2019 County Health Rankings

The annual County Health Rankings measure vital health factors, including high school graduation rates, obesity, smoking, unemployment, access to healthy foods, the quality of air and water, income inequality, and teen births in nearly every county in America.

This year’s report highlights secure, affordable housing, finding:

• Across the U.S., more than 1 in 10 households (11%) spend more than half of their income on housing costs (severe housing cost burden). Among those who own their home, housing cost burden has decreased in the past decade. At the same time, there has been no improvement in the rates among renters. Housing cost burden remains substantially higher among renters than owners, particularly for households with low incomes.
• Severe housing cost burden affects health and is linked to barriers to living long and well. Across counties, increases in the share of households severely cost burdened are associated with more food insecurity, more child poverty, and more people in fair or poor health.
• More segregated counties have higher rates of severe cost burden, for both White and Black households. However, Black residents face greater barriers to opportunity and health than White residents. Nearly 1 in 4 Black households spend more than half of their income on housing.
• Owning a home can, over time, help build savings for education or for other opportunities important to health and future family wealth. In large urban and smaller metro counties, the vast majority of households headed by Whites own their home, while more than half of households headed by Blacks are renters, rather than homeowners. In the past decade, trends in homeownership rates have changed little on average, though gaps among racial/ethnic groups are widening.