FRANK GLUCK

FGLUCK@NEWS-PRESS.COM

Affluent St. Johns and Collier counties remain Florida’s healthiest communities, while the rural regions continue to suffer some of the highest rates of mental illness, substance abuse, and premature death, a new report finds.

Lee County ranks fairly high — now in 12th place in Florida — and is up from 20th place just two years ago, according to the 2017 County Health Rankings from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The annual report assesses U.S. counties based on their economic health, crime, premature deaths, health insurance coverage, medical resources and a number of behavioral factors, such as smoking and drinking rates.

“We still have work to do in this community,” said Mary Andrews, who helps oversee community health initiatives for the Lee Health hospital system in Lee County. "But this type of information helps us design the types of plans that will be the most effective."

Union County, home to about 16,000 residents and a maximum security prison, ranked last in Florida.

Some report highlights about Southwest Florida:

About 15 percent of Lee and Collier residents reported they were in “poor” or “fair” health. Florida’s overall rate is 17 percent.

Rates of obesity in Lee and Collier were 25 percent and 20 percent, respectively. Statewide, it’s 26 percent.

About 13 percent of Collier County adults smoke, and 16 percent do in Lee County. About 15 percent of all Florida adults still smoke.

The Healthy Lee initiative, a decade-old project to promote healthy living in Lee County, will produce its own report on the community's health this summer.

While Lee County's rankings have moved around year to year, Collier's have consistently ranked high. It also earned the nation's top spot in the Gallup-Healthways "well-being index."

“It’s no surprise that Collier remains one of the healthiest counties to live in Florida," said Stephanie Vick, administrator of the Florida Department of Health in Collier County, in a written statement. "We enjoy great weather year-round, have access to beautiful beaches and parks, have a robust health care system, opportunities to participate in community-wide health initiatives, enjoy low crime rates, and our children attend a healthy school system."

Affluence is generally a good predictor of a community's health ranking. St. Johns and Collier counties have the highest median incomes in the state: $71,896 and $62,385, respectively.

While Union County's median household income rate of $41,078 isn't the lowest in Florida, it is below the state average.

But such lists can also overshadow a community's deficiencies. For instance, about 26 percent of Collier County residents under 65 were uninsured in 2014 — the sixth highest rate in Florida.

"Sometimes a high-ranking county can kind of mask what’s going on," said Kate Konkle, an associate researcher at the University of Wisconsin Population Health Institute. "Not everyone in the county may be feeling like that’s an accurate picture of what they’re experiencing."

This year, the report took a deeper look at deaths among people younger than 75. Drug overdoses, particularly among opioid abusers, are behind a “dramatic increase” in deaths among 15- to 44-year-olds in recent years, the report found.

Experts had assumed this was predominantly a problem in small, rural areas, Konkle said.

"And it certainly is, but what our researchers found was that, actually, the suburban counties went from the lowest rates of premature deaths due to overdoses to the highest within a decade,” she said. “I think many of us were surprised to see that.”

The highest rates of drug overdose deaths in Florida were in Dixie (31 per 100,000 residents) and Manatee (29 per 100,000 residents) counties. Lee and Collier's rates were 13 and 12 per 100,000 residents, respectively.

Forty-six Florida counties saw overall improvements in premature death rates, including Lee and Collier. Two, Citrus and Gilchrist, saw worsening rates.

Follow this reporter on Twitter: @FrankGluck