Nicollet and Brown counties again finished strong in fifth and seventh place, but none of the others finished higher than 40th.
"It's always nice to see our rank high", Public Health Director Mary Hildebrandt said.
Pezzino is concerned, however, about racial inequity.
"We are now implementing a project with the Mississippi Department of Medicaid to prevent preterm births, many of which are low birth weight or to teens", she said. In DeSoto, for instance, 7 percent of white births had a low birthweight while the rate was 13 for black births.
"There are pockets of poverty and underprivileged populations, including sometimes maybe even the (University of Kansas) students", Pezzino said.
In health factors, a measure of health behaviors and social factors, the county fell three spots from 62nd to 65th.
"What we're ultimately talking about is the access to opportunity in these counties, which can be governed by economic opportunity that leads to health outcomes". "There are things you can do within your state or your county or your community more locally that can change these indicators". "Do you live in affordable housing in a safe neighborhood?"
Public health officials are required to do comprehensive community assessments every five years and then develop a plan to address the top identified issues.
The Rankings rely on a robust set of data and analysis that allows counties to see what is making residents healthy or sick and how counties compared to others within the state.
"We know were are down, and we are working on it".
The counties partner with Watonwan County as part of the Statewide Health Improvement Partnership, established across the state to create healthier communities.
The rankings are based on factors including smoking, obesity, physical inactivity, access to healthy foods, children in poverty, unemployment, level of education, premature death, low birth weight and air and water quality.
Pennsylvania's healthiest and least healthy counties are in our area, according to new rankings. The same weight is applied to poor physical health days, and Douglas County falls in the worst 20 in that category as well.
"It would even be unsafe, in most cases, I think, to say that these (latest numbers) represent a trend", Tilden said.
Another notable factor in the report is a continuous upward trend in sexually transmitted infections and alcohol-related behaviors.
Pezzino said that's somewhat to be expected in a college town, "but I think taking that for granted probably would be the wrong attitude". About 35 percent of Le Sueur County adults report a high BMI. The percentage of driving deaths involving alcohol had been trending downward, from 33 percent in 2014 to 24 percent previous year, but that number rose to 30 percent in the most recent report.
Karen Matthews, president and CEO of Delta Health Alliance, said her organization is aware of the issues the report highlights in the Delta.
Lancaster came in eighth in the state on health outcomes and 10th on health factors in the ranking by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.
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