By Susan K. Livio | NJ Advance Media for NJ.com
Analysts created the rankings by collecting the most recent data on 35 factors that measure quality of life and "quantity" of life — the percent of the population that lives to 75 and older.
The factors used to determine a county's health include education and income levels, crime rates, proximity to grocery stores, parks and community recreational facilities, commuting distances, the availability of doctors and dentists, and the results of water and air quality tests.
"The County Health Rankings show us that where people live plays a key role in how long and how well they live," said Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation.
So how healthy is your county?
From last to first, here is a quick snapshot of each county's health profile.
The grand opening of Vineland Urgent Care at Landis and Lincoln Avenues in Vineland, was celebrated with a ribbon cutting ceremony with the doctors who founded the facility and local dignitaries in this 2014 photo.
21. Cumberland County
With its stubbornly high unemployment and child poverty rates, Cumberland County's premature death rate is the third highest in New Jersey, defined by the number of years of life lost by people who die before the age of 75. Even though it once again landed in last place, the county made some improvements from last year. The number of preventable hospital admissions declined, more people with diabetes are getting care, and fatal drunken-driving deaths are down.
20. Essex County
With the fifth highest premature death rate, Essex County lags because of higher than average unemployment, child poverty and adult obesity rates. It also has the highest rate of chlamydia, a common sexually transmitted diseases, with more than 5,500 cases reported in 2014, the most recent data available. The high school graduation rate and the crime rate improved from the previous year.
19. Salem County
Salem slid from 17th to 19th place this year as child poverty, unemployment and the percentage of women getting cancer-screening mammographies declined. There were a few bright spots: violent crime fell and remains below the statewide average. More people with diabetes were screened and fewer residents were admitted to the hospital.
18. Camden County
Slipping one slot from last year's report, Camden is held back by its high adult obesity, child poverty and unemployment rates. Its preventable death rate improved, as did the high school graduation rate. Fewer people were uninsured in 2014, the most recent data available.
17. Atlantic County
Rising one spot this year, Atlantic County made gains because its high school graduation improved, and clinical care improved. Unemployment, adult obesity and child poverty got worse.
The north end of the Avalon beach in Cape May County following a storm in January. (Matt Dowling | For NJ.com)
Matt Dowling | For NJ.com
16. Cape May County
Drunken driving fatalities and violent crime declined, and clinical measures – preventing unnecessary hospitalizations, monitoring Medicare patients for diabetes and performing mammography screenings — improved. Cape May slipped down one notch to 16 because it still has one of the highest premature death rates in the state, and child poverty and unemployment are high.
15. Passaic County
With child poverty and unemployment worse than the previous year, Passaic slipped one notch to 15th healthiest county. On the plus side, the percentage of adults who report they engaged in no physical activity is down to 23 percent, on par with the rest of the state. The premature death rate also declined, and the high school graduation rose to 87 percent in 2015.
Amanda Nunan, of Ocean City, wins the 500 freestyle during the Girls swimming Meet of Champions held at Gloucester County Institute of Technology on March 5. (John Munson | NJ Advance Media for NJ.com)
14. Gloucester County
Gloucester County showed the most progress from last year's report, rising from 16th place to 14th place. Gloucester owes its improvement to a decline in the death rates for people 75 and younger. The percentage of people who lacked health coverage also declined from 11 percent to 8 percent, below the state average of 13 percent. Preventable hospital stays dropped from 73 percent to 61 percent.
The new pre-K center, Academy House Child Development Center V in Jersey City in 2015. (Laura Herzog | NJ Advance Media for NJ.com)
Boyars, Gene
13. Hudson County
Violent crime is down in this largely urban county, and the preventable death rate is below the state average. But drunken driving fatalities rose, as did the child poverty rate and the adult obesity rate. Hudson County slipped one notch to 13th place from last year.
12. Mercer County
Rising one notch from last year, Mercer County has access to more doctors, dentists and mental health providers than the statewide average. High school graduation reached 90 percent, tied with the state. Adult obesity and sexually transmitted diseases are up, and fewer women received mammographies.
11. Burlington County
Burlington County dropped from ninth to 11 place, as it reported slightly higher adult, unemployment and poverty rates, and an increase in sexually transmitted diseases.
Toms River South High School seniors celebrate their graduation on Friday, June 20, 2016
(MaryAnn Spoto | NJ Advance Media for NJ.com)
MaryAnn Spoto
10. Ocean County
Rising one notch this year, Ocean County saw its violent crime decline and its high school graduation rate reach 91 percent, besting the state at 90 percent. The premature death rate improved but it is still higher than the rest of the state.
9. Warren County
Warren County slipped from 8th place this year but its stats are still solid. Although unemployment and child poverty rose, these measures are still better than the statewide average. Like nearly every county, adult obesity and sexually transmitted diseases are on the rise.
8. Union County
This mix of densely-packed suburban towns and urban communities maintained its 8th place ranking from last year. Child poverty and unemployment rose but they were at or slightly above the statewide average. The premature death rate is lower than most and opportunities for physical activity abound.
The Rutgers University Scarlet Knight visited the Belmar boardwalk in this 2015 file photo. (Alex Napoliello | NJ Advance Media for NJ.com)
Alex Napoliello
7. Monmouth County
Ample access to medical professionals, a low uninsured rate and a decline in violent crime helped this shore county maintain its 7th place rank this year. Unemployment and child poverty rose here in 2015, but Monmouth fared better on these measures than the statewide average.
6. Middlesex County
Middlesex County performed better or just as well as the state on most measures across the board. The teen birth and smoking rates were low, and access to exercise opportunities was high. Adult obesity rate and the number of sexually transmitted diseases rose, a trend seen in nearly every county. Child poverty and unemployment rose, but remained below the statewide average.
In this January file photo, bear hunt protester Jerome Mandel stands with others outside the Sussex County jail in Newton, in support of Bill Crain, jailed since Friday after his 7th civil disobedience conviction since 2005 protesting the hunt. (Robert Sciarrino | NJ Advance Media for NJ.com)
Bob Sciarrino
5. Sussex County
This rural, low-crime county boasts a 9 percent uninsured rate, compared to 13 percent in 2014, according to the most recent data available. Fewer doctors, dentists and mental health counselors practice in this remote area of New Jersey compared to the statewide average, but the number of people monitored for diabetes grew, and the number of preventable hospital stays fell.
4. Bergen County
With its low crime rate, its 95 percent high school graduation rate and ample access to medical professionals, Bergen County has maintained a top-five ranking every year in the study. Child poverty rose to 9 percent, but remains well below the 16 percent state average in 2015.
3. Somerset County
This low-crime, low-unemployment county has ample access to doctors and hospitals, as well as parks and other recreational facilities. The county's smoking and obesity rates are below the statewide average. Drunken driving deaths dropped from the previous year. Nearly half of its residents commute more than 30 minutes, a worry among public health experts.
Wearing Google Glass Dr. Jordan Safirstein a cardiologist at Morristown Medical Center, left, talks to students in another room as he prepares to transmit live video during an angioplasty procedure in this 2014 file photo. (Robert Sciarrino/The Star-Ledger)
Sciarrino, Robert
2. Morris County
Morris County is home to a low premature death rate, a low crime rate, and ample access to parks and recreational facilities, as well as medical and mental health professionals.
1. Hunterdon County
Low premature death rate? Check. Lower than average smoking, inactivity and adult obesity rates? Check. High educational attainment across the board? Hunterdon, the most affluent county in New Jersey, is also the most healthy.
Red Mill Museum in Clinton, N.J., in Hunterdon County, which was once again crowned the healthiest county in New Jersey. (Kathryn Brenzel | NJ Advance Media for NJ.com)
What the rankings mean:
The goal of the annual rankings, assembled by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, is to give elected and community leaders the information they need to make changes at the local level — whether it is for more health clinics, more bike paths and parks, or investments in affordable housing, community policing and after school programs.
Elizabeth city officials in Union County have used the data to zero-in on neighborhoods where people are using emergency rooms for medical care they could be getting at a doctor's offices, Krishna Garlic said, the city's director of Health and Human Services.
About eight months ago, they identified Mvralag Manor, a large public housing development in the Bayway section of the city.
Working with a health coach funded by the Robert Wood Johnson Foundation, a team of government, nonprofit and other community partners “did an assessment of where are the corner stories, where are they getting access to fresh food, are they follow up with primary doctors, what kinds of medical conditions are they presenting with,” Garlic said.
Trinitas Regional Medical Center provided health screening fairs. The Community Food Bank of New Jersey made weekly trips to offer fresh produce and introduce them to healthy items they may not buy on their own, like quinoa, a good alternative to rice, Garlic said. Paramedics are making home visits.
The goal is to prevent diabetes, obesity and high blood pressure, Garlic said. They intend to measure the success of these strategies by seeing if emergency room visits decline. The project will expand to the Elizabeth Port, or E-Port section of the city soon, she added.
“The rankings allow local leaders to clearly see and prioritize the challenges they face — whether it’s rising premature death rates or the growing drug overdose epidemic — so they can bring community leaders and residents together to find solutions.” said Lavizzo-Mourey of the Robert Wood Johnson Foundation.
Although drug-related deaths are not a separate category, the analysts took special note of the national rise in premature deaths, particularly among people ages 15 to 44. The nation’s heroin and prescription drug epidemic sent the death rate soaring by 85 percent from 2014 to 2015, according to the report.
Drug overdoses killed 1,600 people in New Jersey in 2015.
The highest rate of drug-related deaths occurred in Camden County, where the per capita death rate was 28, compared to the statewide rate of 15 from 2013-15. Cape May and Gloucester were tied for second highest at 26 deaths per 100,000 people, according to the report.
Despite these statistics, the premature death rates improved in 17 out of the 21 counties, while the rest saw no change, according to the report.
State Health Commissioner Cathleen Bennett said the department uses data like what is contained in the report to set goals to improve health.
“State grants to local communities are funding innovative projects to keep the well healthy, support those at risk for health problems and prevent those with chronic conditions from getting sicker," Bennett said.
Hunterdon County and Cumberland County — two suburban-rural counties at the opposite ends of the income spectrum —have placed first and last, respectively, since the project began eight years ago.
Susan K. Livio may be reached at [email protected]. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.
Ad Choices