08-04-2025
County Health Rankings and Roadmaps report considers social rules, power
Johnathan Sublet, who spoke recently at a Topeka Work event, uses the annual County Health Rankings and Roadmap to help the organization he heads, SENT Topeka, be aware of community health needs. (Jill Rice)
TOPEKA — Societal rules — written and unwritten — and how power is distributed and wielded within communities are new measures tracked by an annual report that offers insights into health at a county level.
The 2025 County Health Rankings and Roadmap report, put out by the University of Wisconsin Public Health Institute and the Robert Wood Johnson Foundation, is used by local, regional and state leaders to determine how to understand and impact the health of residents within their communities. Factors that impact health were updated this year for the first time since 2014, said Bethany Rogerson, UWPHI co-director.
'We are focused on lifting up policies and practices that can create the conditions so that everyone has the ability to thrive,' she said. 'Where you live, where you work all play a really important role in shaping health, and that health is more than health care.'
The addition of societal rules and power categories encourages communities to assess those concepts and determine how to make policy and practical changes to improve the health of citizens, Rogerson said.
'We know that community conditions don't just happen by chance,' she said. 'So we realized an opportunity to invite people to explore how community conditions come to be. How did our housing, how did our jobs, our schools, all the aspects that we know shape health, how did they come to be and who shaped them and how?'
SENT Topeka, an organization that works to support Topeka residents through building resilience and relationships, uses the County Health Rankings for data and health insights. Founder and executive director Johnathan Sublet said the new measures fit into the work the organization is doing. He pointed to the food pantry at SENT, which is structured to work like a grocery store where people have choice.
'The first thing a person often loses when they become under-resourced is choice,' Sublet said. 'When we define poverty, it is not just the access to money. We define it as lack of choice in a person's life. Every single person has infinite dignity, value and worth. We want to do everything we can to affirm that dignity, value and worth they have.'
'Part of that means giving them choice back, and it also means giving them power in decisions that are being made within their sphere of influence,' he added.
Wyatt Beckman, senior analyst with Kansas Health Institute, said the broad categories of societal rules and power added this year support discussion at the county level that can be impactful in looking at how the factors influence community conditions.
Expanding the conversation can elicit change, he said.
'You can build community power when you organize and act together, and do things like set agendas, shape who's involved in discussion and decision-making, cultivate relationships, and that power can shape societal rules,' Beckman said. 'Power is not meant to be listed as an inherently good or bad thing, but it's an acknowledgement and does help us have conversations about not only the factors that are shaping health, but how those factors are being influenced and maybe can be adjusted.'
An example Beckman offered is the education people receive, which he said is important to quality of life and shaping experiences.
'Some of the big decisions around that education can be shaped by people who sit on boards of education. Those boards of education have a role in shaping the budgets and policies and regulations that inform and guide that education,' he said.
Communities can ask questions about who is invited into policy-making discussions, including whether they're encouraging and receiving diverse opinions. Partnership and building trust are key elements in working together as a community, Sublet said. At SENT Topeka, focusing on dignity and support are key to building that trust.
'Dignity for us means not doing for someone what they can and should do for themselves. We don't give away everything for free that we do,' he said. 'It means that we don't feel like we transform people's lives or change people's lives, but we journey with them in their lives as much as they allow us to.'
Important in their interactions is not feeling as if SENT Topeka is 'the voice for the people,' Sublet said.
'We want to help them understand the voice they already have and affirm that,' he said. 'While we'll help prepare them for conversations, we don't feel it's our job to go in and speak for them in situations.'
Additional new measures included in the County Health Rankings and Roadmap report this year are:
Access to libraries
Disability: Functional limitations
Feelings of loneliness
Lack of social and emotional support
Access to parks
Adverse climate events
Beckman said the County Health Rankings report is especially helpful at a community level because even when the state may seem to overall be doing well with specific measures, individual counties may be having a different experience.
He noted that most Kansas counties are doing better than the average county in the United States, but that doesn't mean there aren't individual counties showing challenges.
As an example, he pointed to Russell, Edwards and Kingman counties, which have seen 'years for potential life lost' increasing at a level higher than what is seen in the state and U.S. overall.
That factor is a unique angle on what most of us think as life expectancy, Beckman said.
'What years of potential life lost does is it adds up and turns into a rate all of the years between a person dies and the age 75,' he said. 'So it sets age 75 as that average life expectancy, and any deaths before that are added up. What that means in practice is if there are, for whatever reason, things that are causing earlier deaths in a community, that's really going to increase years of potential life lost.'
Beckman called the increase in years of potential life lost 'pretty stark,' and said the increase can't be explained by the COVID-19 pandemic. While the County Health Rankings report doesn't answer why that's happening, it provides the information so that county and state officials can dig deeper.
Broadening of data collected in the County Health Rankings and Roadmap report comes even as its publisher, the University of Wisconsin Public Health Institute, expects to lose funding in 2026. The Robert Wood Johnson Foundation is pulling funding it has supplied for the past 15 years.
'RWJF remains committed to public health data and to meeting the needs of the communities we strive to serve,' a foundation spokesperson said. 'We remain steadfast in our support of the UWPHI team in this final chapter to ensure a thoughtful and collaborative wind-down of the program through the end of 2026.'
Rogerson at UWPHI said the organization's work is rooted in their long-term tracking of health data and information.
'We know that that work to realize that vision is not done,' she said. 'We are still navigating and determining our next steps, but we hope to continue the work as much as possible for as long as possible. We know that communities, policy makers, students, lawmakers, rely on data- informed strategies and narrative change strategies, to advance work related to health and equity.'
