Report: Suburban Maryland Excels in Health Care Access, Lags in Air Quality

Capital News Service
WASHINGTON – Howard County may be the healthiest county in the state, according to a report released Wednesday, but it still faces challenges from environmental pollution.

County Health Rankings, a nonprofit funded by the Robert Wood Johnson Foundation that ranks counties by health status, found that while Howard County posts the lowest numbers of sexually transmitted infections and teen birth rates, the wealthy jurisdiction places seventh in the number of air pollution-ozone days.

Dr. Patrick Remington, co-director of Mobilizing Action Toward Community Health — a Johnson Foundation project — said during a conference call that this reality points to a growing trend in Maryland as well as nationwide: Suburban communities with the highest quality of health care still have to contend with poor environmental conditions when considering their citizens’ health.

“It’s important to understand that each county is different and to then think about what can be done to make improvements,” Remington said. “You can’t reduce air pollution without addressing the automobile and our reliance on it.”

Each type of community has its issues, Remington said. For urban communities, it’s high teen pregnancy rates and poor access to healthy foods; for rural communities, it’s high rates of obesity and unemployment; and for suburban areas, it’s poor air quality.

Julie Willems Van Dijk, associate scientist at the University of Wisconsin Population Health Institute, said different factors contribute to the pollution problem in Maryland’s suburbs, with high vehicular volume among the chief offenders.

“It’s definitely a contributor,” said Van Dijk. “People often say, ‘There’s nothing we can do about that because the EPA is in control of monitoring the air.’ Yeah, that’s true, but we have the opportunity in a democratic nation to talk with our elected officials.”

Its proximity to Baltimore and Washington, said Dr. Peter Beilenson, health officer of Howard County, also makes the county vulnerable.

“It makes sense to me,” said Beilenson. “The wealthiest suburbs in the U.S. are around major cities, so they tend to have more air pollution.”

Despite the pollution problem, Beilenson said he’s happy with Howard County’s distinction as a health leader.

“Obviously, we’re very pleased. We’ve been the healthiest county for two years in a row now,” he said. “Social determinates play a huge role in that, as does our Healthy Howard initiative.”

Social determinants refer to living conditions shaped by the distribution of money, power and resources. Howard County has plenty of the three, given that it’s the third-richest county in the country. Healthy Howard is a community-based effort aimed at improving the health and living conditions of Howard County residents.

Van Dijk said location and personal experience also determines whether air pollution is a serious concern.

“If either you or your child has a respiratory disease like asthma, then air pollution is a particular problem,” she said.

Howard County’s ozone day count is only three less than that of Baltimore City, the Maryland region with the worst health ranking, according to Prince George’s County had the highest number of ozone days at 29, while Allegany County had none.

County Health Rankings found that Eastern Shore jurisdictions like Somerset and Wicomico, two of the lowest-ranked counties due in part to relatively high substance abuse and single-parent household rates, had three and four ozone days respectively, far less than Howard.

Still, compared to other health concerns in Maryland, Van Dijk said, air pollution ranks relatively low.

“It’s weighted at 2.5 percent in comparison to other health factors on our ranking methodology chart,” she said.

While Howard County is the healthiest county in Maryland, Baltimore City sits at the other end of that spectrum. County health rankings from greatest to least are as follows: Howard, Montgomery, Frederick, Queen Anne’s, Carroll, Calvert, Talbot, St. Mary’s, Harford, Anne Arundel, Charles, Garrett, Washington, Worcester, Baltimore County, Kent, Prince George’s, Cecil, Caroline, Wicomico, Somerset, Dorchester, Allegany and Baltimore City.

The rankings are available for free at, and give users a view into each county and independent city in Maryland with a color-coded, easy-to-navigate map that compares each local jurisdiction’s overall health ranking.

Measures used to assess the level of overall health or “health outcomes” include: the rate of people dying before age 75; the percentage of people who reported being in fair or poor health; the numbers of days people reported being in poor physical or mental health, and the rate of low-birth weight infants.

Aside from pollution levels, researchers also considered health factors like adult smoking, adult obesity, teenage births, preventable hospital stays, access to healthy foods and community safety.

When it comes to protecting the air, individual choice, Van Dijk said, also plays a big role.

“Each individual person can make decision depending on where they live,” she said, “for instance, if there’s an opportunity for carpooling or public transportation.”

Van Dijk urged collaboration between leaders and communities as a solution to air pollution and other health concerns.

“We need grassroots as well as grasstops organization,” she said. “In Maryland as well as everywhere else, we need to see what we can do with existing resources.”