County health rankings were released Wednesday, giving Bay area counties a glimpse into the health of their residents.

The rankings, which have been put together for the past six years by the University of Wisconsin and the Robert Wood Johnson Foundation, looks at the community factors that affect the health of the county's residents.

The study looks at two kinds of data: health outcomes and health factors. Each section is further divided into subgroups. Under health outcomes, researchers looked at length of life and quality of life. Under health factors, researchers took the following into consideration: health behaviors, clinical care, social and economic factors and physical environment.

For the first time this year, the study's authors included economic inequality as a factor, which is part of the study's guiding philosophy that health is is more than just a matter of access to health providers and insurance.

When it comes to health outcomes, most of the Bay area was ranked somewhere in the middle of the state. Hernando County was at the low end, coming in the 52nd spot, while Manatee County was ranked the highest in the Bay area at 23rd.

The rankings found that in all Bay area counties, slightly more than one-fifth of residents were uninsured. That's slightly better than Florida as a whole, which has nearly a quarter of all residents going without health insurance.

Most of the counties saw their rankings increase when the study looked at health factors. Almost all of the counties ranked in the top half of the state, with Pinellas, Manatee and Hillsborough counties coming in at 19th, 20th and 22nd, respectively.

Notably, about a fourth of Florida's children live in poverty. In some Bay area counties, like Polk, Citrus and Manatee counties, nearly 30 percent of children live in poverty, while in Pasco County, fewer than one out of five children lives in poverty.

In addition, about one out of every five Bay area residents does not have health insurance, which is slightly better than Florida's uninsured rate of 24 percent.

Most Bay area counties have more adult smokers than Florida's average of 18 percent. In Pasco County, for instance, 26 percent of the county's adults smoke, while in Citrus County, 24 percent of adults smoke.

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CITRUS COUNTY

Citrus County ranked 50th in the state out of 67 counties in health outcomes. The county is 62nd when it comes to length of life, but in terms of quality of life, the county was 18th.

The county was ranked 30th when it comes to health factors. The county's clinical care was ranked 16th in the state, but the county's social and economic factors are ranked 46th.

Citrus County is the lowest in the Bay area when it comes to residents with some college education, and is tied with Polk County for the highest percentage of children living in poverty.

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HERNANDO COUNTY

Hernando County received the Bay area's lowest ranking for health outcomes, coming in at 52nd in the state. It also had the lowest rank for length of life (52 percent) and quality of life (55 percent). More than one out of every five Hernando residents is classified as having poor or fair health.

The county's ranking increased for health factors (33 percent), with both health behaviors and clinical care ranked 27th in the state. The county does better than the state's average when it comes to health insurance, but worse than the state's average when it comes to adult smoking and obesity.

The county is ranked 47th when it comes social and economic factors, which includes the highest unemployment rate in the Bay area (9 percent) and the highest percentage of children living in poverty (29 percent).

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HILLSBOROUGH COUNTY

The survey ranked Hillsborough County 28th in the state when it comes to health outcomes. The county had a high ranking (20 percent) in length of life, but that ranking drops to 41 percent for quality of life. The study found that 17 percent of the county's residents had poor or fair health and that 9 percent of the county's babies had low birth weight.

The county's health factors put it at 22nd in the state. It did best in social and economic factors, where it was ranked 19th.

The study noted that 95 percent of the county's residents had access to exercise opportunities, and that fewer than one out of every five adults in the county smoked. The county also had the highest percentage of adults with some college education (63.6 percent) in the Bay area.

County officials said the rankings helped them to identify specific areas to improve the county's health, including raising awareness about infant mortality, reducing the prevalence of obesity and working on diabetes-related hospitalizations and deaths.

"I am very proud of the way our community has worked together to improve the overall health of our citizens," said Doug Holt, MD, director of the Department of Health in Hillsborough County. "The County Health Rankings identified opportunities where we could work together and focus our efforts to make this Hillsborough a better place to live, work and play."

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MANATEE COUNTY

Manatee County achieved the highest overall ranking of all Bay area counties, coming in at 23rd in the state for health outcomes. The county was well ranked for quality of life (12th), health behaviors (14th) and access to clinical care (18th) and physical environment (13th).

Only 17 percent of the county's adults smoke and a quarter of the county's adults are obese. Ninety-four percent of the county's residents have access to exercise opportunities, and 16 percent of residents reported having poor or fair health.

Officials credit the county's focus on increasing the number of parks and preserves with giving residents access to exercise.

"Manatee County's parks and natural preserves are second to none in Florida," said Manatee County Administrator Ed Hunzeker.

While the county excelled in many categories, it received its lowest ranking (34th) for social and economic factors. Twenty-eight percent of the county's children live in poverty and 37 percent of them are in single-parent households.

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PASCO COUNTY

Pasco County ranked 41st in the state in health outcomes, with nearly one out of five residents being in poor or fair health.

The county's health factors ranking was 26th, reflecting the county's higher ranking in social and economic factors. In Pasco County, 19 percent of children live in poverty and more than three-quarters of residents are high school graduates.

County officials said the rankings have helped them identify health priorities in the county in the past, such as dental care for children, mental health care, substance abuse and infant mortality. Going forward, officials said they will use the rankings to work on drug-abuse prevention, noting that more than one out of every five motor vehicle deaths in the county is related to alcohol.

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PINELLAS COUNTY

In Pinellas County, the overall ranking of 33 put it squarely in the middle of Florida's counties, but one area where the county shines is in clinical care, where the county ranks 7th in the state.

The county also has one of the higher rankings when it comes to health factors, ranked at 19 percent, and health behaviors, coming in 17th in the state. Most notably, the study's authors found that 100 percent of the county's residents have access to exercise opportunities, putting it well above many other Bay area counties.

Dr. Claude M. Dharamraj, the director of The Florida Department of Health in Pinellas County, credits a close partnership with the Pinellas Board of County Commissioners for the county's high rankings.

"As a public-health agency, access to care is one of our core functions, and this has been strengthened by a close partnership with the Pinellas Board of County Commissioners, which funds many health programs that have made a difference," he said.

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POLK COUNTY

Polk County was ranked 29th overall in health outcomes, and 36th in health factors. The county was ranked 16th in the state in physical environment factors like drinking water problems, air pollution and severe housing problems.

However, the rankings were considerably when it came to clinical care (37th) and social and economic factors (45th). Twenty-nine percent of the county's children live in poverty, 68 percent of the county's adults are high school graduates and 23 percent of the county's residents do not have health insurance. In addition, more than one-third of the county's adults are obese.

County officials say the rankings not only show where the county has succeeded, but also tells them where they need to focus their resources.

"The rankings illustrate what programs and initiatives are working and where we still need to go in order to make Polk County a healthier place to live, work and play," said Dr. Ulyee Choe, director of the Florida Department of Health in Polk.