U.S. News, Aetna Foundation release 2021 Healthiest Communities rankings

The updated rankings underscore the impact of physical health on a community’s mental health.
Sandra Levy
Senior Editor
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U.S. News & World Report, in collaboration with CVS Health’s Aetna Foundation, is sizing up the health of America's communities for the fourth year running. This year’s rankings are accompanied by tools highlighting county-level COVID-19 vaccine rates and other pandemic data, as well as editorial explorations of equity and mental health. 

In the 2021 rankings, the top five healthiest communities score above the national average in at least eight of the 10 categories used in the analysis. New Mexico's Los Alamos County took the top spot this year, making it the first community to be ranked No. 1 twice. Los Alamos posted its highest scores in housing, population health and infrastructure. 

Douglas County, Colo., came in at No. 2, followed by Falls Church, Va., at No. 3. Loudoun County, Va., moved to No. 4 and Broomfield County, Colo., rounded out the list at No. 5.

“The coronavirus pandemic has inflicted deep wounds on multiple aspects of a community’s well-being from which it will take time to recover. A county’s population health metrics, including mental health, health outcomes and access to care, have been adversely affected, along with major hits to education, economy and equity,” said Kim Castro, editor and chief content officer at U.S. News & World Report. “This year’s Healthiest Communities rankings name not only the leading counties in the country, but also produce data reflecting other predictors of individual and community health as the country begins to recover.”

The 2021 rankings are accompanied by editorial pieces showing, for example, how many communities that face high levels of vaccine hesitancy score poorly on many other metrics of health. The U.S. News & World Report editorial team also explored issues of equity in Hennepin County, Minn. — a top 500 county that was the site of George Floyd’s murder by a police officer in May 2020 — and of mental health in Honolulu County, Hawaii, which posted the country’s highest score in that subcategory of the rankings, but faced unique challenges during the pandemic.

“Over the past year and a half, the COVID-19 pandemic has exacerbated several issues that we knew existed within the healthcare system, including the interdependence between the health of our communities and our personal health.” said Karen Lynch, president and CEO of CVS Health. “While our country appears to be turning a corner on the pandemic, with more people getting vaccinated every day, we understand that there is a lot of important work that still needs to be done to address the underlying community health issues that were brought to the forefront during the pandemic.”

Separate from the rankings, the COVID-19 tools, which track case numbers, death rates, unemployment and more, have been updated to include vaccine data. These tools complement the rankings data to reveal multiple correlations between the coronavirus pandemic and community health. Based on a U.S. News & World Report analysis, counties that performed well in the Healthiest Communities rankings have slightly lower COVID-19 case rates than average.

Some other key findings from the 2021 Healthiest Communities rankings include:

  • Overall, Iowa counties are most heavily represented in the top 500, with 61 counties in the state making the list;
  • No. 1 Los Alamos County had the 23rd-lowest COVID-19 case rate overall, with 2,721 cases per 100,000 residents over the course of the pandemic; and
  • Counties with higher total scores in the Healthiest Communities analysis scored well in measures of mental health, highlighting the connection between mental health and overall health and well-being.

The Healthiest Communities rankings and accompanying analysis are based on an evaluation of nearly 3,000 communities nationwide across 84 health and health-related metrics in 10 categories, from education and population health to infrastructure and environment. The project serves as a tool to inform residents, community health leaders and elected officials about policies and best practices for better health outcomes by assessing which communities offer their citizens the greatest opportunity to live a productive, healthy life.

To compile the rankings and create the overall Healthiest Communities project, U.S. News & World Report partnered with the University of Missouri Center for Applied Research and Engagement Systems, a research institution skilled in community health assessment. Overall, the rankings are based on metrics drawn from such sources as the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the U.S. Census Bureau and the U.S. Environmental Protection Agency. Much of the data used to compile the 2021 Healthiest Communities rankings came from periods predating the COVID-19 pandemic and would not have been affected by the pandemic’s impact on communities.

As a part of the 2021 Healthiest Communities rankings, U.S. News & World Report will be hosting the second annual Community Health Leadership Forum webinar series. Themes will cover lessons learned amid the COVID-19 pandemic, equitable vaccine distribution and addressing disparities in maternal health. The first webinar, featuring CVS Health's Lynch, will be June 30, with sessions continuing through the summer.

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