Colorado Counties Vary Widely in Important Measures of Public Health

Colorado is, overall, one of the healthiest states in the country. But with the population growing both larger and older, one of the side effects is a widening disparity in the health ratings of the state’s 64 counties.

It's bingo night in Crested Butte at the Eldo Bar. Gunnison County tied for second in the state for the percentage of adults who binge drink, along with San Miguel and Routt counties.

Staff Photo / KBUT Radio

It\’s bingo night in Crested Butte at the Eldo Bar. Gunnison County tied for second in the state for the percentage of adults who binge drink, along with San Miguel and Routt counties.

Where you live in the state does make a difference.

Residents of the mountain communities on the Western Slope generally rank as the healthiest in Colorado, while residents in southeast Colorado and in the San Luis Valley report less healthy numbers, according to data released by the Robert Wood Johnson Foundation and analyzed by Rocky Mountain PBS News.

For Summit County Commissioner Dan Gibbs, the reasons the Western Slope counties score so well are right outside the front door.

“The amount of sunshine, the world class skiing, hiking, fly fishing, the ability to go right outside your backyard and experience nature,” Gibbs said.

He said the healthy atmosphere inspires people to move to the mountains and stay there. Gibbs has lived in Summit County for more than a decade, and said he’s not surprised to learn it’s listed as one of the top ten healthiest Colorado counties.

“People really believe in healthy living. When you’re at a restaurant or bar, people are always quick to say, ‘Hey what are you doing tomorrow? What kind of mountain bike do you have? Do you want to go hiking, fishing, or backpacking?’”

The Johnson Foundation report, released in 2015, looked at a range of factors, from smoking to binge drinking to obesity to premature death.

The RMPBS News analysis of the data found that five out of the ten healthiest counties were on the Western Slope, including Pitkin, home to Aspen, which ranked as the healthiest in the state. Douglas County, a Denver suburb, which also happens to be the wealthiest county in Colorado, scored second.

Healthiest Counties Colorado Counties

Years lost from premature deaths per 100,000 (Source: Robbert Wood Johnson Foundation)
CountyYears lost from premature deaths per 100,000
San Miguel3,445.25

Counties in other regions didn’t fare as well.

“We know that southeastern Colorado, for example, has been one of the most economically depressed areas in the state,” said Jeff Bontrager, director of research on coverage access for Colorado Health Institute, the Denver based non-profit. “Also, when you look at rural areas they may not have as many resources available, especially if it’s an economically depressed area.”

The least healthy of Colorado’s 64 counties included Huerfano, Conejos, Costilla, Las Animas and Rio Grande, all in or adjacent to the southernmost tier.

Along the Front Range, there are big health disparities. Both Adams County, 34th in the rankings, and Denver, 40th, were in the bottom half of the rankings. El Paso County was in the middle at 31st. Boulder County was the 4th healthiest.

“When you look at where counties ranked in terms of being healthy, it aligns so closely to the pattern that we see in poverty rates in the state,” said Sarah Hughes, research director for the Colorado Children’s Campaign, which tracks the health of Colorado kids. She said that it’s important for policy makers to take a broad look at health that would include everything from education to economic development.

“Just focusing on those things that we think of as being traditionally health-related, like health coverage, or access to healthy foods, won’t necessarily be enough to improve the overall health of Coloradans.”

Least Healthy Colorado Counties

Years lost from premature deaths per 100,000 Source: Robert Wood Johnson Foundation
CountyYears lost from premature deaths per 100,000
Las Animas10,846.51
Rio Grande9,151.37

Colorado has seen some positive trends. Smoking rates are going down, and over the last decade fewer teens have been sexually active and fewer are binge drinking. Colorado is still the thinnest state in the country, but that doesn’t show the whole picture.

“Although many people perceive Colorado being the healthiest state in the country, when you take a look down at the specific data about what’s making Colorado healthy and what’s making us not healthy, there are definitely areas for us to improve,” said Kyle Legleiter, the policy director for the Colorado Health Foundation.

“We have remained consistently the leanest state in the country for adults, but when we compare our adult obesity rate for this year to what it was back in 2006, our actual ranking for today would make us one of the most obese states ten years ago.”

And even the healthiest counties aren’t healthy in every measure. Take binge drinking. According to the analysis, only 9 percent of people in Lincoln County on the Eastern Plains and Rio Grande County in southwest Colorado binge drink. In healthy Summit County that number jumps to 33 percent.

“Anecdotally we do hear from grassroots network members in the mountain communities that they do see higher rates of drinking and substance abuse in their communities,” said Hughes. “(I’ve) kind of heard people attribute that to the vacation tourism atmosphere they have up there.”

The Johnson Foundation report also contains a category for “years lost because of premature death.” It’s an age adjusted calculation per 100,000 people of those who die before age 75. A person who died at 65, for example, would be adding 10 years to his or her county’s premature death total. Most counties don’t have 100,000 people, so the numbers are extrapolated.

The resulting range is a high of 11,968 years lost to premature death in Costilla County, to a low of 2,835 years in Pitkin County. The Johnson report cited the National Center for Health Statistics as the source for the mortality ratings, with the data coming for this component of the survey from the 2010-2012 files.

Meanwhile, this legislative session state lawmakers will be taking a closer look at how to lower the cost of health insurance. Fewer Coloradans are now covered through work, and in the mountain regions, the insurance rates are still among the five highest in the country.

To view the complete report with maps, please click here.


This report was produced in collaboration with Rocky Mountain Community Radio. Contact Bente Birkeland at

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