TEST - Map Placement

Civic infrastructure provides us with spaces to meet, make our voices heard, engage in cultural activities, enjoy nature and feel like we belong. These civic spaces support our ability to do things together—whether it’s volunteering at the senior center or attending a community advisory council meeting. Civic spaces are created and maintained with intention—sometimes by governing bodies and sometimes by neighbors working together. They provide a foundation for civic action and local solutions.

Vibrant civic infrastructure is not a reality across all U.S. communities, nor has it ever been. To this day, many groups of people in our communities—but especially people who are Black, American Indian, immigrants, women, LGBTQ+ and have low-incomes—experience the impacts of a history of disinvestment in civic infrastructure and systematic exclusionary policies and practices. Examples of exclusion include “closed door” decision-making on resource allocation, laws restricting voter eligibility or registration, residential segregation and digital redlining.

We all lose when we disinvest in civic infrastructure that can serve everyone. For example, many communities drained their public pools when racial integration was mandated, denying all people in the community a place to gather and connect in healthy ways. 

Systematic exclusionary policies and practices create structural barriers to civic health. They deny many groups of people the ability to safely participate in civic life. This restricts access to opportunities for good health and makes it harder for us to work together to make our communities places where everyone thrives.

The Information Environment

Key Findings

Civic infrastructure and the opportunity to live long and well varies across U.S. counties. Civic infrastructure varies across U.S. counties and regions. Counties in the Northeast, Midwest and West have more available and resourced civic infrastructure (including access to civic spaces and information such as broadband, libraries, newspapers, social associations, parks and schools). These counties often also have more social and economic opportunity.

  • Where types of long-standing discrimination and disinvestment have occurred through policies and practices—such as racial segregation through redlining, legal actions to terminate tribal culture and land rights and disinvestment in rural economies—counties have fewer social and economic opportunities (maps to the right). This includes opportunities for education, employment, income and family and social support. These counties consistently fall among the least healthy in measures of length and quality of life. 
  • Counties in regions such as the U.S.-Mexico Border, Black Belt Region, American Indian/Alaska Native (AI/AN) tribal areas and their surrounding counties, and Appalachia experiencing these forms of structural racism and disinvestment are often more rural and have a greater percentage of the population of color than the U.S., on average. These counties experience higher rates of children living in poverty, people without health insurance, lower household incomes and greater income inequality and lower rates of high school completion than the rest of the nation’s counties, on average. 
  • Among counties outside of these regions, approximately 83% of households have access to broadband internet and 66% of the population lives near a park or recreation facility. Most counties have adequate public school funding to support student achievement of national average test scores. Library visits typically occur twice per capita more often, annually (see figure below).
  • Compared to the rest of the nation’s counties, counties in disinvested regions tend to have less available and under-resourced civic infrastructure. For instance, only 4% of counties in the Black Belt Region have adequate school funding and experience deficits of $8,000 more per student annually than the rest of the nation’s counties, on average. Counties in the U.S.-Mexico Border Region have less than half as many social associations and more than 15% less household access to broadband internet.

See Glossary of Terms & Technical notes for definitions of types of long-standing discrimination and disinvestment and regions and county categories. 

Credits

Recommended citation

University of Wisconsin Population Health Institute. County Health Rankings Key Findings 2016.

Lead Authors

Bridget Catlin, PhD, MHSA
Amanda Jovaag, MS
Marjory Givens, PhD, MSPH
Julie Willems Van Dijk, PhD, RN

This publication would not have been possible without the following contributions:

Research Assistance

Paige Andrews
Keith Gennuso, PhD
Kathryn Hatchell     
Hyojun Park, MA    
Elizabeth Pollock
Matthew Rodock, MPH

Outreach Assistance

Mary Bennett, MFA
Matthew Call
Megan Garske
Kitty Jerome, MA
Kate Konkle, MPH
Jan O’Neill, MPA

Communications and Website Development

Burness
Forum One

Data

Centers for Disease Control and Prevention: National Center for Health Statistics
Dartmouth Institute for Health Policy & Clinical Practice

Robert Wood Johnson Foundation

Andrea Ducas, MPH
Michelle Larkin, JD, MS, RN
James Marks, MD, MPH
Joe Marx
Dwayne Proctor, PhD
Donald Schwarz, MD, MPH
Amy Slonim, PhD
Kathryn Wehr, MPH

Scientific Advisory Group

Patrick Remington, MD, MPH, Chair
Maureen Bisognano, MS
Renée Canady, PhD, MPA
Bridget Catlin, MHSA, PhD
Maggie Super Church, MSc, MCP
Ana Diez Roux, MD, PhD
Tom Eckstein, MBA
Wayne Giles, MD, MS
Elizabeth Mitchell
Ali Mokdad, PhD
C. Tracy Orleans, PhD
Steven Teutsch, MD, MPH