VCU Center on Human Needs Launches New Version of County Health Calculator

Online app shows impact of education and income on health

The Virginia Commonwealth University Center on Human Needs, together with the Robert Wood Johnson Foundation, today unveiled a new version of its County Health Calculator, an online simulation tool that shows how greatly health would be improved if a county, state or the nation had the health benefits that exist in areas with higher levels of college education or income.

The County Health Calculator was developed by researchers at the VCU Center on Human Needs and a data team at the VCU School of Medicine Department of Biostatistics. The interactive tool allows users to move a slider bar to examine how socioeconomic conditions - in the United States, or a specific state or county - are linked to the risk of death or of developing chronic diseases.

The tool focuses on diabetes, a condition of growing prevalence in the United States, and demonstrates how education and income are related to both the prevalence of diabetes and the costs of medical care for the condition. 

“A community and its leaders can use this tool to see how social policies, such as education or economic growth, have a connection to epidemic diseases like diabetes that are driving up medical spending and costing lives,” said Steven H. Woolf, M.D., M.P.H., director of the VCU Center on Human Needs and professor in the Department of Family Medicine.

“Governors who cut spending on education to pay for Medicaid may be missing the point.  As a society we need to keep remembering that health is determined by far more than health care,” he said.

According to Woolf, factors such as education and income – which are the two variables highlighted in this project – along with neighborhood conditions and the community environment exert significant influences on health outcomes, possibly more so than healthcare.

“We developed the Calculator to drive that message home. It illustrates that people live longer and in better health in places where there is more education or higher incomes,” he said.

The tool released today is an upgrade of an earlier version released last year that only looked at the effects on mortality, whereas this tool also measures effects on diabetes and costs.  The County Health Calculator project builds on earlier work by Woolf and Johnson, who in 2008 released the Education and Health Calculator.  That tool, also funded by the Robert Wood Johnson Foundation, only looked at the effects of education. The upgraded tool released today represents a steady progression in sophistication at the VCU Center on Human Needs in using web tools to raise public awareness about social determinants of health.  VCU biostatisticians developed a regression equation based on data from more than 3,000 counties, which generates the projections shown by the Calculator.

Woolf added that the focus on income is not restricted to poverty.

“The tool measures the percentage of Americans with incomes that are more than 200 percent of the poverty level – the middle class and the wealthy. The message applies to rich or poor: income, education, and the opportunities they bring, are not just important for jobs and livelihoods – they are important for health,” he said.

Earlier today, the Robert Wood Johnson Foundation released the 2012 County Health Rankings, a sister project by the University of Wisconsin Population Health Institute. The rankings provide a snapshot of community health for more than 3,000 counties in the United States. Loudoun County ranked number one in the state. According to the Calculator, if Richmond City had the income level of Loudoun County, 55 percent of deaths could be averted.

Both projects were supported by grants from the Robert Wood Johnson Foundation.

The County Health Calculator project is coordinated by Amber Haley, M.P.H., research epidemiologist at the VCU Center on Human Needs, and a team at the VCU Department of Biostatistics including associate professor Robert E. Johnson, Ph.D., Chunfeng Ren, M.P.H., and Brian Bush, MSMIT, database manager. Forum One, a web developer in Alexandria and Burness Communications in Bethesda, Md. also collaborated on this work.