Health & Medicine

California’s healthiest counties are also some of its wealthiest. How healthy is your county?

A new study revealing California’s healthiest, and least healthy, counties highlights the divide between both urban and rural California as well as richer and poorer counties.

The study, published Tuesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, ranked every county by two metrics: Health outcomes, measured by factors such as premature deaths, percentage of people in poor or fair health, the number of poor physical and mental health days taken and babies with low birthweight; and health factors, measured by factors such as health behaviors, clinical care, social and economic factors and the physical environment.

The findings showed that that the Bay Area, Napa Valley and Southern California were home to some of the healthiest counties in the state, while the least healthy counties all were found in rural Northern California and along the Central Valley.

Here are the top 10 healthiest counties in California, according to the report:

  1. Marin County
  2. San Mateo County
  3. Santa Clara County
  4. Placer County
  5. Orange County
  6. San Francisco County
  7. Napa County
  8. Sonoma County
  9. Ventura County
  10. San Diego County

And here are the top 10 least healthy counties:

  1. Lake County
  2. Siskiyou County
  3. Modoc County
  4. Trinity County
  5. Plumas County
  6. Yuba County
  7. Kern County
  8. Tulare County
  9. Fresno County
  10. Humboldt County

Elsewhere in the state, San Luis Obispo County ranked No. 15, Sacramento County No. 29 and Stanislaus County came in at No. 33.

In many cases, the healthiest counties are also the wealthiest counties.

Marin County, the healthiest in California, also claimed the highest median income ($63,110) in the state, according to a 2015 report from the California Franchise Tax Board. Lake County, the least healthy county in the newly released study, also had one of the lowest median incomes for 2015 — $29,955.

So how big is the divide between Marin and Lake?

About 11 percent of Marin County residents recorded being in poor or fair health last year; 18 percent, nearly one in five, of Lake County residents did. Lake County residents also declared, on average, one more poor physical and mental health days than did Marin County residents.

Again and again, Marin County residents reported generally healthier behaviors than did Lake County residents: Fewer smoked (10 percent to 15 percent), there was less adult obesity (18 percent to 24 percent) and much greater access to exercise opportunities (99 percent to 65 percent).

Meanwhile, Lake County residents led Marin County residents in alcohol-impaired driving deaths (41 percent to 30 percent), sexually transmitted infections (443 cases of chlamydia per 100,000 to 295 cases of chlamydia per 100,000) and teen pregnancies (36 per 1,000 females to 7 per 1,000 females).

Lake County residents also were less likely to have health insurance and have a much harder time finding medical care than do residents of wealthier Marin County. While there are 680 people for every one primary care doctor in Marin County, in Lake County that ratio is 2,140 to one.

Among the social and economic factors in the two extreme ends of the study, Marin County has a 2.9 percent unemployment rate and approximately 8 percent of its children live in poverty. In Lake County, the unemployment rate is 5.7 percent and nearly a third of all children live below the poverty line.

While the study found good news in many counties across the state, that good news wasn’t universal.

“The data show that, in counties everywhere, not everyone has benefited in the same way from these health improvements,” the study found. “There are fewer opportunities and resources for better health among groups that have been historically marginalized, including people of color, people living in poverty, people with physical or mental disabilities, LGBTQ persons, and women.”

The study authors wrote that many of the differences in opportunity were “the result of policies and practices at many levels that have created deep-rooted barriers to good health, such as unfair bank lending practices, school funding based on local property taxes, and discriminatory policing and prison sentencing.”

In California, that disparity often falls along racial lines.

While 55 percent of overall Californian households own their homes, that number falls to 34 percent for black residents of the Golden State. Hispanic and American Indian/Alaska Native people also fell below the average.

Childhood poverty is also much more common among racial and ethnic minorities, with black and Hispanic children much more likely to live below the poverty line.

Housing, that omnipresent California crisis, hits the black community particularly hard — about 30 percent of black households report a “severe housing cost burden.”

“The collective effect is that a fair and just opportunity to live a long and healthy life does not exist for everyone. Now is the time to change how things are done,” the report concluded.

The full study can be found at

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Andrew Sheeler covers California’s unique political climate for McClatchy. He has covered crime and politics from Interior Alaska to North Dakota’s oil patch to the rugged coast of southern Oregon. He attended the University of Alaska Fairbanks.