Index: Characteristics of 10 Community Types

by Elizabeth Sherwood, Ari Pinkus and Dante Chinni October 03, 2018

Listed here are the main Health Report findings for the 10 ACP community types the Project didn’t visit for this report. On the bottom of the page is a link to download the health data by community type.

Aging Farmlands: The 161 counties in this group are set on the Great Plains. They are small and rural communities, with only about 3,500 people per county and 92% occupying rural land, according to the U.S. Census. These counties are the oldest on average in the ACP, with more than 23% over the age of 65, and the least diverse racially and ethnically. The Farmlands are 92% white and about 4% Hispanic. These areas experience low rates of higher education. Only 19.6% have a college degree, compared to the national average of about 30%. Though these areas are not prone to excessive drinking, the percentage of driving deaths involving alcohol is 33%, 14% higher than the national average. Access to healthcare is difficult in these communities: The ratio of population to primary care physicians outpaces the national average by more than 1,000:1.

College Towns: These 154 counties are scattered around the country and are generally located near large colleges and universities. Filled with college students, about 8% of the population sits between the ages of 18 and 21 — far higher than any other type. They are also less diverse than the nation as a whole, about 80% white, 7% black and 7% Hispanic. These counties hold a large number of college graduates; 36% have at least a bachelor’s degree, more than any other community type. Despite high levels of education, average median household income in College Towns sits slightly below the national average at $52,100. Access to healthcare in these communities is greater than in other places, with nearly 200 fewer people per primary care physician than the national average. Similarly, the average ratio of population to mental health providers is 359:1, compared to the national average of 470:1. Despite a large population of young adults, excessive drinking only exceeds the national average by 2%.

Evangelical Hubs: Evangelical Hubs are concentrated heavily in the South, forming a belt that spans from Texas to North Carolina. The key distinguishing characteristic for these 372 counties is the high number of religious adherents tied to evangelical churches like the Southern Baptist Convention. Beyond religious ties, a few additional factors drive community culture here: They are less diverse (82% white), and have lower incomes (a median of about $42,700) and lower education levels (about 16% have a bachelor’s degree or more). Access to healthcare in these communities is low, with nearly twice the population per primary care physician and mental health provider than the national averages. Evangelical Hubs are also a leader in teen pregnancy, with a rate of 46 births per 1,000 females ages 15 to 19, nearly twice the national average.

Graying America: Fairly rural and scattered around the country, these 364 counties are full of retirees and those nearing retirement age. Graying America is middle-income, about $47,800 annually for the median household. But, of course, a big defining factor is age. Almost a quarter of everyone in these counties, 24%, are 62 years of age or older; only 19% are under 18. Nearly 80% are white. Healthcare is harder to come by in these areas, with an additional 393 people per primary care physician than the national average. Additionally, injury deaths are particularly high, 94 compared to the national average of 65 deaths due to injury per 100,000 people. Despite a high percentage of the population meeting retirement age, unemployment hovers slightly above the national average by about 1%. The people here also have fewer opportunities to exercise, with 72% having adequate access to exercise facilities compared to the national average of 83%.

LDS Enclaves: Based around Utah and the Mountain West, these 41 counties are the centers of the nation’s Mormon population. The Enclaves are one of the least diverse types, with a population that is 87% white and .5% African American — 9% of the population identifies as Hispanic. The LDS Enclaves are one of the youngest types in the ACP, with 29% of the population under the age of 18. They are middle-income with an average median of $55,600 annually. The people here are fairly well educated, with just over 30% holding at least a bachelor’s degree. Likely due to the large LDS population, there is less excessive drinking in these communities, 4% below the national average. Safety is evident in these communities as well. Reported violent crimes per 100,000 people averages only one-third of the national average.

Military Posts: Marked by the presence of troops and bases, these 89 counties are located largely in rural locales. Their military ties make them relatively young, with only 13% of the population 62 years of age or older. And they feature a larger African American population than average, 16%. The median income in Military Posts sits just above the national average at $57,700. More than a quarter of the people in these communities have a college degree. Health behaviors are not positively emphasized here. These communities report 6% more alcohol impaired driving deaths per 100,000 population than the national average. Adult obesity sits 4% above the national average and physical inactivity hovers just above the national average as well.

Native American Lands: Dotted primarily across the west, these 43 counties are marked by large Native American populations — more than half the people who live in these counties overall are indigenous Americans. College education rates and income are low in these counties. On average, only 14% have a college degree, and the median household income is about $41,700. People have limited access to exercise opportunities, with only 41% of the population receiving adequate access to facilities for physical activity. Combined with other factors, lack of exercise contributes to a high adult obesity rate at 8% above the national average. Likely due to poor health behaviors, nearly one quarter of the population reports fair or poor health, well above the national average of 16%.

Rural Middle America: This collection of 599 counties runs across the northern half of the country, starting up in Maine through the Great Lakes and across to Montana and Washington state. These counties have a less diverse population (91% white) that is spread into less urban locales — 62% of the population lives in places the Census labels as rural. Though they tend to be made up of small towns, these places generally do not rely heavily on agriculture. Wealth in Rural Middle America sits just below the national average, with an average median income of $52,600. Access to healthy food in these communities is favorable, with a Food Environment Index of 8.04, above the national average of 7.7. Although this food is available, these communities still experience a high rate of adult obesity, 32% compared to 28% nationally. This could be due to lack of access to exercise opportunities, which only 65% of adults in these communities have. Despite these issues, healthcare seems accessible here, with only 9% of the population uninsured, 2% lower than the national rate.

Urban Suburbs: These 106 counties hold the wealthy, diverse suburbs of most major cities, and they have come to take on many of those big city characteristics. They are densely populated — the average Urban Suburb is home to roughly 500,000 people — and diverse. The population of these counties is about 58% non-Hispanic white, 11% African American and 16% Hispanic. They are the wealthiest and best educated of all the types in the ACP — average median household income is about $68,000, and 37.2% of adults have a bachelor’s degree. As they grow more dense and urban, poverty rates are increasing. Currently, 15% of children live in poverty and 46% are eligible for reduced price school lunch. People here enjoy more opportunities for physical activities, with 9% more individuals reporting access to exercise facilities than the national average. Healthy foods are also more prevalent, with a Food Environment Index — an index of factors contributing to a healthy food environment — of 8.1 compared to the national average of 7.7.

Working Class Country: Working Class Country counties are heavily clustered in specific rural communities in the eastern half of the United States including Appalachia, the Ozarks and the upper-Midwest. Largely rural in nature, Working Class Country counties are among the nation’s least diverse places — 91% white, 2% African American and 4% Hispanic. These counties generally don’t rely on agriculture but rather exist as small service economies with some small manufacturing. Their average median household income of $42,400, sits about $13,000 below the national median. The percent of people with a college degree, 16.4%, is roughly half the national average. Working Class Country counties tend to be older than the nation at large. About 21% of the population are older than age 65. Nationally that figure is 15.6%. Violent crime rates are low as are home costs. People report more frequent poor mental health days here, 4.3 of the past 30 days compared to the national average of 3.7. Despite elevated needs for care, there are about 1,200 additional people per mental health provider here than the national average.

Use this link to download the health data sorted by ACP Community Type:  2018 CHR Data For ACP By Typology 040218 CLEAN