Jeffrey D. Allred, Deseret News
The autumn leaves change in the mountains in Morgan County Wednesday, Oct. 19, 2011.\r\n

SALT LAKE CITY — The cool, clean mountain air of Morgan County does more for its residents than provide a breath of fresh air.

For the third year running, the northeastern Utah community has been named the healthiest in the state.

And also for the third time, several southeastern Utah counties have landed at the bottom of the rankings, suggesting scant access to health care, as well as resources, are having an effect on residents there.

The standings were released Tuesday by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. It is the third year that health data for more than 3,000 counties across the country has been dispersed in such fashion, pitting the counties of each state against each other.

"Our health officers fight tooth and toenail to get their share of the dollars that are coming from the government," said Terrie Wright, spokeswoman for the Southeastern Utah District Health Department. With residents spread across four counties and more than 17,000 acres of land, funds dedicated to various health screenings and outreach efforts seem not to stretch as far.

The area is also replete with coal mines, which might also be to blame for a variety of health concerns.

"Coalminers need something moist in their mouths, the environment is very dry and that's why they turn to chewing tobacco," Wright said.

The data suggests that nearly 20 percent of adult residents in Grand, Uintah, Duchesne, Carbon and Emery counties smoke or use tobacco. The rest of the state hovers around 10 percent, according to the report.

Carbon County has ranked No. 26 out of Utah's 29 counties, since 2010, when the nationwide comparison reports were first released. The rural nature of the county and smaller sample sizes, Wright said, plays against them.

But despite its low ranking among Utah counties, Wright takes comfort in knowing that Carbon is still healthier than dozens of counties across the country.

Across the state, health directors believe residents in Morgan are choosing to be healthy.

"We determine what our health is going to be by the choices we make," said Gary House, executive director of the Weber-Morgan Health Department. "The lifestyle that we live, what we eat, what we drink, whether we choose to exercise or not, whether we have access to affordable quality of care. All of these are personal choices and combined, all of them determine whether or not we're going to be healthy, or whether we're going to put ourselves in a position to be at risk for illness and disease."

Morgan is also somewhat rural, boasting just 14 people per square mile in its eight cities and towns. It has one of the lowest smoking rates in the state, as well as low rates for obesity, teen births and motor vehicle crashes. Morgan also has some of the state's lowest numbers of uninsured or poor individuals.

There are just four fast food restaurants in the county as well, according to the report.

While Morgan tops the state in health outcomes, which means people are living longer and having a better quality of life there, it comes in second among health factors, which includes many of the lifestyle choices House referred to.

Summit, Davis, Cache and Utah counties also ranked fairly high in various categories. Salt Lake County came in at No. 12, one spot lower than where it was last year. The report indicates, however, that the movement isn't due to slipping health, but rather improving neighboring counties.

"Where we live really matters to our health," said Dr. Patrick Remington, associate dean at the University of Wisconsin School of Medicine, which helped to compile the annual report. Access to healthy foods, walkable communities and health care, as well as education levels and available programs help to determine an individual's fitness level.

Remington said that while lifestyle choices and eating habits make the most difference in the lives of citizens when it comes to health, unemployment and poverty also play a critical part.

"It's all of our responsibilities to promote health in our communities," he said, adding that cities with close-knit families and available networks of social support are generally healthier.

"I like it up here, there's fresh air and friendly people," said one of the oldest residents in Morgan County, Mabel Welch. The 100-year-old doesn't diet, but also doesn't take many medications, and credits a positive attitude for much of her longevity.

"I give a lot of food away. I just love to do that," Welch said. "It sure makes me feel good. If I was down, if I felt depressed, I wouldn't be as healthy."

The centenarian also said the "nice, fresh air — without all that pollution and smoke and all that business" in Morgan hasn't hurt.

The report aims to affect various health policies and changes in counties across the country. Remington said that promoting healthy behaviors goes a lot further than treating the sick. Complete rankings and additional information regarding the County Health Rankings can be found online at www.CountyHealthRankings.org.

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