According to a study released by The Robert Wood Johnson Foundation, which ranks the nation’s health county-by-county across the country, many of the counties with the worst health conditions also have high poverty rates, and many have high Black populations.

“We didn’t want this to be just a black and white analysis,” Patrick Remington, associate dean for public health at the University of Wisconsin, told “Poverty is the common thread. If they are wealthy, there is a better chance that they are healthy.”

The counties are ranked by the health of residents and how long they live. The study is also based on major factors affecting health including obesity, smoking, binge drinking, access to primary health providers, rates of violent crime, liquor store density, unemployment rates, rates of high school graduation, and the rates of children living in poverty.

The counties that received the poorest ranks often had numerous challenges to surmount, according to the study, including two- and three-fold higher rates of premature death caused by avoidable factors.

Meanwhile, residents of healthier counties are most likely to be employed and have access to health care providers.

“These rankings demonstrate that health happens where we live, learn, work and play. And much of what influences how healthy we are and how long we live happens outside the doctor’s office,” Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, told

The study and full county health rankings can be viewed at