Montezuma County ranks near the bottom compared with other Colorado counties in health outcomes and factors, but is toward the top in the quality of its physical environment, according to a

The annual national rankings – released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute – are based on a variety of health factors.

Montezuma County ranked as the 44th healthiest Colorado county, in the bottom 25 percent.

“We have lower socio-economic families in this community, and that affects a lot of things,” Montezuma County Public Health Director Bobbi Lock said.

This year’s ranking is a slight improvement from last year’s, when Montezuma County ranked 46th healthiest out of 60 ranked counties.

Montezuma County scored 51st out of the 58 counties for length of life, 47th for health behaviors and 51st for social and economic factors.

The county ranked 35 out of 58 for quality of life. The rate for adults in fair or poor health is the same as the Colorado average rate, and the low birth weight rate in the county is better than the state’s. Montezuma ranks slightly worse than the average Colorado rate for number of poor physical or mental health days.

Montezuma County had a lower level for high school graduation (71 percent) than the state (77 percent) and U.S. top performers (95 percent). The county’s rate rose, up from 62 percent in 2010.

The county’s unemployment rate was 5.6 percent. Unemployment peaked in Montezuma County at 9 percent in 2010 and has been declining in recent years, but remains higher than state and national averages.

About 29 percent of Montezuma County’s children live in poverty, according to the rankings. That’s up from 21 percent in 2002 and nearly double the Colorado average rate of 15 percent.

“It affects every aspect of their lives,” Lock said.

Even though there are lots of opportunities for outdoor recreation in the county, there are still cost barriers for many people, Lock said. If you want to hike, you need to purchase good hiking shoes and have a good car to get to the trail, she said.

The adult obesity rate has gotten worse in Montezuma County, from 18 percent in 2004 to 22 percent in 2013, according to the rankings.

Lock said she uses Colorado Department of Public Health and Environment data more than the Robert Wood Johnson Foundation numbers.

The county public health department is gearing up for a survey that will seek input on what public health issues are important to county residents. That survey will go out in the fall, Lock said.

“We want to make sure that we are offering all the public health possibilities,” she said.

For the second consecutive year, La Plata County ranked as the 15th healthiest county in Colorado, according to the annual County Health Rankings.

“RWJF’s County Health Rankings allow us the opportunity to have access to local data, which is a critical tool for us to use in prioritizing the issues that we face in our communities so that we can focus on solutions,” said Liane Jollon, executive director of San Juan Basin Public Health.

The rankings evaluated 58 Colorado counties.

La Plata County ranked 18th in the state for length of life and 14th for quality of life (based on poor or fair health, poor physical health days, poor mental health days and low birth weight).

La Plata County was about average with state percentages for health behaviors such as smoking, obesity and physical inactivity.

Jollon said the county’s obesity and physical activity rates were positive takeaways from the rankings. Obesity rates remained level from last year, and the amount of adults who said they don’t have time to exercise decreased from 18 to 12 percent over the last five years.

“As a community, we are doing well in that direction,” she said.

However, the rankings did show some alarming statistics for La Plata County.

A new category for firearm fatalities was the “most alarming” statistic, Jollon said.

In La Plata County, 12 people per 100,000 residents died in a firearm-related incident. In Archuleta County, 21 people per 100,000 residents died. For the healthiest counties in the country, the rate is 7 people per 100,000 residents.

Jollon said the health department is exploring projects to promote gun safety, and has a new program that aims to reduce suicides by firearms.

Another negative takeaway from the ranking was La Plata County’s percentage of excessive drinking. Twenty-two percent of residents said they had binged drank in the last 30 days, above the state average of 19 percent and well above the U.S. top performer average of 12 percent.

La Plata County’s score in “Access to Exercise Opportunities” (79 percent) was well below the state and top performer average (91 percent). Representatives for the rankings did not immediately respond to questions.

According to the report, “Access to Exercise Opportunities measures the percentage of individuals in a county who live reasonably close to a location for physical activity. Locations for physical activity are defined as parks or recreational facilities. Parks include local, state and national parks.”

La Plata County’s rate of uninsured residents (14 percent) was higher than state average (12 percent) and national average (8 percent).

Unemployment in La Plata County (3.5 percent) was below the state average (3.9 percent) but above the national average (3.3 percent).

Dolores County was ranked the 46th healthiest county in the state overall, but ranked as the No. 1 county in the state for quality of physical environment for the second year in a row.

The county has less air pollution and fewer people driving to work alone than the Colorado average.

Archuleta County was ranked 24th healthiest county in Colorado.

Archuleta had a higher than average rate of uninsured residents (17 percent). The county had a score of 25 percent children in poverty (15 percent statewide) and an unemployment rate of 4 percent.

Because of its small population, San Juan County was not ranked.

The top five healthiest counties are Douglas, Broomfield, Boulder, Routt and Eagle.

Jollon said the health department will hold meetings that invites the community to discuss the rankings.

jromeo@durangoherald.com and jacobk@ the-journal.com