Based on measurements ranging from the number of fast food restaurants to obesity and smoking rates, Boone County is ranked the second-healthiest county in Indiana. Boone was ranked second in health outcomes, which includes mortality and morbidity, and in health factors, which is based on access to care, education, the physical environment, and other topics.

HamiltonCountywas ranked first in both health outcomes and health factors.

It’s the second consecutive year Boone has risen in the list compiled by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Boone was Indiana’s fourth-healthiest county in the study’s first year, and was ranked third in 2011.

The 2012 study, designed to rate the nation’s health by using common standards, and how long Americans live, was released at midnight.

Richard Stroup of the Boone County Healthy Coalition and Dr. Herschell Services, Boone County Health Officer, said the rating shows a steady improvement in making the community a healthier place to live and work.

Within subcategories, under health outcomes Boone ranked second in mortality, and fifth in morbidity. Mortality, defined as the years of potential life lost before age 75, is a projected 5,591 per 100,000 population; the 2012 Census counted just over 56,000 residents in Boone. A person who dies at age 25 counts as 50 years lost, for example.

Morbidity is a measure of poor or fair health, poor physical health days, poor mental healthy days and low birth weight.

Under health factors, the county was second in clinical care, second in social and economic factors, and 55th in physical environment, including air pollution levels and the number of fast food restaurants.

Boone has a primary care physician for every 410 residents, higher than any other county, and far above the national benchmark of one doctor for 631 people. Indiana’s patient-primary care physician ratio is 889 to 1.

That, Dr. Servies said, shows that the county “has the resources to address the health care needs of the community.”

“Boone County benefits from the great cooperation of all of our health partners, and it shows by the participation at Healthy Coalition meetings and activities,” Stroup said.

“The County Health Rankings show that Boone County health care partners and local policymakers have been setting a proper foundation to address the health needs of our county,” said Stroup. “They continue to improve our health infrastructure.”

Cindy Murphy, RN, Boone County Health Department administrator, said although she is “pleased with the county’s health ranking, there is still much work to be done.”

Specifically, Murphy said, the county needs to lower tobacco use and obesity rates.

Three of every 10 Boone County residents age 20 and older are considered obese, with a body mass index higher than 30, the Robert Wood Johnson Foundation said in the county ranking release. The figure was based on information from the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention.

Being overweight increases the risk for coronary heart disease, type II diabetes, hypertension, stroke, respiratory problems and osteoarthritis.

According to the RWJ Foundation, “studies show an increase in obesity and diabetes prevalence with increased access to fast food outlets in a community.” In Boone, 40 percent of the restaurants are considered fast food establishments.

Twenty percent of Boone’s adults smoke — the RWJ’s figure is based on “the estimated percent of the adult population that currently smokes every day or ‘most days’ and have smoked at least 100 cigarettes in their lifetime.”

Also contributing to the county’s clinical care rank was the 85 percent of diabetic Medicare patients who underwent diabetic screening and 68 percent of Medicare enrollees ages 67-69 who had at least one mammogram over a two-year period.

LaGrange County was third in health outcomes, followed by Dubois, Hendricks, Brown, Putnam, Wells and DeKalb; the bottom 10 counties were, in descending order, Crawford, Lake, Delaware, Jennings, Switzerland, Fayette, Sullivan, Starke, Pike and Scott.

ClintonCounty was 22nd, Montgomery County 52nd and Marion County 82nd.

WarrickCounty was ranked third for health factors, followed by Hancock, Hendricks, Dubois, Vanderburgh, Delaware, Monroe and St. Joseph. The bottom 10 were Washington, Scott, LaGrange, Parke, Vermillion, Newton, Daviess, Switzerland, Sullivan and Knox.

MarionCounty was 19th, Montgomery County 25th and Clinton County 48th.