Living Well

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A diagnosis of America's healthiest places. Manhattan ranks as one of the healthiest places in the nation. Yes, you read that right. The concrete jungle of New York City outranks the pristine countryside, as one of the healthiest places in America, according to market research firm MedStat. In fact - with apologies to Oliver Wendell Douglas of Green Acres - those who live in big metro areas not only rate themselves as pretty healthy, but are considered healthier than their rural counterparts.

How is that so? MedStat polled 100,000 Americans, and asked them a series of questions - such as how often they eat fruits and veggies, how often they smoke, the types of diseases they suffer from (diabetes, arthritis, etc.), and how they rate their overall health. The company then combined the answers to create an overall health ranking (ranging from Excellent to Poor) for the nation's 3,140 counties. Turns out counties with an Excellent or Very Good overall health rating (shown in red) are almost always in a major metro area (typically called Metropolitan Statistical Areas or MSAs), and have an average population of 367,559. Counties with a Poor rating (shown in green) are typically rural, and have an average population of 16,826.

Judging by the accompanying map, the nation as a whole, is looking a little green. But in actuality, the U.S. population has a relatively healthy glow. While 68.6 percent of the nation's counties have a health rating of Fair or Poor, only 34.8 percent of Americans are diagnosed with Fair or Poor health. This vast disparity is due in large part to the fact that only a small share (27 percent) of the country's total population resides in these unhealthy counties. The remainder of the overall population (65.2 percent) is considered to be in Good, Very Good, or Excellent health, even though 31.4 percent of all counties can claim the same. And 73 percent of U.S. residents live in a Good to Excellent-rated county.

Those who are healthy also appear to be wealthy and wise. The average household income in counties with an Excellent or Very Good overall health rating is $55,632, $15,741 above the national average of $39,891. Households in counties with a Poor overall health rating earn on average $16,896 less than the national average. As for educational attainment, the average number of years of school completed by a person residing in a county with a top health rating is 13.9 compared with 12 years for denizens of counties with Poor health.

Additionally, those who live in healthier areas generally have more physicians to choose from per capita. For example, Santa Clara County, California, with an overall health status of Very Good, has 1,150 physicians' offices, according to the 1997 Economic Census, to serve a population of 1.6 million. That equals one physician's office per 1,409 people. Whereas Wayne County, Michigan, with an overall health rating of Fair has 1,101 physicians' offices for its population of 2.1 million - resulting in significantly fewer treatment facilities per capita: One office per 1,933 residents. But the waiting rooms in Apache County, Arizona are even more packed. With only five physicians' offices to serve 68,562 people, there is only one office for every 13,897 people. Apache County ranked Poor for overall health in MedStat's ratings.

Those in the healthier hot spots are increasingly taking matters into their own hands. Vic Corsiglia, a physician with the San Jose Good Samaritan Medical Group in San Jose, California says that the healthy residents of Silicon Valley are quicker to seek out specialists such as dermatologists and chiropractors, as well as alternative medicine practitioners like acupuncturists. They're learning a lot about their health from the Internet. "[The Internet] drives people to ask questions," says Corsiglia. "They'll come in and say, `I saw this on the Internet. What do you think?'"

But Corsiglia has neither a Web site nor an e-mail address for his patients to access. In fact, many physicians are missing the e-boat, according to Cyber Dialogue. While just 4 percent of online users currently access a Web site operated by their doctor's office, 50 percent would be interested in doing so. Of that group, 29 percent would consider switching doctors for the opportunity to communicate with their physician in cyberspace.

That kind of healthy consumerism spills over into products as well. Rick Birken, general manager of Cash Grocer Natural Foods in suburban Alexandria City, Virginia isn't surprised his county received an Excellent rating - one of only four counties in the country to do so. "The young people are buying produce and organic foods, while the older customers are buying vitamin supplements," says Birken. What's on the store's bulletin board? Plenty of flyers for Yoga classes, chiropractors, massage therapists, and acupuncturists. Go figure.

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