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For the sixth year in a row, Morgan County ranks as Utah's healthiest county and Carbon County as its least healthy, according to the County Health Rankings national study.
The study, published Wednesday, looks at data from a range of measures, from the obvious — smoking rates, poverty and violent crime— to the obscure, such as rates of chlamydia and low birth weight in babies.
The state's healthiest counties are along the Wasatch Front and Back, whch have high education and income levels. The exceptions are southwestern Utah's Washington County, which ranked seventh for overall health outcomes, above Salt Lake and Weber counties, which also fell lower in the rankings than their neighboring Wasatch Front counties.
The least healthy counties are in rural eastern Utah, where income and education levels are generally low.
Cache and Wasatch county remained at No. 2 and 3, respectively, and Sevier and Duchesne counties were at No. 25 and No. 26, respectively, among the 27 Utah counties ranked for overall health outcomes. Two counties, Rich and Daggett, are too sparsely populated to be ranked, said Kate Kunkel, associate researcher at the University of Wisconsin Population Health Institute.
The study is published each year by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute, and is designed to give governmental agencies the kind of detailed information they need to improve public health.
County-by-county and state-by-state data are available at countyhealthrankings.org.
Dave Cunningham, executive director of the Southeastern Utah Health Department, said the rankings obscure the fact that residents of his region are about on par, health-wise, with national averages — just not with Utah, one of the nation's healthiest states.
"It has kind of frustrated the people locally when these rankings come out. … They are just comparing us to the rest of the state."
Both culturally and industrially, Carbon and neighboring Emery County are different from the rest of Utah, Cunningham said.
More people die at younger ages because of the lung problems associated with working in coal mines and power plants, he said. Carbon County has the highest rate of premature deaths, and reported the highest percentage of residents — 17 percent — who could not go to a doctor because of the costs.
"It's a different culture. It's not the LDS culture," Cunningham said.
For instance, 19 percent of adults in Carbon County smoke tobacco, compared with 9 percent of Utah adults.
The third county in the southeastern region, Grand County, also ranks among the least healthy. Cunningham said low incomes in Moab's tourist economy have something to do with that.
Cunningham said the health department uses such studies to guide its advocacy efforts.
For instance, the health department slashed its suicide rate in half last year after beginning a suicide prevention program.
This weekend, it's sponsoring a 5K and 10K foot race to raise awareness for tobacco cessation.
Unfortunately, most of the federal grants are for population-wide programs, not for helping individual people change their lifestyles, Cunningham said.
"If you're trying to change behavior … you still have to get to the individual," he said.
Brian Bennion, executive director of the Weber-Morgan Health Department, said it's a good study because of its depth and breadth. "They know what they're doing and these indicators are very helpful," Bennion said.
The health department will use the data and collect its own from local and state sources, as well as focus groups, as it does a community-wide health assessment, Bennion said. The assessment, the first in 25 years, began last September.
The data show a sharp contrast between rural Morgan and its more urban neighbor, Weber County.
Morgan has low crime, high education levels, low unemployment and ranks top in quality of life and overall health outcomes.
But Weber has lower income and education levels, higher crime and lower quality of life. It ranks as the 16th healthiest.
Salt Lake County, consistently ranked among the top half of Utah counties, ended at No. 9 this year after bouncing between No. 9 (2010) and No. 12 (2014).
The new study provides two pictures for every county: health outcomes that tell the story of where a county is now and health factors, which predict where it's going, said Kunkel, of the University of Wisconsin.
To determine the current health of a county, researchers counted premature death, the percentage of people reporting poor or fair health, poor physical and mental health days each month and the rate of low birth-weight babies.
If other measures, such as tobacco use, alcohol-caused auto accidents, income, exercise and obesity are all trending in a good direction in a county, health is likely improving, she said.
"We encourage communities to look at both of them," Kunkel said. "We want to help them start the conversation about health in their community and to broaden the conversation about health in their community."
Twitter: @KristenMoulton