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It’s the combination of programs that exist and work together. There aren’t 

enough resources...so we work really hard at working together and filling 

gaps in creative ways. —Jackie Spencer, Association Community Educator, 

 Cornell Cooperative Extension of Tioga County

Anchored in the north by New York’s Finger Lakes and divided in the south by the broad, meandering 

Susquehanna River, Tioga County is home to green rolling hills, hardwood forests, fertile farmland, and 

wide-open spaces.

The county seat, Owego, has a long history as a river and rail trade center. Today, it is a sleepy, quiet area 

with all the natural charms of a rural locale.

Life can be challenging here. Many families live in or at the margins of poverty. Twenty-one percent of 

youth are food-insecure. Nearly 32 percent of the county’s housing was built before 1939, and a large 

number of residents live in older, minimally insulated homes ill-equipped to withstand the area’s 

punishing winters. Basic services are located far from where many people live, making them difficult to 

access.

Douglas Camin / GNU License 1.2

Owego, New York, is the county seat of Tioga County.
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Yet good things are happening in Tioga County. Collaboration and resource sharing among regional and 

local nonprofit and government agencies are strong, and large private and public employers are investing 

in the community’s health. A culture of volunteerism and resilience contributes to local solutions for 

challenges like food insecurity and transportation.

All these factors may help explain why Tioga County is among the ten percent of Appalachian counties—

and one of two counties in Appalachian New York—identified as a Bright Spot, performing better than 

expected across 14 of 19 health outcome measures. For example, Tioga County performed better than 

expected on the following measures:

 Stroke mortality: 23 percent better than expected

 Infant mortality: 21 percent better than expected

 Heart disease mortality: 19 percent better than expected

 Suicide mortality: 17 percent better than expected

 Injury mortality: 17 percent better than expected

These better-than-expected results are likely influenced by local characteristics and strategies that 

improve overall well-being. The field work for this case study showed that Tioga County residents 

collaborate to improve care and well-being outside of core medical facilities. For example, residents have 

pooled resources to improve access to dental care for children. Many county initiatives depend on 

volunteerism. Volunteerism is valued on both the giving and receiving ends, and is a critical element of 

the community health network, especially in helping provide transportation to medical services and 

prescription pickup.

Tioga County’s classification as a Bright Spot means that, on average, the county performed better than 

expected on a number of health outcome measures, given its characteristics and resources—that is, the 

socioeconomics, demographics, behaviors, health care facilities, and other factors that influence health 

outcomes. It does not mean that all residents here enjoy excellent health. In fact, the county still lags 

behind the rest of the nation on many health indicators. Like other counties with limited resources, Bright 

Spot counties face challenges to attaining good health outcomes. Tioga County’s performance, however, 

indicates that certain county conditions or programs may be helping generate better-than-expected 

outcomes—and that other resource-challenged Appalachian counties may benefit from adopting similar 

initiatives. 1

 1 See Table 22 in the data appendix at the end of this case study for a full list of actual health outcomes for Tioga

County compared with predicted outcomes. For details on the outcome measures, see the data files accompanying 

the report Identifying Bright Spots in Appalachian Health: Statistical Analysis.
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COUNTY OVERVIEW

Figure 9: Map - Bright Spot Community Tioga County, New York

Tioga County represents a metropolitan county in Northern Appalachia.

It is one of two Bright Spot counties in Appalachian New York. 

Tioga County is located west of Binghamton in southwest New York State, in the “Southern Tier” of 

counties lining the Pennsylvania border. The county’s name comes from an Iroquois word describing a 

meeting place “at the fork.” 

The population, currently about 50,000, fell more than three percent between 2000 and 2015. Ninetyseven percent of residents are white, and residents’ median age, 43.5, is higher than the national median, 

37.8. The population is also relatively well educated: nearly 62 percent of adults in Tioga have some 

college education, compared with just over 63 percent nationally. 

Employment is diversified, but higher salaries at Lockheed Martin and Crown Holdings, two national 

manufacturing and technology companies, affect county income averages. Tioga’s 2014 unemployment 

rate, 6.1 percent, fell just below the national rate of 6.2 percent. Classified by the Appalachian Regional 

Commission as a transitional county in fiscal year 2017, Tioga County’s median annual household 

income was $52,195 in 2014, compared with the national median of $56,135. 2

 

 2 Table 20 in the Tioga County data appendix at the end of this case study provides a quantitative profile of county 

characteristics.
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As part of the Binghamton metropolitan area, Tioga County enjoys the advantages of neighboring 

counties’ educational, cultural, and economic development resources. Cornell University is 25 miles from 

the county center. 

Although Tioga does not have a hospital, level-one and level-two trauma centers are within a half-hour 

drive of any location within the county. This compares favorably with many large cities, where traffic 

congestion can mean longer response and transportation times, even over shorter distances. It may also 

help explain why Tioga performs better than expected on mortality rates from poisoning, stroke, and 

injury, which are affected by the speed with which emergency treatment is provided.

People in Tioga County consider themselves resilient—able both to get by with the resources at hand and 

to pull together to recover from adversity. This community self-identification is rooted in a shared history 

of disaster and recovery. 

Because of its location and geography, 

Tioga County is vulnerable to 

catastrophic floods. Mountain peaks 

5,000 feet high trap clouds and channel 

rain into narrow river valleys. Just in 

the past two decades, the county 

experienced major floods five times: in 

1996, 2004, 2005, 2006, and 2011. The

2011 flood was the worst in modern 

times, putting 90 percent of Owego 

under water. Other parts of the region 

and state are also vulnerable, so 

resources for recovery are often spread 

thin, and local communities must work 

together to recover and rebuild. Tioga

County’s communities have been 

through this cycle a number of times. 

Resilience is not just a buzzword here—it is attached to a real history of self-reliant recovery that includes

resource sharing and creativity. This history also helps explain the strong culture of volunteerism in 

Tioga. There’s a sense here that neighbors helping neighbors makes life in Tioga County possible for 

many people. 

A DEEPER LOOK AT TIOGA COUNTY: COMMUNITY STRENGTHS

In many ways, Tioga County exemplifies the word “community.” It is a place where people recognize the 

need to work together—and are more than willing to do so—for the common good, even when it comes to 

sharing limited resources and giving up a degree of local or organizational control. 

Field work helped identify local practices in Tioga County that appear to be contributing to overall health, 

document effective practices that could be replicated in other counties, and identify promising practices 

and strategies that should be explored further.3 Specifically, these factors were identified in Tioga County 

that may have contributed to better-than-expected results:

 3 For a full explanation of the methodology, see Appendix B: Research Approach. For a list of key informants 

interviewed for this case study, see Table 21 in the data appendix at the end of this case study.

Photo credit: Mary Beth Jones

©2017

Mary Beth Jones

A 2011 flood had a severe impact on Tioga County, including the village of 

Owego.
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 Regional and local cross-sector collaboration and resource sharing: Within the county and 

across the Southern Tier region, cooperation and resource sharing among nonprofit and public 

agencies produce local solutions to shared challenges, such as access to transportation and food 

insecurity. 

 Volunteers meeting community needs: Volunteerism is part of Tioga County’s culture. Small 

and large volunteer organizations are skilled at identifying and resolving issues, setting priorities, 

and committing resources to address local challenges. Volunteers often step up to fill gaps in 

government-funded services. 

 Employers that support health as a shared value: Large private and public local employers 

provide a range of health benefits, including personal wellness services. Over the years, large 

national companies have established themselves as active community members who view good 

health as vital.

As in the other Bright Spot communities explored in this report, people in Tioga County have worked to 

elevate physical, social, and economic health in a number of ways. Their approaches fall into three

general overarching categories of leadership, cross-sector collaboration, and resource sharing.

Community Leaders Engaged in Health Initiatives

In Tioga County, leadership is a platform for the collaboration necessary to make the best use of limited 

resources and ensure services and supports for everyone. This is critical given that Tioga County has no 

hospital, no pediatric specialists, and only one part-time dentist who accepts Medicaid.

Regionally, the Rural Health Network of South Central New York, a nonprofit organization based in 

adjacent Broome County, spearheads this type of coordination. The network brings together health care 

and social service leaders in its three focal counties—Tioga, Broome, and Delaware—and supports 

regional projects that involve other Southern Tier counties. These projects educate local citizens about 

wellness practices and healthy lifestyle options; build infrastructure that supports physical activity, such 

as biking and hiking trails; and improve access to health care services. 

The nonprofit community also plays a strong leadership role. The Tioga County Non-Profit Network

meets quarterly to exchange ideas and information to serve residents’ needs. Representatives from 

approximately 20 groups attend these meetings, which are facilitated by the head of the Tioga County 

(Cornell University) Cooperative Extension Service. These discussions often lead to collaborative 

approaches to local challenges.

Opioid abuse is one area where nonprofit leadership has been essential. Tioga County Allies in 

Substance Abuse Prevention holds quarterly panel discussions with parents, law enforcement personnel, 

and mental health counselors on this issue, and operates a coalition of volunteer representatives from local 

school districts, nonprofits, and the general community, including parents. 

In addition, several large employers actively invest in community health, which they view as vital to 

maintaining their workforces. These public and private organizations offer a range of health benefits, 

health education, and other opportunities to help Tioga residents pursue personal health improvement. 

Lockheed Martin is one of the largest and oldest employers of Tioga County residents, with health 

benefits that include not only comprehensive health coverage but also a robust employee health program 
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that offers free flu shots, free onsite health screenings, and access to walking paths and weight 

management groups. These benefits are available to employees and their family members. 

Crown Holdings, Inc., which manufactures metal packaging products, is another large employer with an 

employee health care package that covers medical, dental, and vision care, and prescription drugs; a 

tuition assistance program for employees who wish to return to school; and disability coverage under an 

accident and health plan.

One of the largest public employers in the county, the Owego Apalachin Central School District, is 

unionized and offers its employees excellent health benefits. Another large employer, Tioga Downs 

Casino, is also unionized and offers health benefits.

Cross-Sector Collaboration

In Tioga County, researchers found a pattern of cooperation among health care providers, planners, 

educators, and other decision makers. Leaders here see collaboration as critical to ensuring that their 

communities thrive. Collaboration is pervasive across sectors, organizations, and programs within the 

county, and with other counties in the region.

As mentioned, the Rural Health Network of South Central New York serves as a forum for sharing ideas 

and information, coordinating grant-seeking activities, and reducing funding competition for area health 

initiatives. This high level of cooperation across counties helps ensure that everyone gets the services they 

need, especially in lean times. 

There is also significant collaboration among nonprofits, government agencies, and health and advocacy 

groups. For example, Family Health Services for Tioga Opportunities, Inc., a nonprofit safety net 

service provider, collaborates with the county health department on testing services; with the extension 

service on breastfeeding support groups; and with Lourdes Hospital on pregnancy education for young 

women. Another project with nearby primary care practices helps community members get transportation 

for their medical appointments.

In addition, CASA-Trinity, an alcohol and substance abuse prevention center, pools the efforts of 

professionals and citizens, and the Tioga Health Coalition promotes health throughout the county. Again, 

these efforts reflect an orientation toward sharing resources of time and expertise in ways that address 

local problems in the absence of financial resources and outside support.

Collaboration has made dental care available in the county. Although dental care for children of lowincome families is a critical need in Tioga County, the state does not provide funding for it. The local 

response was to create a mobile dental services program that employs a van equipped to provide basic 

dental services to schoolchildren around the county. The dental division of Tioga County Public Health

worked with school administrators to get the program up and running. Adults can also get dental services 

through the van before and after school and during school vacations. Tioga County Public Health 

similarly supports a mobile program that provides mammograms to low-income women in outlying parts 

of the county.

Resource Sharing

Because Tioga County has so few health care providers, regional sharing of health care resources is 

crucial. Residents have access to high-quality health care from providers in neighboring counties, 

including level-one and level-two trauma centers, as well as satellite outpatient clinics that operate in and 
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near Tioga County. Traveling outside the community for health care is typical, but, for most people, not 

onerous.

Within the county, researchers found a strong pattern of resource sharing among social services and 

health providers. For example, the newly renovated Tioga County Health and Human Services building is 

perceived as the area’s most valuable safety net resource, housing agencies providing services related to 

health care, mental health, employment, food stamps, and other assistance. Because these services are all 

located in one building, it is much easier and more convenient for residents to get the assistance they 

need. What’s more, that assistance is better coordinated among the various service providers. 

Volunteerism is another form of resource sharing that plays a key role in Tioga County. Residents here 

take pride in helping each other through extensive volunteer networks. In fact, people interviewed during 

the field work consistently cited volunteer-led grassroots initiatives for solving local challenges—such as

lack of access to transportation, food insecurity, and substance abuse—undertaken because of limited 

resources and outside assistance. Services such as conflict mediation, arbitration, court assistance, fire and 

safety support, emergency response, and youth leadership are frequently provided by volunteers instead 

of through tax dollars. Nonprofit groups, schools, and employers all actively encourage and support 

community volunteering. 

Nonprofits in Tioga County value their volunteers; many organizations provide support and training, 

while some provide insurance coverage. They are also mindful of the need to maintain an influx of 

younger volunteers to keep their organizations going. And county policy makers recognize that funding is 

essential to support volunteer programs so they can operate effectively.

Volunteerism has been crucial to meeting public transportation 

needs. In 2014, the Tioga County government ended the public 

transit van service on which many residents relied, leaving them 

with no way to get to medical appointments or pick up 

prescriptions. (New York State had reduced its transportation 

subsidy, making the service unsustainable.) In response, citizen 

groups sprung up across the county to replace the van service. 

These all-volunteer groups, including the Community Care 

Network of Nichols and Neighbors Helping Neighbors in 

Richford, provide transportation to people who need it. Others are 

stepping in and sharing resources like vehicles and fuel.

Food insecurity and nutritional risk are also challenges for lowincome families in parts of the county. Other than one or two wellrun mom-and-pop food stores in each of the county’s six villages, 

two supermarkets on either side of Owego serve Tioga’s residents. 

Over the past 15 years, these markets have changed ownership a 

few times, with each change resulting in a reduced variety of foods 

available for residents. Local farms and community gardens offer fresh produce at outdoor farmers’

markets during the growing season, and many of these markets accept food stamps. 

Similar to the response that the public transportation crisis elicited, several organizations stepped up to 

provide nutrition assistance, including the Open Door Mission, Tioga County Rural Ministry, the AntiHunger Task Force, and Meals on Wheels. These organizations are largely dependent on volunteers. In 

addition, Tioga County citizens have organized backpack and lunchbox food programs for low-income 

schoolchildren.

Mary Beth Jones

Dot Richter, executive director of the 

Community Care Network of Nichols
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Local citizens and social service professionals have started a range of service organizations that depend 

largely on volunteer and in-county support. These groups include the Finger Lakes Parents Network, for 

parents with developmentally disabled children; the New Hope Center, a resource center for victims of 

domestic violence; a Healthy Neighborhoods program that provides free in-home safety assessments; the 

Bridge, a network of churches that helps educate congregation members on community issues; and 

Reality Check, a youth tobacco-control project. 

Throughout Tioga County, concern for the health and well-being of children and youth is evident. Two 

family resource centers in Tioga County offer parenting education and host parent-child activities. 

Resource center staff are also available for home visits to provide further support for low-income parents. 

In addition, use of the Supplemental Nutrition Assistance Program (SNAP) is on par with the national 

average (76 percent and 78 percent, respectively). Services include nutrition education for low-income 

women who are pregnant or already have children. These supports may contribute to Tioga County’s 

better-than-expected rates of infant mortality and low-birth-weight births. Concern for youth safety and 

well-being is also apparent in the countywide push for tobacco-free establishments and spaces such as 

parks and community fairs.

CREATING A CULTURE OF HEALTH IN TIOGA COUNTY

Tioga County may be lacking in financial resources and other advantages, but it is rich in other critical 

health-promoting assets: a culture of collaboration and volunteerism, resilience and resourcefulness in the 

face of adversity, an ability to respond quickly to new challenges, and a strong sense of community pride 

and altruism. The region’s history of pulling together to recover from natural disasters may have helped 

strengthen social cohesion. Partnership and pooling of resources are evident both within Tioga County 

and across the Southern Tier region, where communities work together to address issues such as food 

insecurity and transportation.

Particularly noteworthy in Tioga County is the tradition of volunteerism, which seems to be part of the 

way of life here. Volunteers often fill significant gaps in government-funded services addressing issues 

ranging from transportation to emergency response and safety to youth leadership to food insecurity. 

Nonprofits, schools, and employers all support volunteer programs and activities.

Employers support community health by providing a range of health benefits, including personal wellness 

services. This is particularly important given that Tioga has no hospital of its own and a shortage of care 

providers. With good health benefits, residents are better able to get the health care services they need 

from providers outside the county.

These assets, though difficult to measure, make for a community where people feel connected to each 

other, look out for each other, and help each other. They also contribute to a community where health, in 

many ways, is better than expected—and has the potential to become even better.
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REFERENCES

American Community Survey, 5-Year Estimates, 2011–2015, Selected Housing Characteristics.

Chandra, A, J.D. Acosta, K.G. Carman, T. Dubowitz, L. Leviton, L.T. Martin, C. Miller, et al. 2016. 

“Building a National Culture of Health.”

https://www.rand.org/content/dam/rand/pubs/research_reports/RR1100/RR1199/RAND_RR1199.pdf

DATA USA. 2017. Economy. October 3. 

https://datausa.io/profile/geo/tioga-county-ny/#economy

Ellison, Ayla. 2016. Hospital CFO Report: 6 common characteristics of hospitals vulnerable to closure.

February 09. Accessed July 27, 2017. 

http://www.beckershospitalreview.com/finance/6-common-characteristics-of-hospitals-vulnerable-toclosure.html

Holmes, G. Mark, Nancy M. Lane, Thomas A. Arcury, Michael L. Schwalbe, Randy Randolph, John 

Frank, Sharita Thomas, et. al. 2018. Identifying Bright Spots in Appalachian Health: Statistical Analysis.

Washington, D.C.: Appalachian Regional Commission.

Marshall, Julie L., Logan Thomas, Nancy M. Lane, G. Mark Holmes, Thomas A. Arcury, Randy 

Randolph, Pam Silberman, et al. 2017. Health Disparities in Appalachia. Washington, D.C.: Appalachian 

Regional Commission.

Office of Disease Prevention and Health Promotion. US DHHS. 2017. Healthy People / 2020 Topics & 

Objectives/ Access to Health Services. Accessed July 27, 2017. 

https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Tioga Opportunities, Inc. Child Food Insecurity, 2018. 

https://tiogaopp.org/tioga-opportunities-inc-news/community-services-news/item/66-2017-tioga-countychild-food-insecurity.html
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APPENDIX: TIOGA COUNTY DATA

Table 20: Tioga County Characteristics

Characteristic Tioga County United States

Population, 2010–2014 50,464 314,107,084

Percent population change, 2010–2015 -3.30% 4.10%

Median age, 2015 43.5 37.8

Percent of persons over age 65, 2015 18.30% 14.90%

Median household income, 2014 $52,195 $56,135

Per capita income in past 12 months (in 2015 

dollars), 2011–2015 $29,427 $28,930

Unemployment rate, 2014 6.1% 6.2%

Percent persons in poverty, 2014 11.4% 15.6%

Percent white alone, 2015 96.70% 77.10%

Percent black alone, 2015 1.00% 13.30%

Percent adults with at least some college, 2010–

2014 61.67% 63.27%

Distance to nearest large population center from 

county center Ithaca, NY – 28.4 mi. N/A

ARC designations, fiscal year 2017 Transitional

Northern Appalachia N/A

Source: These data are compiled from the U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics, 

2014, and the U.S. Census Bureau American Community Survey Selected Social Characteristics, General Economic 

Characteristics, Demographic and Housing Characteristics, and Educational Attainment Tables for years 2010–2014 

and 2011–2015.
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Table 21: Tioga County Key Informants 

Name Location Title Organization Interview 

Date

Elaine D. Jardine Owego Planning Director

Tioga County Economic 

Development and 

Planning Office 

1/30/2017

Mary Maruscak Owego Population Health 

Coordinator

Rural Health Network of 

South Central New York 1/30/2017

Jackie Spencer Owego Family Development 

Program Leader

Family Resource Center –

Cornell Cooperative 

Extension

1/30/2017

Susan Medina Owego Director of Dental Services Public Health Department 1/30/2017

Shawn Yetter Owego Commissioner Social Services 

Department 1/31/2017

Cara Zampi Owego

Community Educator –

Tobacco Free Tioga and

Reality Check Programs

Cornell Cooperative 

Extension 1/31/2017

Sara Begeal Owego Clinical Director Tioga County Community 

Services Board 1/31/2017

Nancy Glasgow Owego Director, Family Health 

Services Tioga Opportunities, Inc. 1/31/2017

John Holton Jr. Owego Director Veterans’ Service Agency 2/1/2017
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Table 22: Tioga County Health Outcomes – Actual vs. Predicted

Outcome Measure Actual Predicted

Percentage 

Difference

(negative = 

better)

Stroke mortality per 100,000 people, 2008–2014 31.24 40.78 -23.4%

Infant mortality per 1,000 births, 2008–2014 5.36 6.80 -21.1%

Heart disease mortality per 100,000 people, 2008–2014 165.12 203.77 -19.0%

Suicide mortality per 100,000 people, 2008–2014 10.56 12.77 -17.4%

Injury mortality per 100,000 people, 2008–2014 36.63 44.06 -16.9%

COPD mortality per 100,000 people, 2008–2014 41.17 47.80 -13.9%

Percentage of adults with diabetes, 2012 10.10% 11.31% -10.7%

Opioid prescriptions as a percent of Part D claims, 2013 4.38 4.65 -5.8%

Percentage of Medicare beneficiaries w/ depression, 2012 13.80% 14.96% -7.7%

Low-birth-weight births (<2,500 g) per 1,000 births, 2007–2013 7.39 7.94 -6.8%

Cancer mortality per 100,000 people, 2008–2014 165.90 177.10 -6.3%

Years of potential life lost, 2011–2013 6,637 6,927 -4.2%

Percentage of excessive drinkers, 2014 18.70% 19.67% -4.9%

Average Medicare condition score, 2013 0.97 0.99 -2.5%

Poisoning mortality per 100,000 people, 2008–2014 14.00 13.95 0.3%

Physically unhealthy days per month per person, 2014 3.10 3.03 2.2%

Mentally unhealthy days per month per person, 2014 3.40 3.33 2.0%

Percentage of obese adults (>30 BMI), 2012 31.5% 30.7% 2.6%

Heart disease hospitalizations per 1,000 Medicare 

beneficiaries, 2012 60.10 54.60 10.1%

Notes:

Percentage Difference = 100 * [ (Actual / Predicted) – 1]

Green = County value was better than predicted

For details on the outcome measures, see the data files accompanying the report Identifying Bright Spots in 

Appalachian Health: Statistical Analysis.
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Table 23: Tioga County Health Drivers vs. National Median

Driver Measure Lower is 

Better?

National 

Median

Tioga

County

Air pollution (average daily particulate matter 2.5), 

2011 Yes 11.87 11.92 

Average travel time to work in minutes, 2010–2014 Yes 22.82 23.68 

Chlamydia incidence rate per 100,000, 2013 Yes 287.16 231.78 

Dentists per 100,000 population, 2014 No 37.45 18.05 

Economic index, fiscal year 2017 Yes 108.79 92.29 

Full-service restaurants per 1,000, 2012 No 0.68 0.81 

Grocery stores per 1,000 residents, 2012 No 0.20 0.20 

Median household income, 2014 No $45,226.00 $52,195.00 

Mental health providers per 100,000 population, 2015 No 80.00 129.87 

Percentage of adults currently smoking, 2014 Yes 17.8% 14.2%

Percentage of adults not physically active, 2012 Yes 27.7% 26.6%

Percentage of adults with at least some college, 

2010–2014 No 56.3% 61.7%

Income inequality ratio,

4 2010–2014 Yes 4.4% 4.5%

Percentage of diabetics with A1C testing, 2012 No 85.4% 86.4%

Percentage of doctors who e-prescribe, 2014 No 65.0% 92.0%

Percentage of eligibles enrolled in SNAP, 2014 No 78.0% 76.0%

Percentage of households with income below poverty, 

2014 Yes 15.8% 11.4%

Percentage of Medicare women with recent 

mammogram, 2013 No 61.0% 63.0%

Percentage of population with access to places for 

physical activity, 2011 and 2014 No 61.9% 70.8%

Percentage of total population in social assistant jobs, 

2013 N/A 0.01% 0.01%

Percentage receiving disability OASDI and/or SSI, 

2014 Yes 5.4% 5.8%

Percentage spending >30% of income on housing, 

2010–2014 Yes 29.0% 27.2%

Percentage w/ no car, low access, 2010–2014 Yes 19.7% 14.8%

Primary care physicians per 100,000 population, 2013 No 48.54 29.85 

 4 Income inequality is the ratio of household income at the 80th percentile to that at the 20th percentile. A higher 

ratio reflects greater division between the top and the bottom of the income spectrum.
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Driver Measure Lower is 

Better?

National 

Median

Tioga

County

Social associations per 10,000 population, 2013 No 12.68 13.73 

Specialist physicians per 100,000 population, 2013 No 25.93 37.65 

Students per teacher, 2013–2014 Yes 14.13 12.76 

Teenage births per 1,000, 2007–2013 Yes 39.96 29.98 

Uninsured rate for people under 65, 2013 Yes 17.24 9.37 

Notes:

Green = County value was better than national median

For details on the driver measures, see the data files accompanying the report Identifying Bright Spots in 

Appalachian Health: Statistical Analysis.