People who live in Roanoke and Pulaski County are the least healthy in the Roanoke and New River valleys, according to a report released Wednesday.

Those in Montgomery County were found to be the healthiest.

Compiled by the Robert Wood Johnson Foundation and the University of Wisconsin's Population Health Institute , the fourth annual County Health Rankings & Roadmaps report used standard measures to compare cities and counties across the state and the nation.

The rankings were based on how long people live and how healthy they are, taking into account a variety of factors including smoking and obesity rates, exercise, access to health care, education and income, and the environment in which they live.

For the most part, densely populated areas with affluent and well-educated residents were the healthiest, while urban centers and rural counties with higher concentrations of poverty were at the other end of the spectrum.

That much was no great surprise, said Dr. Molly O'Dell, director of the Virginia Department of Health's New River district.

"Because health is not a static condition," she said. "It's as much influenced by socioeconomic factors as it is by an individual's genetics."

"And our health is also influenced by where we live," said O'Dell, whose district includes Montgomery and Pulaski, two counties situated next to one another geographically but far apart in the rankings.

Of 133 cities and counties examined in Virginia, Pulaski County ranked 119 . That was the lowest of the jurisdictions in the Roanoke and New River valleys.

With a ranking of 23rd statewide, Montgomery County had the best showing in the local region.

Roanoke ranked 116th, with many of the surrounding localities falling between 30th and 75th on the list.

Statewide, Fairfax County was at the top of the list. Petersburg was the least healthy jurisdiction, followed by the far Southwest Virginia counties of Tazewell, Buchanan and Dickenson.

Martinsville and Henry County were also among the least healthy localities.

Many of the factors tracked by the study - whether they were personal behaviors such as smoking and lack of exercise or system-wide failures such as inadequate access to health care - could be improved through individual or collective effort.

"It's really a call to action," Dr. Cathy Callahan , an associate professor at the Edward Via College of Osteopathic Medicine in Blacksburg, said of the report.

"It distills a multitude of factors that affect health into a simple ranking that calls individuals and community leaders to action," Callahan said.

Behind each numerical ranking were myriad indicators, as detailed as birth weight statistics, sexually transmitted diseases and the ratio of restaurants that offer fast food.

In Roanoke, for example, the following snapshot emerged:

• The adult smoking rate was 27 percent, compared with a state average of 18 percent.
• The adult obesity rate was 34 percent, compared with a state average of 28 percent.
• The high school graduation rate was 77 percent, compared with a state average of 88 percent.
• The child poverty rate was 30 percent, compared with a state average of 16 percent.

The statistics show "there really are pockets of poverty where access to health care is limited, and there are increased rates of risky health behavior," Callahan said.

Roanoke's overall rating of 116 was unchanged from four years ago, the first time the annual study was conducted.

Montgomery County moved up on the list from 39 to 23 statewide.

In the more rural areas, relatively small numbers could lead to yearly fluctuations that should be viewed with caution, O'Dell said.

But in general, the report "does allow us to compare apples to apples, community to community," she said. "It's a great barometer of what's going on in the health of a community."

Many of the factors that influence good health play out beyond what happens in the medical setting.

"What we eat, the safety of our communities, how much family and social support we have and our level of education and understanding all influence our health and well-being," State Health Commissioner Dr. Cynthia Romero said in a news release.

"It takes the combined efforts of businesses, health care providers, government, consumers, local health departments and community leaders to create a healthier Commonwealth.

"Using the Rankings & Roadmaps, together we can find ways and create opportunities to help Virginians live longer, healthier lives."

Online: www.countyhealthrankings.org

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