County Health Rankings & Roadmaps (CHR&R) brings actionable data, evidence, guidance, and stories to diverse leaders and residents so people and communities can be healthier. The University of Wisconsin Population Health Institute created CHR&R for communities across the nation, with funding from the Robert Wood Johnson Foundation.
This report will highlight how access to opportunity and economic security is both tied to residents' health and variable depending on their location within your state.
Growing Healthy Places Means Ensuring Opportunities for All
Communities thrive when all people can be healthy in their neighborhoods, schools, and workplaces. CHR&R brings actionable data and strategies to communities working to ensure that healthy places are available to all. This report highlights how health outcomes and health factors differ by place within Washington. We also outline how economic security – or the ability of individuals, households, and communities to meet basic needs with dignity – is important to health. We call attention to childcare cost burden as a barrier to economic security and health.
Growing Community Power to Improve Health and Equity
The Take Action to Improve Health section of the CHR&R website helps communities find tools and guidance to take action, select evidence-informed strategies, and make lasting changes. Take Action to Improve Health is a hub for information to help improve a community’s health and foster health equity. Find resources including:
- What Works for Health, a searchable menu of evidence-informed strategies.
- Action Learning Guides, self-directed learning modules that combine guidance, tools, and reflection activities.
Using Data to Improve Health Equity
Data show a persistent pattern across the country in barriers to opportunity for people with lower incomes and for people of color. Differences in the opportunities available to different groups of people are related to unfair policies and practices.
Our progress toward health equity will be measured by how health disparities change over time. Explore our website to learn more about:
- Health outcome and factor measures for your state and county.
- Measures with data available by race and ethnicity to illuminate differences in opportunities for health.
- Additional data resources for Washington that provide information about health and opportunity by age group, gender, and zip code.
What are Health Outcomes?
How Do Counties Rank for Health Outcomes?
The green map shows Washington’s health outcome rankings by county. The map is divided into four quartiles with less color intensity indicating better health outcomes. Specific county ranks can be found in your Washington state overview.
What Do Differences Between Ranks Mean?
Counties are ordered by the health outcome rank, with a top-ranked county (rank = 1) having the best health outcome score. Ranks are good for sparking conversations, but they do not show differences in health within counties or describe the magnitude of difference in community health experienced between ranks. The chart next to the map shows the spread of health outcome scores (ranks) for each county (green circles) in Washington. This graphic shows the size of the gaps between ranked counties. The background colors correspond to the four quartiles used in the map.
Figure 1. Health outcome ranks displayed using quartiles (map) and underlying health outcome scores (chart)
What are Health Factors?
How Do Counties Rank for Health Factors?
The blue map shows Washington’s health factor rankings by county. The map is divided into four quartiles with less color intensity indicating better health factors. Specific county ranks can be found in your Washington state overview.
What Do Differences Between Ranks Mean?
Counties are ordered by the health factor rank, with a top-ranked county (rank = 1) having the best health factor score. The chart next to the map shows the spread of health factor scores (ranks) for each ranked county (blue circles) in Washington. This graphic shows the size of the gaps between ranked counties. The background colors correspond to the four quartiles used in the map.
Figure 2. Health factor ranks displayed using quartiles (map) and underlying health factor scores (chart)
Economic Security is Key to Thriving Communities
Economic security enables families to cover basic needs such as housing, education, childcare, food, and medical care. Each of these needs has demonstrated ties to health. However, economic security is not equally accessible to all people. When a single household expense consumes the majority of a paycheck, it becomes difficult to meet competing needs and can force households into tough decisions like choosing between quality childcare, paying rent, and purchasing nutritious food. Individuals, households, and communities deserve the opportunity to meet basic needs with dignity. Advancing a just recovery from the COVID-19 pandemic, and the layered impacts of racism and economic exclusion, requires intentional action to ensure all people and places have what they need to thrive. Check out policies and programs that can be implemented in your community at What Works for Health.
Childcare Cost Burden in Washington and the U.S.
Childcare cost burden measures the percentage of household income needed to pay for childcare. When childcare is affordable and accessible, it can support parents’ and guardians’ ability to participate in paid work and can provide lifelong benefits to children. The U.S. Department of Health and Human Services’ benchmark suggests childcare is no longer affordable if it exceeds 7% of a household’s income. This measure of childcare cost burden reflects the experience of a household with two children.
Childcare Cost Burden in Washington Counties
The childcare cost burden exists among counties in Washington and ranges from 21% to 37%.
- Childcare cost burden varies by county level of urbanization ranging from 22% in Large urban metro counties to 27% in Rural counties.
- Median household income varies by race and ethnicity across Washington counties, ranging from $51,261 for American Indian & Alaska Native households to $102,959 for Asian households. These income disparities demonstrate how economic security is not equally accessible to all people living in Washington.
Figure 3. Childcare cost burden in Washington by county
Childcare Cost Burden Across the U.S.
The typical cost burden of childcare among counties in the U.S. is about 25% of household income - meaning a quarter of every dollar earned goes to paying for childcare. Families in every state experience a childcare cost higher than the 7% federal benchmark of affordability. The childcare cost burden in Washington is 27%.
Figure 4. Childcare cost burden in the U.S. by state
Interact with the data
Visualize the County Health Rankings measures of Median household income, Childcare cost burden, and Children in poverty by race and ethnicity groups or by county level of urbanization within a state.
Christine Muganda, PhD
Jess Hoffelder, MPH
Keith Gennuso, PhD
Marjory Givens, PhD, MSPH
Sheri Johnson, PhD
Matthew Rodock, MPH
Anne Roubal, PhD
Ganhua Lu, PhD
Eunice Park, MIS
Elizabeth Blomberg, PhD
Nicholas Schmuhl, PhD
Suryadewi Nugraheni, MD, MA, PhD
With key contributions from:
Michael Stevenson, MPH
Lindsay Garber, MPA
Beth Silver, MCM
and the entire County Health Rankings & Roadmaps Team
The Centers for Disease Control and Prevention
Dr. Amy Glasmeier, PhD and the Living Wage Calculator at the Massachusetts Institute of Technology
Communications & website support:
This work is made possible with support from the Robert Wood Johnson Foundation.