PETERSBURG, Va. (WRIC) — Virginia’s Tri-cities are in the midst of a health crisis, according to a recent ranking that places Petersburg, Hopewell and Colonial Heights as three of the most unhealthy localities in the commonwealth.

The County Health Rankings and Roadmaps, which are released annually by the University of Wisconsin’s Center for Population Health Medicine, placed Petersburg in dead last for health outcomes at 133 out of 133 Virginia localities.

Hopewell and Colonial Heights didn’t fare much better, ranking at 131 and 97, respectively.

The Analysis

The Health Outcomes factor, which is one half of the study’s analysis, is determined based on a mixture of “premature death” calculations (in other words, the years of “potential life” lost when people die before the age of 75) and a variety of statistics that collectively measure people’s quality of life, including number of poor health days and birthweight among infants.

The other half of the study concerns Health Factors — the underlying measures, including access to medical care and the economic health of the community, that contribute to individual medical outcomes.

While Hopewell and Petersburg have identical Factors and Outcomes rankings, Colonial Heights ranks 64th in Factors, meaning their outcomes are lagging behind underlying conditions in the community.

Ericka Burroughs-Girardi, senior outreach specialist for the County Health Rankings & Roadmaps, told 8News the ranking shouldn’t be a source of despair.

“Our goal is for people to take these resources and make real change,” she said.

Tackling the Problem Head-on

That change, Burroughs-Girardi said, has to begin in the community, starting with the underlying Health Factors.

“If we are able to improve our health factors, then our health outcomes will improve,” she said.

But she added that that change can take time – and goes far beyond what we normally think of as the “healthcare system.”

Factors influencing health include things like the quality of air and water, behaviors like alcohol consumption and economic factors like employment and education.

Dr. Alton Hart is the director of the Crater Health District, which includes the cities of Petersburg and Hopewell, and he said they’ve been working on community initiatives to tackle health issues.

“We really cannot do this work alone. We can’t focus just on what happens in the four walls of our clinic,” he said.

Those programs include things like the “Blue Zone intiative,” a local application of a national model headed by cardiologist Dr. Clifford Morris. The initiative seeks to turn Hopewell into a “Blue Zone” by replacing drug dependency in the community with holistic health plans that focus on exercise and diet changes.

“I think the Blue Zone initiative is a model I would hold up as having promise,” Dr. Hart said, adding that it’s been shown to be effective in 65 other communities.

Health and Wealth

One of the biggest underlying causes of poor health outcomes, according to the study, are economic factors in the community, and Burroughs-Girardi emphasized that the health ramifications in communities like Petersburg and Hopewell run much deeper than many people realize.

In Petersburg, many of those issues tie back to the city’s long industrial decline. According to a brief written by the Richmond Federal Reserve, Petersburg was a thriving center of industrial production until the mid-1970’s, when several large companies closed their operations there.

The resulting economic decline and population slump contributed to many of the problems that plague Petersburg today. Burroughs-Girardi said this is a pattern seen in many communities the institute studied.

“Once the economy leaves, you see a drop in taxes and what happens? The people who can afford to move get up and go to another county,” she said.

She added that the people who are left behind have fewer job opportunities, and public institutions like schools and hospitals suffer, steadily undermining underlying Health Factors. That can make it difficult for the people who remain to live healthy lives.

“What we choose to do with our body makes a difference,” she said. “But there are many factors beyond our control.”

One example she gave was of food deserts – areas where residents find themselves with no local grocery store and have to either drive long distances to access supermarkets or rely on unhealthy fast food.

Both Petersburg and Hopewell have large areas with low access to food, according to the USDA.

That means dietary decisions may not be a decision at all for some – especially if they don’t own a car.

Other economic factors include the cost of childcare (Virginia has one of the highest childcare costs in the nation) and the number of people making a living wage (the median household income in Petersburg and Hopewell is below the living wage for a family with two children).

A Long Process

Dr. Hart told 8News that while he’s proud of the work the Crater Health District has done, it may be a while before the effects can be seen in health statistics.

For example, he said there’s a connection between childhood trauma and health outcomes not only for the individual, but everyone in the community. That means early-childhood intervention can have a huge health impact – but conversely, the wider effects in the community won’t be seen for many years, when the child grows up.

“This type of improvement takes time,” he said. “We’re talking about years to improve the health of a community.”

Burroughs-Girardi echoed that thought, pointing to efforts in Richmond that combine health outreach with community wealth building and improved public education as a model to watch.

“You’re not gonna see the effects for a long time,” she said. “It takes literally a generation to change health outcomes.”

But, she added, “It all makes a difference.”