Douglas, Washoe and Storey rounded out the top three highest-ranking Nevada counties for health outcomes in a new report through the County Health Rankings and Roadmaps program, which highlighted how certain problems — including the severity of the housing crunch in the north and the scarcity of child care in the south — are hitting some regions harder than others.

The program, which measures the health of residents in nearly every county in the country, assessed data across a multitude of factors that affect health outcomes, including health behaviors, clinical care, and social, economic and physical environment. Established by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, the goal of the program is to improve health outcomes and to close the health disparities between people of different socioeconomic statuses. 

While Washoe County ranked well in terms of the percentage of adult smokers, adult obesity and child poverty, it received poor rankings regarding housing problems such as overcrowding and high housing costs. The county received Nevada’s second-highest ranking in residents experiencing housing problems at 17.9 percent — behind Clark County at 19.5 percent. 

“As a county, we are making great strides in public health but there is still much to accomplish,” Kevin Dick, District Health Officer in Washoe County, said in a press release. “Working with partners in the community, we can use these rankings and the data behind them to identify and address barriers to healthy lives for residents of Washoe County.” 

To address the issue of housing, Mary Jane Ostrander, division manager at the Carson City Human Services Division (CCHS), said at a community meeting that her agency will lease properties to be used as shared housing. Using a federal Housing and Urban Development grant that will take effect on Oct. 1, three to five individuals will be housed together in a unit until they can find their own places. 

Ostrander said the Northern Regional Behavioral Health Housing Subcommittee will review opportunities to provide supportive housing for people with behavioral health issues. She added that a nonprofit organization called JUST in HOPE Foundation is fundraising and planning to build Northern Nevada’s first housing project specifically for adults with intellectual and developmental disabilities. 

Rayona Lavoie, a management analyst at the Washoe County Health District, said the Eddie House (a shelter for homeless, runaway, foster and other at-risk youth) received funds from the Washoe County Health District in 2021, which helped increase the number of transitional age youth served through the community-based living program. 

“Outreach efforts have expanded into motels and they’ve also partnered with Washoe County Jan Evans Juvenile Justice Center to make sure that individuals are getting care and services,” Lavoie added.

Lavoie said the Eddie House accommodated about 300 youths and of those individuals, 18 percent had an increase in employment, and eight transitioned to stable housing. 

Public health officials at the Washoe County Health District called for more emphasis on eradicating food deserts and improving access to youth services, education and employment, as many of the public health issues have been overshadowed by the pandemic for the past two years. 

“If there’s been one of those silver linings of the pandemic, it’s that it shined a light on the role that structural racism and discrimination play in affecting health outcomes in every community,” Dick said. 

Clark County, which ranked sixth for overall health outcomes in Nevada, faces a different set of challenges, including the need to improve child care cost burdens for families. 

Additionally, the percentage of children in poverty (18 percent) was twice as much as the top-performing counties in the country (9 percent). And other social determinants such as school funding adequacy and school segregation — the extent to which students within different race and ethnicity groups are evenly distributed across schools — indicated the county lags far behind the 90th percentile. 

In Clark County, a family with two children spent an average of 30 percent of its household income on child care, whereas the highest-ranked counties in the country are spending only 18 percent. The report also stated that Clark County only has two child care centers per 1,000 people under 5 years old whereas the top-performing counties have 12 on average. 

The disparities in child care cost burden were especially stark between different races and ethnicities, considering a median household income for a Black family in Clark County is $41,900, while a white family has a median income of $69,000 and an Asian family has a median of $70,000. 

Since last year, the Southern Nevada Health District (SNHD) has initiated four strategies to address health disparity using the $22.6 million in funding provided by the Centers for Disease Control and Prevention. SNHD is planning to expand COVID testing services to at-risk or rural communities, improve data collection and recording, expand community capacity to provide equitable access to health resources and services and develop culturally appropriate educational information and campaigns. 

“We are ‘attempting’ to reach health equity and I use that verbiage because it would be a very big thing to achieve,” said Maria Azzarelli, manager of the district’s office of chronic disease prevention and health. “When you achieve health equity, each person has a fair and just chance for optimal health. It involves acknowledging that each segment of our population has differing levels of disparities.”