Fulton County and 15 others in Georgia scored F grades in a state report released Friday that underscores the high rate of premature deaths among African-Americans.

The counties' grades reflect the difference in death rates before age 75, according to the report, which also details how African-Americans and other minorities generally have worse health and more limited access to medical services than other Georgians.

Elissa Eubanks/AJC (ENLARGE)

Jonathan Lester, 1, of Atlanta wails at getting his vaccinations from licensed practical nurse Pamela Glover as his mother Kavindra Lester holds him still. African-American infants are twice as likely to die in their first year than white infants in Georgia.

Some suburban counties with higher than average income levels — such as Gwinnett, Fayette and Henry — were included in the 14 counties that received As for the best minority health results.

Georgia's Department of Community Health and its Minority Health Advisory Council, which released the report, called for counties and their business, religious, education and health care leaders to work together to solve the problem.

Other than Fulton, F grades went to Hall, Jackson and Clarke counties and several rural counties in South Georgia. Each county was also graded on other factors impacting minority health, such as socioeconomic conditions, including poverty and education; prenatal care; and access to primary medical care and mental health services.

Of Georgia's 159 counties, 118 are rural. Those counties have about half as many doctors per capita as the metro Atlanta counties and "dramatic shortages" of nurses, therapists and nutritionists, according to the report.

Friday's report marks "a landmark day in Georgia's history," said Dr. Rhonda Medows, commissioner of Community Health, who added she hoped the data and grades would "stimulate awareness and galvanize communities."

Fulton County health officials said they are already working with residents on prevention and education on health issues. "We understand there's a lot more work that needs to be done," said Kim Turner, interim director of the Fulton County Department of Health & Wellness.

"This report already moves Georgia forward," said Dr. David Satcher, former U.S. surgeon general and director of the Center of Excellence on Health Disparities at Morehouse School of Medicine. "It helps people at the local level to understand where they are."

But some health officials noted the state has major barriers to progress on disparities, citing lack of funding for mental health services, substance abuse treatment and public health.

"With the state, each year our grant-in-aid has been cut," said LaTonje May of Macon-Bibb County's health department.

The differences in health status, or "health disparities," among different population groups are not just a Georgia phenomenon.

About 83,000 deaths in the U.S. each year are attributed to the unequal health issue, said Dr. George Rust, director of the National Center for Primary Care at Morehouse School of Medicine.

Still, in 2007, the United Health Foundation, a nonprofit founded by insurance giant UnitedHealth Group to improve health, ranked Georgia 40th in health status overall, saying African-Americans in the state experience 44 percent more premature deaths than whites. A national Institute of Medicine report found that, even when their insurance coverage and income are the same as whites', minorities often receive fewer services — and lower quality of care — than whites. In Georgia, which has had a persistent problem with high rates of infant mortality, the death rate among African-American infants is more than twice that of whites, Rust said.

"We have the opportunity in Georgia to show the rest of the nation the way out," said Rust, noting that the state always has been a leader in civil rights.

"We can achieve equality and improve health outcomes for everyone if we all pull together and work to make it happen in each community across Georgia," said Rust, co-chair of the Minority Health Advisory Council.

In launching a "health equity" project, a Community Health division will host town-hall meetings across the state and provide grants of $75,000 to $100,000 to groups that address illnesses and conditions that burden Georgia's minority populations. Private donations also will be sought.

Health disparities have a big impact in Georgia because of its large minority populations, Rust said. Georgia's population estimates for 2005 showed nearly 30 percent of residents are African-American, while blacks make up about 13 percent of the U.S. population; 7.1 percent of Georgians are Latino/Hispanic; and 2.6 percent Asian. He also noted the state's high percentage of residents without health insurance.

Rust said that, besides being a moral issue, improving health outcomes for minorities will help others. An adequate medical safety net across Georgia would reduce taxes by lowering government spending for indigent care, and would cut the cost of health insurance, he said. Rust added improvements also would reduce infectious disease rates.

The report is available at www.dch.georgia.gov, Community Health's Web site. The grades came from various statistical sources, including the U.S. Census Bureau and the state's vital records database.