County health rankings reveal troubling trends in Twiggs, Bleckley, Wilkinson

Recently released data from the University of Wisconsin Population Health Institute shows that Twiggs, Bleckley and Wilkinson counties have worse health outcomes compared to Georgia and the United States. 

The report, County Health Rankings and Roadmaps, tracks and outlines factors that contribute to overall health in each county, including birth weight, physical inactivity, excessive drinking, teen births, employment, preventable hospital stays and number of health providers. 

In most of the 30+ categories measured, each of the three counties performs worse than both the state and country. 

Where rural Middle Georgia falls short

The rankings, for instance, measure premature death by total years of potential life lost. In Georgia, it is estimated that 8,900 years of life per 100,000 people were lost due to premature death. In Wilkinson County, which fared the worst among the three counties, 14,700 years of life were lost per 100,000 people.

Many factors in the data indicate potential issues in local communities that may need to be addressed. 

In Wilkinson County, a disproportionately high percentage of driving deaths involve alcohol — 36% compared to Georgia’s 20% and 26% for the U.S. 

Wilkinson County also has the highest percentage of adult obesity — a body mass index (BMI) of 30 or more — compared to Twiggs and Bleckley, both at 37%, but those counties’ percentages are higher than Georgia and the U.S. percentage of 34%.

The data gave Twiggs a drastically low figure for access to exercise opportunities at just 9%. The factor measures the percentage of the population with adequate access to locations for physical activity. The Georgia average is 74%. Bleckley has 75%, and Wilkinson doesn’t have enough data to provide a measurement.

All three counties have remarkably low access to healthcare professionals. There is only one primary care physician in Twiggs County. Bleckley and Wilkinson fare relatively better, but both are still much worse than the Georgia and U.S. figures. The U.S. average is one physician per 1,300 people.

“One contributor to the lower health rankings for counties compared to the state overall is the lack of local healthcare providers,” said Michael Hokanson, a spokesperson for the Georgia Department of Public Health in the North Central district. “(Twiggs) has a minimal health infrastructure with no hospital or emergency room to serve residents, and during emergencies patients must be transported to neighboring counties.” 

Following nationwide trends among rural communities, all three counties have a severe lack of practicing dentists. According to the Centers for Disease Control and Prevention (CDC) the percentage of adults who have visited the dentist at least once in the past year is higher among those in urban areas (66.7%) than in rural areas (57.6%).

The data appears to indicate Twiggs County has no dentists at all. Bleckley County has one dentist per 6,130 people, and Wilkinson has one per 8,680. The figure in Georgia is one per 1,860 and one per 1,360 in the United States.

Twiggs and Wilkinson counties have a notably higher number of injury-related deaths than Bleckley, Georgia and the U.S. The deaths included in this measurement include homicides, suicides, motor vehicle crashes, poisonings and other similar circumstances. In Wilkinson, there are 103 injury deaths per 100,000 people, and there are 104 in Twiggs. Bleckley meets the Georgia average at 73, lower than the U.S. average of 80.

Also of note is income inequality in Twiggs County. The ratio of household income at the 80th percentile (lower incomes) to income at the 20th percentile (higher incomes) is 7.7, a much higher figure than Wilkinson (5.7), Bleckley (5.3), Georgia (4.8) and the U.S. (4.9).

Many of these poor factors and outcomes for Twiggs, Bleckley and Wilkinson are due to being rural areas. Across the United States, folks in rural areas generally fare worse than people living in suburban or urban areas. 

One contributor to the lower health rankings for counties compared to the state overall is the lack of local healthcare providers. This is issues is especially apparent in rural counties. We can see in Twiggs county that, according to the County Health Rankings and Roadmaps, for the entire population of 7,860, there is a single primary care physician. The county has a minimal health infrastructure with no hospital or emergency room to serve residents, and during emergencies patients must be transported to neighboring counties. 

Areas where the counties exceed expectations

There are, however, bright sides to this data for the local counties. 

Twiggs has a high food environment index, meaning that people who live in the county have quality access to food. Bleckley and Wilkinson are around the Georgia average. 

In all three counties, a higher-than-average number of female Medicare enrollees ages 65-74 received an annual mammography screening. 

Bleckley and Wilkinson counties’ high school completion rates match up with both the state and country at around 89%. 

All three counties have more social associations — civic, political, religious, sports and professional organizations — than the average county. 

What can communities do to improve outcomes?

The researchers involved in the County Health Rankings and Roadmaps study have a section of their website, countyhealthrankings.org, devoted to methods to improve community outcomes that are scientifically backed. 

For the areas where Twiggs, Bleckley and Wilkinson struggle, some of these action items include building social support for physical activity, comprehensive risk-reduction sex education, healthy school lunch initiatives, alcohol taxes, and financial incentives for health professionals to move to underserved areas.

One of the recommended actions — providing medical care at schools — is already taking place in the Twiggs County Schools Wellness Center. The school is providing low-cost medical care to the community. Students from the Central Georgia Tech’s dental hygiene program come to the clinic to perform cleanings periodically, and patients with more serious dental problems can receive a referral. 

“What I learned when I became superintendent was we had no full-time medical, no full-time dental or full-time mental health services in our community, and this was at the time of Covid, so we had many of our students who were suffering with asthma-related symptoms, grief, mental health issues related to grief and stress,” Twiggs schools Superintendent Mack H. Bullard told the Times Journal Post in September.

The Georgia DPH North Central district uses data and surveys to address public health gaps in local communities. Twiggs and Wilkinson counties fall under the North Central district, while Bleckley is under the South Central district’s jurisdiction.

A survey conducted among people in the North Central district for 2022 showed that the community’s largest concerns include access to care, chronic disease and health inequities.