Administrator role, Brad Karger leads an organization with 700+ employees and an annual budget of more than $162 million. Brad has been in leadership positions with Marathon County for the past 30 years. He is known statewide for generating innovative ideas and solutions to problems, openness and transparency, and a commitment to community service that extends well beyond the normal workday.  Email Brad Karger.

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