Marathon County Continues to Be a Leader in Wisconsin for Health

Written by Joan Theurer & Jenna Flynn

The 2021 County Health Rankings were released on March 31. Every year, we at the Marathon County Health Department wait in anticipation to see how we’re doing as a county in terms of our health in comparison to other counties both in and outside of Wisconsin. We view the Rankings like getting an annual “check-up” for our county — we get a baseline of our health and areas to pay attention to in the coming year.

County Health Rankings - logo

The Rankings are the result of a partnership between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. Professionals in the County Health Rankings & Roadmaps program use a standard way to measure factors that influence how long people live and how well they live and then rank the health of counties in all 50 states. More than 30 measures are included in the results and can be used to help communities understand how healthy their residents are today (Health Outcomes) and what will impact their health in the future (Health Factors).

So, how did we do for our 2021 annual health check-up? I’m happy to report:

Marathon County continues to be among the healthiest in Wisconsin!

In fact, as you can see in the graphic below, Marathon County ranked in the top quarter for both metrics: health outcomes (17 out of 72 counties) and health factors (14 of 72).

Marathon County Health Outcomes & Health Factors

Screen capture of Marathon County 2021 Health Rankings as determined by the County Health Rankings & Roadmaps program.

The good news is that for the past several years, Marathon County has been — and continues to be — in the top quarter or third of the 72 counties: 14 in 2020, 22 in 2019, 14 in 2017, and 16 in 2016. Keep in mind, our ranking is based on what is happening in our county in relationship to other counties in Wisconsin. Marathon County has gone on record in working toward being the healthiest, safest, and most prosperous county — Being among top counties demonstrates our commitment in achieving this goal.

For the first time, the report this year highlights our strengths, as well as our opportunities to improve, among health factors measured in comparison to the nation, analyzing data from a single year or multiple years. (Explore the County Health Rankings Model.)

For example, in terms of our health as a community, the following factors scored well (low or high, as appropriate) for Marathon County:

  • Percentage of adults age 20 and over reporting no leisure-time activity
  • Percentage of driving deaths with alcohol involvement
  • Number of births per 1,000 female population age 15–19
  • Percentage of population under age 65 without health insurance
  • Ratio of population to primary care physicians
  • Percentage of female Medicare enrollees ages 65–74 that received an annual mammography screening
  • Percentage of fee-for-service Medicare enrollees that had an annual flu vaccination
  • Percentage of adults ages 25 and over with a high school diploma or equivalent
  • Percentage of adults ages 25–44 with some post-secondary education
  • Percentage of people under age 18 in poverty
  • Ratio of household income at the 80th percentile to income at the 20th percentage
  • Number of deaths due to injury per 100,000 population

We have opportunities for improvement in:

  • Percentage of adults who are current smokers
  • Percentage of the adult population (age 20 and older) that reports a body mass index (BMI) greater than or equal to 30 kg/m2
  • Percentage of adults reporting binge or heavy drinking

An annual check-up provides us the opportunity as a community to build upon our strengths while continuing our efforts to make improvements. Together, we can improve the overall health of the communities we live, learn, work, and play in. And, as a Health Department, we can work toward our goal of becoming the healthiest, safest, and most prosperous county in the state of Wisconsin, as outlined in our 2018–2022 Strategic Plan.


In order to understand the Rankings in full, we invite you to read on to see answers to some of the most commonly asked questions about the results or to view the short explanatory YouTube video below.


Health Outcomes are factors that influence “how healthy residents are today,” such as the following:

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


Health Factors are factors that “influence the health of residents in the future” (NOTE: Areas of strength and opportunities to improve are highlighted), such as follows:

  • Health Behaviors
    • Tobacco Use — adult smoking
    • Diet and Exercise — adult obesity, food environment index, physical inactivity, access to exercise
    • Alcohol and Drug Use — excessive drinking, alcohol-impaired driving deaths
    • Sexual Activity — sexually transmitted infections, teen births
  • Clinical Care
    • Access to Care — uninsured, primary care physicians, dentists, mental health providers
    • Quality of Care — preventable hospital stays, mammography screening, flu vaccinations
  • Social and Economic
    • Education — high school completion, some college
    • Employment — unemployment
    • Income — children in poverty, income inequality
    • Family and Social Support — children in single-parent households, social associations
    • Community Safety — violent crime, injury deaths
  • Physical Environment
    • Environmental Quality — air pollution-particular matter, drinking water violations
    • Housing and Transit — severe housing problems, driving alone to work, long commute-driving alone


Screen capture of County Health Rankings Interactive Model.

Q. What do the Rankings tell us about our community?

The Rankings inform 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. People living just a few blocks apart may have vastly different opportunities to live a long life in part because of their neighborhood, according to the Robert Wood Johnson Foundation. Use their tool HERE to explore how life expectancy in America compares with life expectancy in the area you live.

Below you can see from screen captures pulled from their online tool how life expectancy differs right here in Wisconsin between Marathon County (80.43 years) and Forest County (74.84 years).

Marathon County Image Life Expectancy 2021-04-22


Forest County Image Life Expectancy 2021-04-22

The data for census tracts, counties, and states are for 2018; national-level life expectancy estimates are drawn from provisional data for 2020.

The Rankings look at many factors that contribute to making communities healthier places. It’s important to remember, as our communities have suffered in many ways this year, those who came into the pandemic with the fewest opportunities are likely to exit it with an even greater burden.

Q. Does the 2021 rank reflect the impact COVID-19 had on our county?


The data that was used to calculate ranks for the 2021 Rankings are from 2019 and earlier. COVID-19 has likely worsened disparities and will have an impact on measures such as unemployment, children in poverty, income inequality, premature age-adjusted mortality, food insecurity, and severe housing cost burden.

Q. Why do ranks change?

There could be a number of reasons why ranks change:

  • The county experiences health gains or losses.
  • Other counties around the one in which you live experience gains or losses.
  • There could be random variations in the measures.
  • There could be changes in the methodology of a measure.

It’s importatnt to look beyond improvement in the actual ranks and take a look at each ranking to paint a picture of our current assets and challenges when looking at the health of our Marathon County communities.

Q. What counties in Wisconsin are the healthiest for 2021?

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

Q. What can the average person do with this information?

Anyone can help spread the word about the Rankings. For example, people can:

  • Reach out to friends and colleagues about the County Health Rankings report.
  • Visit the County Health Rankings website,, to find resources and tools to take action.
  • Follow the County Health Rankings on Facebook and Twitter and let friends and colleagues know about the Rankings through social media.
  • Write an op-ed or talk to local media about the Rankings and what needs to be done to improve the health of your community.
  • Meet with local leaders and community residents to discuss barriers to health and ways to overcome them. Host a virtual town hall meeting or invite people to participate in one.
  • Get together with local partners and engage with our Action Learning Guides to dig into specific topics with a blend of guidance, tools, and hands-on practice and reflection activities.
  • Use the Partner Center to learn about how to take steps to partner with other community members and leaders.
  • Sign up for the newsletter to get updates on new learning opportunities, examples and stories, and strategies.

Q. What are we doing as a community to be the healthiest county in Wisconsin?

The Rankings inform us where we need to focus our community efforts to be among the healthiest counties in Wisconsin. The findings support the Marathon County Community Health Priorities and the LIFE Report Calls to Action.

If interested in learning about the latest data for Marathon County, I encourage you to visit Marathon County Pulse. While we ranked among the healthiest across the state, this report helps us identify areas for improvement. Some groups in our community may not be doing as well as others. We know there are stark differences in health and opportunity, particularly among communities of color and lower income communities. It is important to bring partners together to address the disparities that exist in Marathon County so that all in our community have the opportunity to thrive.

Creating healthy communities is everyone’s business. Good health allows people to fulfill their potential to thrive. Marathon County is fortunate to have strong partnerships across diverse sectors committed in creating a culture of health where all people enjoy the opportunities to live, learn, work, and play in a healthy community.

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.

Jenna_FlynnJenna Flynn

Public Health Educator | Marathon County Health Department

Jenna Flynn is a Public Health Educator with the Marathon County Health Department. Jenna holds a bachelor’s degree in Sociology and a master’s degree in Public Health. She grew up in Northern Wisconsin and is proud to serve the central region. In her free time, Jenna enjoys reading, spending time with her family, cooking, and participating in the many outdoor activities that Wisconsin has to offer. Email Jenna Flynn.

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