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The health problems facing rural and urban poor in Illinois

Each year, researchers at the University of Wisconsin’s Population Health Institute put out the County Health Rankings. The rankings show how counties across the country match up on things like life expectancy and residents’ health.

Julie Willems Van Dijk is one of the directors.

“The reason we do it is to raise awareness about how healthy our communities are, and how healthy they’re not. To do so in a way that piques people’s interest by comparing them to other counties in their community. And ultimately in a way that helps everybody see … that health in your community is not just about what the doctors and nurses do. But it really is about decisions that are made by businesses, by government,” Willems Van Dijk says.

Most of the counties around Chicago do really well,  but Cook County is way down near the bottom - 75 out of 102 Illinois counties in health outcomes.

Twenty spots down the list from Cook is Edwards County. Edwards County ranks 96th of all Illinois counties for health outcomes. It’s worth looking at because unlike most of the sickest counties, it isn’t particularly poor. Edwards County’s poverty level is better than the state average.

“Income, and especially poverty are definitely drivers of health,” Willems Van Dijk says.

But that’s not what’s happening in Edwards County.

Edwards is due south from Chicago, down near where Illinois, Kentucky and Indiana meet. It’s incredibly sparse with just 30 people per square mile. The Illinois average is almost eight times as much.

Misty Pearson is the administrator of the Edwards County Health Office.

Edwards is one of only two counties in Illinois without an official health department. That’s why it’s called a health office, instead of a department of health like in almost every other county.

“We are not certified by the state of Illinois, by choice, I guess. Not my choice, I would change that if I could,” Pearson says.

The health office isn’t certified because Edwards County leaders are so against the state being involved in their county they refuse to take health funding from Illinois because it comes with strings attached - like state oversight.

“Food sanitation, we don’t have that. None of our restaurants are inspected. It does [make me nervous]. There are certain restaurants I won’t eat at,” Pearson says. “The only thing we can do that a health department does is vaccines for children.”

So Edwards County - despite its low health ranking and relative economic strength - isn’t the best indicator of the state’s health needs overall.

The state government can’t force people to vaccinate their kids or make counties take its money.

Still, experts say Illinois needs to come up with policies that work for Edwards County with 30-people per square mile, and Cook County with 5,500-people per square mile.

They say it can be done. Because despite their differences in population and demographics the two counties face similar health challenges.

At the top of the list is access to doctors.

The Illinois Department of Public Health has a map of areas with a dearth of primary care providers.

There are a lot of downstate counties shaded in - but there’s also a bunch of Chicago neighborhoods -- from Rogers Park up north to Austin on the West Side and Chicago Heights down south.

Harold Pollack with the University of Chicago says the state could help poor people in urban and rural areas by raising Medicaid rates, or just paying its bills on time.

“I can tell you that as someone who takes care of an adult on Medicaid that there are services that we can’t use because the providers that we’d like to use don’t accept Medicaid,” Pollack says.

So physician shortages might not be the happiest point of unity, but Misty Pearson in Edwards County and Harold Pollack in Chicago say they - and others - will be thinking of it when they go into the voting booth.

In a little more than a week there will be millions of people at the polls. They’ll each have different experiences and different expectations, but they’ll all be voting on the future of one state.

“How are we going to make these budget numbers work … and also pay for the services that people in the state actually want and will continue to demand,” says Pollack..

Patrick Smith is a WBEZ Reporter/Producer. Follow him on twitter @pksmid.

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