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Philadelphia’s rankings: good for visitors, bad for us

Philadelphia is ranked 14th among best cities for shopping, one of the 10 for families to visit, among the top 15 hottest cities of the future. The health of its residents, not so much.

Philadelphians gleefully share a lot of city rankings with pride. And why not: It's a great feeling to be part of this vibrant community! The Philadelphia Convention & Visitors Bureau notes that the city was ranked 14 among the"25 Best Cities for shopping." says we are among the "10 Best Cities for Families to Visit." We were named one of "The 15 Hottest American Cities of The Future" in 2012 by Business Insider. A recently derived Global Liveable Cities Index (GLCI) that studied various factors among people living in 64 cities around the world, ranked Philadelphia 20th for livability. And when The New York Times revealed its Top 52 Places To Go in 2015, Philadelphia was No. 3, after only Milan and Cuba. Hey, even the Pope is coming to visit us in September- we are on a roll!

Recently, the Robert Wood Johnson Foundation (RWJF) released 2015 County Health Rankings for jurisdictions around the country. The University of Wisconsin Population Health Institute produces the rankings using county-level measures (Philadelphia County and City can be used interchangeably) from a variety of national data sources that are standardized and combined using scientifically-informed weights. Let's just say that a lot more science is involved than that used to determine how great our shopping, burgers and ice cream are.

What makes a county healthy? The Rankings examined four types of health factors that influence our health: health behaviors; clinical care; social and economic; and physical environment. Creating what RWJF calls a culture of health involves so much more than good health care. In the County Health Rankings, each of the four types of health factors is based on a series of important measures. Social and economic factors include education, employment, income, and community safety. That means that universal pre-K, good public schools, a high employment rate, income equity, a decrease in poverty and safer communities will contribute significantly to our overall community health. It's all inextricably connected. Health behaviors include tobacco use, diet and exercise, alcohol and drug use, and sexual activity. Clinical care refers to access to health care and the quality of that care. Finally, physical environment includes air and water quality, along with housing and transit.

When it comes to health, Philadelphia ranked 67th of Pennsylvania's 67 counties. That's right, dead last. What's in a number? At the start, poverty and a public school system in crisis negatively impact the health of our city. The PEW Charitable Trusts' "Philadelphia 2015: The State of the City" report noted that Philadelphia has the highest poverty rate among the nation's 10 largest cities. (For details, search the report for "poverty"; you'll find plenty.) Among the 25 largest cities, only Detroit's poverty rate is higher. As for educational attainment, while there are signs that graduation rates may be improving, our public schools have a long way to go. Deep poverty and lack of quality education for all are tied to poor community health. All of us are impacted.

But don't despair, Philadelphia. Within the various measures we can still find promising improvements. A fact-filled 2014 Community Health Assessment done by the Philadelphia Department of Public Health noted improvements in over a dozen key health indicators over time. These included decreases in adult and youth smoking, adult and child obesity, and adult and youth sugary drink consumption. Correspondingly, there has been increased access to healthy foods and recreational facilities. There has also been a decrease in violent crime and firearm homicides among adults. The number of deaths in the city in 2013 (PEW again, PDF page 13) in the city in 2013, the last year for which statistics were available, was the lowest in at least a half-century. These improvements correspond to city policies and programs designed to foster good health. Despite impressive gains, however, there is still much to do. Some health indicators are moving in the wrong direction. For example, rates of diabetes, hypertension, and child asthma hospitalizations have increased consistently since 2000.

The County Health Rankings are not limited to simply showing us where we are now. The report also provides numerous evidence-based programs that can be incorporated into our city's roadmap to improved community health. Some of these programs are already under way and others are in various stages of planning. Philadelphia is a city of neighborhoods, and creating a healthy city involves us all. A recent poll (search the PEW report for "poll") found that 48% of Philadelphians feel the city is "headed in the right direction" and 67% think Philadelphia "will be better as a place to live five years from now." There's that number 67 again. A better place to live must also be a healthier place to live.

Best shopping, best burgers, best biking and wonderfully livable. Imagine the healthiest county/city in Pennsylvania. Heck, why not No. 1 in the nation? Now that would be something to gleefully share. Given the many factors that make up good health, everyone has a role to play in creating a culture of health for all Philadelphians. Let's get going.

Marla J. Gold is Dean Emerita and Professor of Health Management and Policy at Drexel University School of Public Health, and a member of the Philadelphia Board of Health.

Read more about The Public's Health.