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For the second year in a row, northeast Nebraska’s Thurston County ranks the least healthy in the state, while its neighbor, Cedar County, retains the crown of healthiest.

“It doesn’t come as a surprise,” said Julie Rother, director of the Northeast Nebraska Public Health Department, which encompasses both counties.

“We have historically in our health district had some of the leading counties in the health ranking and some of the counties at the end of the rankings.”

The eighth annual County Health Rankings report by the Robert Wood Johnson Foundation in Princeton, New Jersey, and the University of Wisconsin Population Health Institute was released Wednesday.

It placed Thurston County 78th of the 78 Nebraska counties examined for length and quality of life. 

The study looks at the majority of counties in the nation, ranking them based on the ages people die and health factors such as smoking, obesity, sexually transmitted infections, teen births, uninsured rates, air pollution, high school graduation rates, child poverty and preventable hospital stays.

Only 78 of Nebraska’s 93 counties were ranked because some had populations too small to provide reliable numbers for the study.

Rother said there are many complicated social, economic and fiscal factors that lead to counties being so close geographically yet so distant in terms of health and quality of life.

Largely rural, Thurston County is one of the poorest counties in the state, has one of the highest teen pregnancy rates, and 52 percent of its residents are Native American.

“We do know there are social disparities of health," Rother said. "Health is not all about access to health care. There are a lot of other factors that play into how healthy people are and a lot of those can be addressed by public health programs and policies that address some of these social disparities. It’s challenging to do that when your funding is limited.”

Where you live influences how well and how long you live, the rankings show. Many factors beyond medical care affect health, the study said, including housing, education, jobs and access to healthy foods.

Nebraska’s healthiest counties following Cedar County are Pierce, Washington, Polk and Valley. The five counties in the poorest health, starting with least healthy, are Thurston, Scotts Bluff, Kimball, Box Butte and Keith.

According to the report, the least healthiest counties have more smokers, more teen births and more alcohol-related car crash deaths.

Lancaster County ranked 17th in the study and Douglas County came in 55th.

It’s an improvement for Lancaster County, which last year ranked 21st.

Judy Halstead, director of the Lincoln-Lancaster County Health Department, said Lancaster County ranks lower in areas such as mental health and HIV diagnosis because people move to Lincoln for services.

“We rank higher in those health areas where people need the services. You will see this matches in the clinical care category, where we rank third, because of all of the providers and services available in Lancaster County,” Halstead said.

“In short, people with the needs gravitate to the services available in Lincoln that are not available in other counties.”

She credited Lancaster County’s improvement in the rankings with a focus on increasing the community’s physical activity and great health providers who treat people.

Halstead advocated a three-pronged approach to continuing to improve Lancaster County’s health — improved mental-health and substance-abuse services, promotion of physical activity for people of all ages and income levels, and health screenings for early detection of diseases and access to treatment.

This year the study looked closely at national death trends in people younger than 75. Nationally, the report shows, drug overdoses were the leading cause of death among people ages 25 to 44. The leading causes of death for those ages 15 to 24 were listed as homicide, suicide and motor vehicle crashes.

In Nebraska from 1997 to 2014, 24 counties saw improvements in death rates of people under 75, five saw worsening rates and the rest saw no change.

“Young adults who are not in school or working represent untapped potential in our communities and our nation that we can’t afford to waste,” said Julie Willems Van Dijk, director of the County Health Rankings & Roadmaps.

“Communities addressing issues such as poverty, unemployment, and education can make a difference creating opportunities for all youth and young adults. The County Health Rankings are an important springboard for conversations on how to do just that.”

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Reach the writer at 402-473-7304 or nbergin@journalstar.com.

 On Twitter @ljsbergin.

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