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HAZARD – Nearly every southeastern Kentucky county is ranked near the bottom in the state in terms of health, according to a newly released study ranking county health statistics.

The nationwide study was conducted by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, and looks at several different factors to determine the rankings, including smoking, mortality and rates of the uninsured.

The data is separated into two categories: health outcomes, which takes into account mortality rates, low birth weight and whether respondents report that they are in good or poor health, and health factors, which takes into account obesity and physical inactivity among other things.

In terms of health outcomes, four of the eight counties in the Kentucky River Area Development District are among the 10 unhealthiest in the state, while the remaining four are still included in the 25 least healthy. Perry County is ranked 115th out of 120 counties, while both Wolfe and Owsley are even worse, at 118th and 120th respectively. Other counties include Letcher (113), Lee (108), Knott (107), Breathitt (102) and Leslie (99).

Perry County also ranks 101st in the health factors category.

Counties in the north-central part of the state generally fared well, with Oldham County at the top.

High rates of poverty, a lack of access to health care, and lifestyle habits are all likely factors in these poor rankings, remarked Karen Cooper, director of the Kentucky River District Health Department in Hazard. Poverty, in particular, and the price of healthy food versus unhealthy food specifically, can be a major factor.

“Poverty impacts a lot of different things,” Cooper said, adding that there is often a disparity in prices between healthy and unhealthy food choices. “Obviously it’s healthier to eat fresh fruits and vegetables rather than canned and processed foods.”

In terms of price, the more unhealthy foods such as potato chips loaded with oil and fat may cost more than a healthy salad, and a parent of two on a fixed income may opt for the cheaper product.

“When your dollars are stretched, then you’re going to go and get the most bang for your buck,” Cooper said.

While Perry County, the most populous of the Kentucky River counties, does have several choices for consumers to purchase groceries, other counties, such as Owsley, may have only one full-fledged grocery store. That, in turn, limits choice for consumers, and could also drive up cost, Cooper noted.

Additionally, both a lack of access and a lack of health care also leads to poor health, she continued. Several health providers work here in Perry County, but again, in other counties there may be a severe shortage. And in some cases, people may not opt for preventative screening and only visit a provider when they show symptoms of illness. This is especially prevalent in men.

“Our folks tend not to go (to the doctor) unless they see symptoms, especially our men,” Cooper remarked.

Women are more likely to undergo important screenings such as Pap smears and mammograms, even those without insurance, she continued, in part because local health departments are able to offer those kinds of services. But that also may not always be the case for men.

Yet another factor influencing these rankings rests with lifestyle choices, including what has become an increasingly inactive culture. Cooper noted that while this languorous culture has become more pervasive everywhere, and not just in the Kentucky River District, it does have a negative effect in an area where other factors, such as high rates of smoking and heart disease, are already prevalent.

“I think part of it is lifestyle,” she said. “And it’s not just this part of the state, it’s everywhere, but it’s a sedentary lifestyle.”

And the numbers back this up. Perry County is ranked 119th out of 120 Kentucky counties in terms of health behaviors. Physical inactivity in particular is at 40 percent, compared to the 21 percent national benchmark, and 31 percent statewide.

Other statistics in Perry County include 32 percent adult smoking, 39 percent adult obesity, 9 percent excessive drinking and 19 percent of the population is uninsured. All of those figures are above both the national and statewide averages.

So, is there a quick fix? Cooper says not likely, but that doesn’t mean health care providers and health officials should stop trying, and there is certainly hope for future generations that they can lead healthier lifestyles.

Some local schools are also taking a lead in this regard. Both Perry Central and Cordia High School, the latter in Knott County, as well as Dennis Wooton Elementary in Perry County, have begun programs for healthier school lunches while encouraging an active lifestyle, and have been recognized by national organizations for their efforts. It will be these kinds of endeavors that could lead to a healthier generation and reverse an alarming trend in health that, at present, has may Eastern Kentucky counties near the bottom.

“You try to educate and you try to change the lifestyle of the next generation,” Cooper said. “You try to keep those kids, and encourage them to eat healthy from the start. You try to encourage them to exercise and to buy into that.”