Leafy, affluent Morris displaced equally prosperous and rural Hunterdon as the healthiest county in New Jersey, according to interviews and data measuring personal habits, educational and financial achievement and access to medical care.
Hardscrabble and sparsely populated Cumberland County ranked at the bottom, as it has in previous reports. This is the ninth report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The goal is for government, business and community leaders to use the information to advocate for positive changes, such as adding clinic programs for uninsured or under-insured people or building a park or recreation center. "No one should have less of an opportunity to be a healthy because of where they live," Marjorie Paloma, the foundation's program director said during a morning press conference announcing the latest report at the Statehouse in Trenton. 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.
From last to first, here is a quick snapshot of each county's health profile.
21. Cumberland County
Largely rural and economically disadvantaged Cumberland County has ranked at the bottom of the health county report card since it began nine years ago.
Household income is a driving factor behind a lot of health outcomes, and once again, Cumberland reported the lowest median household income at $49,110, according to Census data. New Jersey's median household income was $76,126. The child poverty rate is 25 percent, compared to New Jersey's 15 percent rate. It's even higher among black children (30 percent) and Hispanic children (36 percent). In the plus column, the percent of uninsured citizens declined, and the percentage of people with diabetes who are monitored is up. High school graduation rates improved, too.
20. Salem County
Salem slid from 19th last year, but has always hovered toward or at the bottom.
Blame the county's 21 percent child poverty rate, compared to New Jersey's 15 percent. And 34 percent of Salem County residents are obese compared to 26 percent statewide.
Salem bests the state in some areas, however. Only 8 percent of its residents lack health coverage, compared to 10 percent statewide. Salem's violent crime rate is lower, too.
19. Camden County
Down from 18th healthiest in 2017, Camden County suffers because it has slightly higher child poverty and unemployment rate than the rest of New Jersey, and more of its citizens are obese. But drunken-driving deaths are down and its high school graduation rate is up.
18. Essex County
Essex County improved its rank from 20th last year, as hospitals reduced the number of avoidable admissions and increased the number of people monitored for diabetes. But the child poverty rate is 21 percent compared to the state's 15 percent, and obesity is rising.
17. Atlantic County
Atlantic County stayed the same from last year — near the bottom of the rankings largely because of economic instability. Unemployment in 2016 was 7.4 percent compared to 5 percent statewide; child poverty was at 23 percent compared to 15 percent in New Jersey. But there are reasons for optimism. Premature deaths are on the decline. So are preventable hospital admissions. And high school graduation rates are up.
16. Cape May County
This sparsely populated seaside county maintained its rank from last year. Economic troubles offset the gains in clinical care. Unemployment and child poverty rates in 2016, 9.8 percent and 19 percent, respectively, far exceeded the statewide average. Obesity also rose. But Cape May made progress, with fewer people getting admitted to the hospital, and more people screened for diabetes and breast cancer.
15. Gloucester County
Slipping from 14th healthiest last year, Gloucester saw its child poverty and unemployment rates rise slightly. Nearly one-third of its population is obese. But violent crime is way below the state average and the high school graduation rate is at 92 percent, besting the state's 90 percent rate.
14. Mercer County
Mercer County slipped two notches from last year's report to 14th healthiest county. Obesity and sexually transmitted diseases rose and mammography screenings declined. But Mercer still showed progress. Fewer people died before their 75th birthday and more people are being monitored for diabetes.
13. Passaic County
Passaic County was one of three counties that improved by two rungs in this year's rankings.
Deaths related to intentional injuries (like suicide and homicide) and unintentional injuries (poisoning and traffic accidents) are lower than the state average. Passaic residents also enjoy shorter commutes. Its premature death rate is in line with the state average, too. Still, there are far fewer dentists, primary care doctors and mental health professionals than the population needs.
12. Hudson County
This urban county is home to wide income disparities. It shows in the data.
Unemployment in 2016 was 4.7 percent here, below the statewide 5 percent. But 23 percent of its children lived in poverty compared to 15 percent in the rest of the state.
The rate of uninsured people was 15 percent, a drop from previous years, yet it remains higher than the state at 10 percent.
Violent crime is down, but remains higher than the state average.
11. Warren County
Warren County fell from 9th healthiest last year.
More people in Warren County smoke, drink to excess, and weigh too much than the rest of New Jersey. People in this rural county also have less exposure to air pollution, and are less likely to be admitted to the hospital unnecessarily.
10. Ocean County
Ocean County is 10th healthiest, the same as in last year's report.
Child poverty and unemployment rose, but violent crime dropped. Ocean County performed better in air pollution tests compared to the rest of the Garden State.
9. Burlington County
Up from 11th place last year, Burlington County is measurably healthier based on medical data.
The percent of uninsured people declined to 6 percent, better than New Jersey at 10 percent. Mammograms and diabetes screenings rose. There were far more mental health providers than the state average.
8. Union County
The eighth-healthiest county in New Jersey, Union residents lived longer, were more likely to report being physically active, and spent fewer days in the hospital than people statewide.
7. Monmouth County
Monmouth County maintained its 7th-place standing from last year. Access to medical care likely played a big role. Here, primary care doctors, dentists and mental health providers are plentiful. The number of people who have had breast cancer screenings and undergo diabetes monitoring is at or higher than the statewide average. Obesity is rising, although still below the 26 percent statewide average, at 23 percent.
6. Middlesex County
Middlesex County maintained its 6th-place ranking from previous surveys. But that belies the progress it made: high school graduation rates rose, as did the percentage of people who were screened for diabetes and breast cancer. The premature death rate was lower than the state average, too.
5. Sussex County
Sussex County maintained its fifth-best position this year because it scored well on the socio-economic indicators and responses to questions about residents quality of life.
Only 12 percent of county residents surveyed described their health as either fair or poor, compared to 17 percent statewide. High school graduation rates, an indicator of economic stability, reached 93 percent in the 2014-15 school year compared to 90 percent statewide. The number of children raised in single-parent households and the unemployment rate was markedly lower than the state average.
4. Bergen County
Bergen County is the fourth-healthiest county in part because of its low crime rate, its high school graduation rate and its far better than average access to dentists, primary care doctors and mental health professionals.
3. Somerset County
Somerset County residents embrace healthy habits. Only 11 percent smoke compared to 14 percent statewide, and only 17 percent reported no leisure-time activity or exercise. Obesity rates rose somewhat since the last report but at 22 percent, then remain below the 26 percent statewide average. Residents of this affluent county are more likely to have attended at least some college, have wider access to an array of medical professionals, and regularly undergo breast cancer screenings and monitoring for diabetes.
2. Hunterdon County
Usually the perennial top dog, Hunterdon with its rolling hills, farms and large homes, saw a slight rise in child poverty, obesity and sexually-transmitted diseases since the 2017 report. Yet Hunterdon's standings were still far better than the state average in all of these measures.
Hunterdon reported the highest median income in 2016, at $113,684, according to recently released Census data. Nobody has a higher high school graduation rate than Hunterdon, at 96 percent.
The number of alcohol-related driving deaths were nearly half of the state average, a decline from last year's report.
1. Morris County
Morris County outperformed the rest of the state in a variety of categories: from high school graduation rates, to lower levels of premature death, to a reduction in the number of preventable hospital admissions. Morris is also one of affluent New Jersey's wealthiest counties, and wealth translates into good health. Only 6 percent of its residents were uninsured and 3.9 percent were unemployed.