Across 24 measures, Mississippi ranked near the bottom or last when measuring health outcomes, health care access and health care quality.

New health data released today reinforces an all too familiar narrative of the counties in Mississippi: Those in the Delta struggle, while the affluent communities remain on top.

The County Health Rankings, a system that uses a variety of statistics to measure health factors and outcomes, listed Rankin as the healthiest county (unseating DeSoto, last year’s top county), with DeSoto and Madison as Nos. 2 and 3 in the rankings. Holmes, Coahoma and Quitman were ranked as the least healthy counties.

The data project is a collaboration between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, which started in 2011. Together the two organizations release annual rankings for each state’s counties. The project includes maps on its websites that lets users compare counties for each measure. Click here to see each county’s health ranking.

Those Mississippi counties ranking lower have higher rates of sexually transmitted infections and teen births, as well as a high ratio of people per primary care physicians.

While both STIs and teen births have decreased in Holmes, the county still has a higher per capita infection rate than other counties and a higher rate of teen births.

The assessment is divided into two fields: health outcomes and health factors. A county’s outcomes are measured by the length and the quality of one’s life; the quality component takes into account answers to surveys asking how many poor physical and mental health days a person has experienced recently, as well as the frequency of low birth weight.

A county’s health factors are comprised of wide-ranging inputs: They include traditional health barometers, such as obesity and smoking rates, as well as social and economic standards, such as child poverty and high school graduation rates.

“There’s definitely a strong correlation between economic opportunity and health, and across the state you’ll see that,” said Justin Rivas, a community coach with the Population Health Institute. “For example, in some of the lower-performing counties in Mississippi, the children poverty rate is very high, there’s a very low median household income, and that usually correlates to access to health care in terms of providing better health outcomes in the long run.

“What we’re ultimately talking about is the access to opportunity in these counties, which can be governed by economic opportunity that leads to health outcomes. Look at the median income in the upper (ranked) counties and the lower (ranked) counties and see how that translates to health.”

Census data supports the correlation: The median income in Rankin is $59,370, while in Holmes it’s $20,800, the lowest in the state.

Karen Matthews, president and CEO of Delta Health Alliance, said her organization is aware of the issues the report highlights in the Delta.

“Access to a primary care provider is an issue that affects many other aspects of health,” Matthews said. “Unfortunately, many Delta residents don’t have reliable access to a primary care provider and are not able to address symptoms before they worsen or get care for chronic conditions on a regular schedule.”

She added that the Delta Health Alliance is working to curb low birth weights and teen pregnancy with funding from state and federal grants.

“We are currently implementing a project with the Mississippi Department of Medicaid to prevent preterm births, many of which are low birth weight or to teens,” she said. “In the first years, we have brought the rate to even with the state level, with the program participants being recruited from patients flagged as having risk factors in their health records for preterm delivery. Almost all of these patients are African American. The disparity between African American and Caucasian births in Mississippi is stark and we are working to close the gap.”

The County Health Rankings report also includes data on racial disparity, and Rivas observed a wide gap in Mississippi regarding teen births and low birthweight, even in the overall healthier counties. In DeSoto, for instance, 7 percent of white births had a low birthweight while the rate was 13 for black births. In Madison, the white teen birth rate was 9 per 100,000 teenage females, while the number is nearly four times as high (34) for black female teens.

Rivas said the intentions of the rankings are to show what specific areas people can target to improve health at a local level.

“The reason why we provide these rankings is because they’re kind of a catalyst to take action,” he said. “There are things you can do within your state or your county or your community more locally that can change these indicators.”

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Alex Rozier, from New York City, is Mississippi Today’s data and environment reporter. His work has appeared in the Boston Globe, Open Secrets, and on In 2019, Alex was a grantee through the Pulitzer Center’s Connected Coastlines program, which supported his coverage around the impact of climate change on Mississippi fisheries.