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Half of Georgia Counties—Mostly Rural—Have Poor Health Outcomes – Flagpole

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Half of Georgia Counties—Mostly Rural—Have Poor Health Outcomes – Flagpole


One of my objectives with Trouble in God’s Country has been to put Georgia’s performance across a range of socio-economic measures into a national context. As regular readers may recall, I’ve reported that Georgia has hugely disproportionate shares of its geography and population mired at the bottom of the national ladder for various measures.  

In 2020, for example, Georgia had more people living in counties that were in the bottom national quartile for per capita income than any other state in the nation. Likewise, I found in analyzing educational attainment data that the 147 counties outside my 12-county Metro Atlanta region would constitute the second-worst educated state in the nation, behind Mississippi and just a little better than West Virginia. The Atlanta region would constitute the second-best educated state in the country, behind Colorado and ahead of Massachusetts.

Doing the same thing with health data has always been a little trickier, but a couple of months ago the nonprofit organization County Health Rankings & Roadmaps (CHRR) came to the rescue.   

As a little background, CHRR has, for more than a decade now, been collecting and reporting key population health metrics on the vast majority of counties in the nation (there are always some counties you can’t get data for). The program is run by the University of Wisconsin’s Population Health Institute and funded, at least in part, by the Robert Wood Johnson Foundation. 

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As part of its annual report, it has historically included in-state rankings; with this year’s report, it includes data that makes it possible to rank all counties nationally. Which is just what I needed.

So, the question I’d been waiting to get an answer to was simply: Would the same thing hold true with health? The answer, sadly, is… absolutely.

CHRR gauges county-level health outcomes by stirring together local data for the following measures: premature death rates, the percentage of live births reported with low birthweight, the percentage of adults reporting fair or poor health, and the average number of physically and mentally unhealthy days reported in the past 30 days.

Eighty-three of Georgia’s 159 counties are in the bottom national quartile for health outcomes, based on the CHRR rankings—more than any other state. This includes all but 20 of the counties south of the Gnat Line.

According to the Census Bureau’s latest population estimates, those 83 counties are home to 2.43 million Georgians. I’m still stitching together the national population analysis, but I’ll go out on a limb and say I’ll be more than a little surprised if we don’t also lead the nation in the number of people living in bottom-quartile counties.

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The counties at the top and bottom of the Georgia list won’t come as a surprise to anybody.  The top five Georgia counties for health outcomes, per the CHRR report, are (in order): Forsyth County, Oconee County, Cherokee County, Cobb County and Columbia County. The bottom five are: Early County at 155th; Crisp at 156th; Randolph County at 157th; Hancock County at 158th and Miller County at 159th.

One other factoid I can include here is that the Georgia-North Carolina contrast I’ve found with other measures holds true with health outcomes as well. Generally regarded as perhaps Georgia’s closest peer state, North Carolina has somehow managed to do a much better job than Georgia of limiting the number of its citizens who fall into the nation’s bottom tier for economic performance and educational attainment.

The same is true with CHRR’s health outcomes. Only 19 of North Carolina’s 100 counties and 6.7% of its population fell into the bottom national quartile for health outcomes in the latest study. In contrast, 22% of Georgia’s population live in the 83 counties that landed in the bottom quartile for health outcomes. 

With both per capita income and educational attainment, I’ve been able to demonstrate that the gap between Georgia and North Carolina developed over time. With both those measures, there was a time when the two states had very comparable data profiles. But over time, North Carolina has done a better job of pulling its citizens out of the bottom national quartile for economic performance and educational attainment. I’ll be surprised if the same pattern doesn’t hold true with health outcomes.

Charles Hayslett is the author of the long-running troubleingodscountry.com blog. He is also the Scholar in Residence at the Center for Middle Georgia Studies at Middle Georgia State University. The views expressed in his columns are his own and are not necessarily those of the Center or the University.

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Who Mississippi State baseball will play next in NCAA Tournament super regional

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Who Mississippi State baseball will play next in NCAA Tournament super regional


STARKVILLE — Mississippi State baseball has made the super regionals in the NCAA Tournament and will face a team its already played four times.

The No. 14 national seed Bulldogs (43-17) are matched up with No. 3 Georgia (49-12). The best-of-three series will take place in Athens, Georgia, because Georgia is the higher seed.

The super regionals run from June 5-8, and the winner will make the College World Series.

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MSU is 0-4 against Georgia this season, getting swept at Dudy Noble Field and then losing a fourth time in the SEC Tournament quarterfinals. Georgia won the SEC regular season and tournament championships.

Both teams made it through their regionals without a loss. Mississippi State blew out Louisiana 19-5 on May 31, while Georgia defeated Liberty.

MSU has played Georgia only once in postseason history, losing in the 1990 College World Series.

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Mississippi State baseball history in super regionals

Mississippi State has played in 10 super regionals and won five of them. It has won three straight super regionals. MSU is 2-4 as the visiting team in super regionals.

New Mississippi State coach Brian O’Connor is 7-2 in super regionals.

NCAA baseball tournament schedule

  • Super regionals: June 5-8
  • College World Series: June 12-22

Sam Sklar is the Mississippi State beat reporter for The Clarion Ledger. Email him at ssklar@usatodayco.com and follow him on X @sklarsam_.



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Georgia football picks up two commitments for 2027 recruiting class

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Georgia football picks up two commitments for 2027 recruiting class


Georgia football landed a pair of commitments Sunday for its 2027 recruiting class.

Wide receiver Taurean Rawlins from Mount Vernon School in Atlanta posted on his X account on May 31 that he’s  pledged to the Bulldogs.

Georgia also picked up a commitment from offensive tackle DJ Dotson from Hattiesburg, Miss., he posted on his Instagram account.

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Both are rated 3-star prospects.

“I loved the support and love they showed towards me and my family,” Dotson said in a text message to the Athens Banner-Herald.

The 6-foot, 175-pound Rawlins is rated the No. 58 wide receiver in the 2027 class and the No. 478 overall prospect.

Rawlins had 67 catches for 1,395 yards and 17 touchdowns last season, according to MaxPreps.

Rawlins and Dotson give Georgia 10 commitments for this cycle.

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Rawlins is the first wide receiver commitment. He also had offers from Ohio State, Florida and Michigan.

Georgia signed four wide receivers in its 2026 class: Craig Dandridge, Ryan Mosley, Dallas Dickerson and late addition Tre Shields.

Rawlins’ coach at Mount Vernon is former Georgia star wide receiver Terrence Edwards.

The 6-foot-7, 330-pound Dotson is rated as the nation’s No. 85 offensive tackle prospect and the No. 851 overall prospect.

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He picked Georgia over Ole Miss, LSU and Georgia Tech, according to 247Sports.

Georgia also has offensive line commitments in its 2027 class from Kelsey Adams from Langston Hughes, Abram Eisenhower from Lowndes and Ty Johnson from Mount Pleasant, S.C.



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A Georgia Wildlife Haven Forged by Fire and Peat Nears UNESCO Recognition – Inside Climate News

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A Georgia Wildlife Haven Forged by Fire and Peat Nears UNESCO Recognition – Inside Climate News


FOLKSTON, Ga.—The world’s smallest heron hops from blade to blade in a patch of tall grass, testing its footing above the dark water as it searches for an evening meal.

“This was already worth the trip out today,” Joshua Howard said earlier this month from a gray flat-bottomed tour boat just a few yards away. The tiny creatures, called Least Bitterns, are secretive birds, not easy to spot.

With one quick movement of its neck, which seems to take up most of its body, the tiny heron plunges into the water and comes up with a fish. Howard and his guide continue down the swamp between walls of Spanish moss-adorned cypress trees and alligators, hoping to find more of the birds and wildlife that call the Okefenokee National Wildlife Refuge home.

A least bittern fishes in tall grass on the banks of the Okefenokee Swamp. Credit: Ryan Krugman/Inside Climate News
A least bittern fishes in tall grass on the banks of the Okefenokee Swamp. Credit: Ryan Krugman/Inside Climate News

By July, the vast swamp Howard has visited since childhood and still tries to reach at least once a week could be internationally recognized as a United Nations Educational, Scientific and Cultural Organization (UNESCO) World Heritage Site.

The Okefenokee, on the Florida border in southeast Georgia, hosts the largest blackwater swamp in North America, a slow-moving wilderness roughly five times the size of Atlanta. It began forming hundreds of thousands of years ago, as the Atlantic Ocean retreated and left behind Trail Ridge, a long, low fossilized beach dune, and a shallow depression that trapped water between the ridge and higher uplands to the west.

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The Okefenokee is a blackwater swamp, meaning its dark waters are stained by tannins released from decaying vegetation and cypress trees. Beneath the dense canopy, the water takes on the color of steeped tea, reflecting cypress trunks and drifting lily pads like dark glass.   

The refuge was established in 1937 by President Franklin D. Roosevelt, following a series of visits from Cornell biologist Francis Harper. Harper had come to admire both the swamp’s landscape and its people, but it was his wife—who had once tutored Roosevelt’s children—who ultimately helped push the president toward protecting the land.

The refuge’s latest conservation effort now depends partly on another layer of federal and international politics. The Okefenokee’s UNESCO nomination comes amid renewed uncertainty over the United States’ relationship with the organization.

Earlier this year, President Donald Trump moved to again withdraw the United States from UNESCO, though the withdrawal would not take effect until December—months after a decision on the Okefenokee nomination is expected. The United States also remains part of the World Heritage Convention, the international agreement governing World Heritage Sites.

In addition, World Heritage designations have continued in the United States during previous periods when the country was formally withdrawn from UNESCO, including under both Trump and President Ronald Reagan. The Okefenokee effort has also received support from prominent Republicans, including Secretary of State Marco Rubio and former Georgia Gov. Sonny Perdue, who served as Trump’s agriculture secretary.

Still, regardless of shifting politics around UNESCO, the landscape at the center of the nomination remains largely unchanged.

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Today, the Okefenokee stands as a protected wilderness of blackwater channels, peat and dense wetland forests, supporting a rich array of wildlife and plant life.

A great blue heron and a barred owl perch among Spanish moss in the Okefenokee National Wildlife Refuge. Credit: Ryan Krugman/Inside Climate News

As Howard floated through the swamp at the refuge’s eastern entrance for about an hour and a half, he saw nearly 200 alligators, owl fledglings, hawks, herons and more. What he somewhat incredulously called an “above average” number of encounters was partly driven by drought conditions that pushed animals toward remaining water, though abundant wildlife sightings are far from unusual.

Across the swamp, an estimated 15,000 alligators inhabit the blackwater alongside almost 250 bird and 64 reptile species. Black bears and bobcats move through the uplands, and there are rumors of Florida panthers wandering the refuge. It is also a stronghold for endangered species, including red-cockaded woodpeckers, wood storks and eastern indigo snakes.

Hooded pitcher plants, one of the many carnivorous plants found in the Okefenokee. Credit: Ryan Krugman/Inside Climate NewsHooded pitcher plants, one of the many carnivorous plants found in the Okefenokee. Credit: Ryan Krugman/Inside Climate News
Hooded pitcher plants, one of the many carnivorous plants found in the Okefenokee. Credit: Ryan Krugman/Inside Climate News

To fully experience the Okefenokee, visitors often paddle deep into the backcountry by canoe or kayak, traveling through areas inaccessible to motorboats. Along the way, they pass open prairies filled with lilies, wildflowers and carnivorous plants, including the Okefenokee giant pitcher plant, which can grow more than four feet tall and traps insects inside its tubular leaves.

Some visitors spend nights on raised wooden platforms scattered throughout the swamp, with multi-day trips carrying paddlers far into the blackwater wilderness. Yet even with those routes, only about 5 percent of the Okefenokee is currently accessible to humans. 

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Despite being one of the best-preserved wetlands in North America, and especially on the eastern seaboard, the Okefenokee has repeatedly faced pressure from industry and development. Before it became a wildlife refuge and federally designated wilderness area nearly a century ago, logging companies cut through vast cypress forests, disrupting habitats and the natural systems that shaped the swamp.

Later, the Suwanee Canal Company attempted to drain the Okefenokee to clear the way for development. The company planned to carve a canal through Trail Ridge and connect the swamp to the Suwannee River, but water repeatedly flowed back into the basin. The project ultimately collapsed, driving the company into bankruptcy before the canal could be completed.

More recently, the Okefenokee has faced renewed pressure from a high-profile mining dispute near Trail Ridge and continued development across the Florida border. Yet the swamp’s beauty and biodiversity continue to draw roughly 800,000 visitors each year—and now the attention of UNESCO.

The Okefenokee was first placed on the United States’ tentative UNESCO World Heritage list in 1981, but the nomination stalled for decades. In 2023, the Department of the Interior authorized work on a formal nomination, a push driven in large part by advocates including Kim Bednarek, executive director of Okefenokee Swamp Park.

Kim Bednarek, executive director of Okefenokee Swamp Park, in the wildlife refuge. Credit: Frank FortuneKim Bednarek, executive director of Okefenokee Swamp Park, in the wildlife refuge. Credit: Frank Fortune
Kim Bednarek, executive director of Okefenokee Swamp Park, in the wildlife refuge. Credit: Frank Fortune

The nonprofit, which runs tours and educational programs near and in the refuge, helped lead the campaign and raise money for the years-long nomination process. To qualify, researchers and advocates had to demonstrate the swamp’s “outstanding universal value,” the central standard for World Heritage designation.

The nomination was formally submitted in January 2025. Later that year, scientists with the International Union for Conservation of Nature, which advises UNESCO on natural sites, visited the swamp as part of the evaluation process. Advocates are now awaiting a recommendation from the organization ahead of a final decision expected this July at the UNESCO World Heritage Committee meeting in Busan, South Korea.

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UNESCO’s standard of “outstanding universal value” is reserved for places considered significant not just to one country, but to humanity. Advocates and scientists argue the Okefenokee qualifies because of its biodiversity and the remarkable condition of its peatlands, which have remained largely intact for thousands of years and are a natural carbon sink.

Peatlands form when organic material builds up faster than it decomposes. In the Okefenokee, still blackwater, low oxygen levels and acidic conditions—created largely by tannins from cypress trees—slow decay enough for layers of plant matter to accumulate over thousands of years.

“We do not have a similar peatland in the world in the subtropics,” said Hans Joosten, one of the world’s leading peatland experts. According to Joosten, the swamp’s location—sandwiched between the Gulf of Mexico and the Atlantic—provides the humidity and rainfall needed to sustain this rare subtropical peatland.

An inch of peat can take more than 50 years to form. In parts of the Okefenokee, those layers reach more than 15 feet deep, storing an estimated 124 million tons of carbon and forming one of North America’s most significant peat systems.

Many of the estimated 15,000 Alligators in the Okefenokee are tagged as part of research initiatives. Credit: Ryan Krugman

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The swamp’s Muscogee Creek name, often translated as “land of the trembling earth,” reflects what lies beneath its surface. Deep peat can shift, swell and occasionally rise toward the top, where visitors may see methane bubbles break through the blackwater or floating mats of peat drifting at the surface. Those peat mats can become platforms for new plant growth, reshaping the swamp as they move and settle.

The biodiversity hotspot is supported by another cycle, one much faster than peat formation. The swamp is frequently reshaped and renewed through natural wildfires. The fires clear dense vegetation and invasive species, return nutrients to the soil, and maintain the open conditions needed for fire-dependent ecosystems like the longleaf pine, one of the most endangered forest types in North America.

“To be put on the same list as places like the Grand Canyon and Yellowstone would just be amazing,” Howard said with a Southern drawl as he floated along the remnants of the Suwannee Canal.

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Howard, tall and broad with silvering hair and an easy smile, had arrived at the swamp after a long day working as a school administrator in Charlton County. “You want to know why I think this place deserves to be on that list?” he asked. “Because when I got here this evening, I was stressed and now I am not.”

Howard has been coming to the swamp for almost 50 years and has spent the last seven serving as president of Friends of the Okefenokee National Wildlife Refuge, a nonprofit that helps raise money for its preservation. While the group is not directly involved in the UNESCO bid, Howard said its members strongly support the designation.

If approved in July, the designation would make the Okefenokee Georgia’s first UNESCO World Heritage Site and the first national wildlife refuge in the country to receive the status.

For Bednarek, the recognition would do more than honor the swamp’s ecology. It could fundamentally change how the Okefenokee is seen internationally. National wildlife refuges typically operate with far less tourism, funding and global visibility than national parks. 

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“They have this iconic brand that refuges don’t,” Bednarek said. UNESCO World Heritage status, she said, functions differently. “It’s a global brand that people travel far and wide to see.”

For now, though, the Okefenokee remains what it has long been: a slow-moving wilderness of blackwater, peat and cypress.

As dusk settled over the swamp, Howard’s guide cut the boat motor and the sounds of insects and distant birds filled the blackwater again. Methane bubbles continued rising quietly to the surface, signs of the trembling earth beneath the water.

In July, delegates in South Korea will decide whether the Okefenokee receives World Heritage status. But the swamp itself will keep moving at its own pace.

The Okefenokee’s blackwater swamp is surrounded by a dense canopy of cypress trees. Credit: Ryan Krugman/Inside Climate NewsThe Okefenokee’s blackwater swamp is surrounded by a dense canopy of cypress trees. Credit: Ryan Krugman/Inside Climate News
The Okefenokee’s blackwater swamp is surrounded by a dense canopy of cypress trees. Credit: Ryan Krugman/Inside Climate News

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