A well-known ranking of healthiest counties showed Routt County dropped from fifth place in 2020 to 10th in 2021 and to 53rd in 2022 rankings of Colorado counties, with much of that decrease related to a decline in housing factors.

One reason the county’s online ranking — produced by U.S. News & World Report — fell can be attributed to a current low score of 33 (on a scale of 1-100) in housing factors, as compared to national averages. That same housing factor number was 62.3 in 2020.

According to latest U.S. News & World Report rankings, 33.8% of Routt County households spend at least 30% of their income on housing compared to the national median of 22.8%. In the county, residents need to work 50.3 hours per week to pay for affordable housing compared to the national median of 40.6 hours. The national median for “vacant houses” is 16.3% but 40.5% in Routt County.

Routt County Public Health Director Roberta Smith, in the role since July 2020, said housing is an important social determinate of public health.

“We realize that when you don’t have access to housing, there is a trickle-down effect to public health,” Smith said.

The Healthy People 2030 Framework released by the U.S. Office of Disease Prevention and Health Promotion highlights five areas of social determinants of health including economic stability, education access and quality, health care access and quality, neighborhood and built environment and social and community context.

Smith along with Fritha Morrison, epidemiologist and data manager, said the methods and data sources for U.S. News & World Report are not readily apparent. So, they put more stock in the County Health Rankings released through the University of Wisconsin Population Health Institute. In those institute rankings, Routt rose one position from last year to rank fifth in 2023 among the 59 rated counties in Colorado, as determined by selected health outcomes and health factors. Through the past 10 years, the institute has rated Routt in a range of fourth to 12th in health outcomes and factors.

The County Health Rankings notes that 16% of individuals in Routt are spending 50% or more of their household income on housing, and that percentage of spending is considered a severe housing cost burden. Also, 15% of households in Routt experience at least one of four issues: overcrowding, high housing costs, lack of kitchen facilities or lack of plumbing facilities.

The institute ranks Moffat County as 41st out of the 59 rated Colorado counties this year, and Moffat has been ranked varying from 31st to 47th since 2013. For health outcomes, Moffat is ranked this year in the lower middle range of Colorado counties in the 25%-50% category. For health factors that can be modified to improve the length and quality of life, Moffat is ranked “among the least healthy counties in Colorado” in the 0%-25% category.

The health outcomes consider factors ranging from low birth weight to poor physical or mental health days to length of life. Health factors measured include adult smoking, obesity, physical activity, excessive drinking, teen mom births, mental health providers, preventable hospital stays, children in poverty, income inequality, air pollution and many more factors.

By comparison, the healthiest counties in Colorado are spread largely across the central and northern mountain communities, with Douglas and Pitkin counties ranking first and second respectively. The least healthy counties are located largely in the southeastern section of Colorado. Jackson County is not included in the rankings.

On July 17, Routt County Public Health leaders presented the draft 2024-2028 Public Health Improvement Plan to the Board of County Commissioners. Every five years, the Colorado Department of Public Health and Environment works with partners across the state to assess how Colorado is doing in regards to health and environment through the process of community health assessments and public health improvement plans.

The 2024-2028 improvement plan in Routt was built on the foundation of the Yampa Valley Community Health Needs Assessment that was completed in 2022. The new plan identifies four focus areas: adult behavioral health including mental health and substance use or abuse, youth behavioral health, healthy housing, and access to healthy and affordable food.

The Moffat County Public Health Department also presented its new Public Health Improvement Plan to the Moffat County Commissioners in July. The main areas of concern in the Moffat plan include substance use disorder, behavioral health, suicide prevention and affordable housing.

The Moffat department has three full-time staff including Executive Director Becky Copeland, a registered nurse, as well as a public health nurse and administrative assistant. In August, Moffat County hired Dr. Kevin Fitzgerald as the public health medical director. Fitzgerald is based in Grand Junction and also serves at the public health medical director for Mesa County.

Routt County Public Health was established as a stand-alone department in June 2019 with one shared public health director dividing time between Routt and Moffat counties, an arrangement that lasted about one year. Before that, the public health role lived at nonprofit Northwest Colorado Health.

The Routt department has grown to employ an epidemiologist and data manager as well as a public health nurse, emergency preparedness and response coordinator, public health educator and office technician. Dr. Brian Harrington serves as the county public health officer.