Hancock is Maine’s healthiest county, while Piscataquis is home to the state’s least healthy residents, according to new rankings released Wednesday.
About 17 percent of residents in last-place Piscatquis County are in poor or fair health, compared to 13 percent in Hancock County, an independent annual report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute found.
Thirty-four percent of Piscataquis County adults are obese, compared to 25 percent of adults in Hancock County, according to the rankings. Residents of the central Maine county are almost twice as likely to die prematurely as their coastal counterparts.
The report, which ranked counties in every state in the nation, evaluated Maine’s 16 counties on more than two dozen factors that influence health. The criteria included healthy behavior indicators, such as obesity and smoking, as well as social and economic factors including unemployment, education and violent crime. The rankings also measure access to quality health care and physical environment, including drinking water safety and the prevalence of fast food restaurants.
Nationally, the data revealed that unhealthy counties have more than twice the rate of premature deaths than healthy ones and much higher childhood poverty rates.
That trend largely held true in Maine. The four counties in the poorest health, starting with the least healthy, were Piscataquis, Somerset, Washington and Aroostook.
Those four counties have traded places “at the bottom of the heap” in recent years, said Tom Lizotte, director of marketing at Mayo Regional Hospital in Dover-Foxcroft.
“It’s not surprising,” said Lizotte, who is also a founder of the Piscataquis Public Health Council. “What do all four of those counties have in common? Very rural areas, aging populations, poverty and unemployment.”
The rankings highlight the proven link between poverty and overall health, he said. Piscataquis County’s unemployment rate of 10.4 percent tops the statewide average of 7.5 percent, and the county’s childhood poverty rate of 30 percent far exceeds Maine’s average of 19 percent, Lizotte said.
“Poor people are more likely to smoke cigarettes, more likely to have issues with obesity, they’re more likely to be less physically active than other folks,” he said. “That comes through in the rankings.”
About a quarter of Piscataquis County’s adults smoke and report getting no physical activity in their leisure time, the rankings found.
“The key is how do we use this data to get people to make different lifestyle choices?” Lizotte said.
The four healthiest counties in Maine, starting with most the healthy, were Hancock, followed by Cumberland, Sagadahoc and York.
Hancock has historically performed well on the rankings, taking the No. 1 spot in 2011 and coming in second last year.
“This is a really helpful big-picture snapshot,” Doug Michael, executive director of Healthy Acadia, a community health group that serves Hancock and Washington counties, said of the rankings. “One of the things I like about it is it looks at health behaviors but it also looks at health outcomes.”
Hancock County performed particularly well on the report’s physical environment category, which includes access to recreational activities and healthy foods, two areas that community health leaders have focused on improving, he said.
At the same time, the Down East region records high numbers of unhealthy air quality days, another indicator in that category, Michael said. Hancock County also won points for public drinking water safety, which is a credit to many of its municipalities but doesn’t reflect that more than half of the county’s households use private wells, he said.
“We have to look a little bit deeper beyond the surface of some of these indicators,” Michael said.
Neighboring Washington County came in last place in 2012, but inched up two spots to No. 14 this year.
“There are some real stubborn socioeconomic indicators that are making it challenging for Washington County’s ranking to rise,” Michael said.
Nearly 40 percent of all restaurants in Maine are fast-food establishments, the report found. Access to fast food restaurants is associated with higher rates of obesity and premature death, the report stated.
Penobscot County had the highest proportion of fast food joints, at 46 percent of all restaurants. Piscataquis County had the lowest proportion at 24 percent, one bright spot for the last-place finisher.
“We have one McDonald’s in Piscataquis County,” Lizotte said. “But then again we don’t have a lot of people here.”
Piscataquis also showed the lowest rate statewide of the sexually transmitted disease chlamydia. Androscoggin County had the highest rate, with 268 out of every 100,000 people infected.
Nationally, Maine compares well to other states in overall health, Lizotte pointed out. In December, Maine was ranked the ninth healthiest state in the country.
“Even a county with poor health status in Maine is far ahead of other areas in the country,” Lizotte said. “That’s a small consolation when you’re ranked at the bottom.”