TOP FIVE HEALTHY COUNTIES

1 — Forsyth

2 — Fayette

3 — Oconee

4 — Gwinnett

5 — Cherokee

17 — DeKalb County

29 — Fulton

42 — Clayton

Source: The 2013 County Health Rankings, released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Rankings are based on a wide variety of health factors including the following: obesity, smoking, poverty, excessive drinking, high school graduation rates and the ratio of the population to primary care physicians.

A complete list of rankings is available at www.countyhealthrankings.org

Metro Atlanta counties secured top spots in an annual ranking of the healthiest counties in the state with Forsyth leading the way, according to a study released Wednesday.

Just behind Forsyth is Fayette, followed by Oconee, Gwinnett and Cherokee. On the flip side, the five counties with the poorest health, starting with the least healthy, include Clay, Stewart, Terrell, McDuffie, and Wilcox, according to the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

They based the rankings on a wide variety of factors including everything from obesity and poverty to excessive drinking and the ratio of the population to primary care physicians. See the full rankings of Georgia's healthiest counties at www.ajc.com/ga-health-rankings.

Not all metro Atlanta counties cracked the top 25 (Fulton landed at No. 29, and Clayton took the No. 42 spot), but the study of the state’s 159 counties shows urban areas generally scoring higher.

In Clay county, in south Georgia near the Alabama border, 54 percent of the children live in poverty, compared to 10 percent in Forsyth. Some 33 percent of adults are obese in Clay county compared to 23 percent in Forsyth.

Even in Forsyth, the land of million-dollar lake homes and rolling farm pastures about 35 miles north of Atlanta, the statistics don’t exactly paint a picture of health. One in five adults in Forsyth are considered “physically inactive,” which means they don’t spend any of their free time exercising.

David Howard, assistant professor in the Department of Health Policy and Management at Emory’s Rollins School of Public Health, said he uses the data “cautiously.” The ranking is based on several health outcomes, and he said one county may score higher than another county because it has lower obesity rates – but could also have a higher smoking rate.

That said, he believes any time a new highway, new building, new school is built, health needs to be part of conversation.

“We should be continually looking at the health implications. When we have a new building – where are we going to put the sidewalks. If we are looking at a new school, we should be looking at redoing the school menu, because they have important downstream implications for health.”

Marsha Davis, an associate dean at the College of Public Health, knows the data all too well. She’s organized a conference this week to address health disparities in Georgia and help develop ways to boost health throughout the state.

“Lots of factors go into health outcomes. It’s not just one thing driving the data, but in the data it says it: where you live in Georgia matters,” said Davis. “Your Zip code should not matter, but obviously it does.”

Davis said social and economic factors such as education and income play major roles in a community’s overall health. And access to health care is also a problem in many counties, particularly rural areas, she added.

But Davis, who secured a USDA grant to fight obesity in Colquitt County (which is No. 88 in the ranking and has an obesity rate of 31 percent) is hopeful about change. The program teaches elementary-aged children about healthy eating and also offers healthy eating workshops for parents at night. Schools are looking at ways for kids to get more time to exercise, such as boosting recess time. And community leaders – at school and in the government – have come together to work on creating walkable trails.

“The children are change agents,” said Davis. “They can improve the health of their families.”

Davis said the UGA conference Thursday will gather more than 250 people, including many leaders in health care, to address everything from programs to help prevent young people from smoking to making communities more walkable to get leaders in the community to come together to improve Georgia’s health.

“It’s daunting,” said Davis about Georgia’s health challenges. “At the same time, it’s like the ripple on the ocean or pond and once you start, other things will fall into place. It’s better to start the ripple instead of saying, ‘there’s nothing we can do.’”

See the study at www.countyhealthrankings.org