Union County ranks 15th out of Oregon’s 36 counties in health factors, according to the annual report by the Robert Wood Johnson Foundation. Last year, the county was ranked number 8.

Wallowa County scored better at 13, coming up from number 16 in 2017. Baker County dropped from 17 in 2017 to 22 this year.

In the “health outcomes” category, which focuses on poor or fair health, poor physical health days and poor mental health days, the county scored 24 out of 36.

The report lists a number of health-related items including smoking, obesity, excessive drinking, access to primary care physicians and dentists, unemployment and air pollution.

According to the report, the healthiest counties in the state this year are Benton, Washington, Clackamas, Deschutes and Hood River counties. The least healthiest are Josephine, Umatilla, Klamath, Coos, Malheur and Jefferson counties.

Carrie Brogoitti, Center for Human Development’s public health administrator, said the annual report has been coming out for quite a few years and uses a set of core measurements to rate the county’s overall health.

“There is a lot of information (on the report),” Brogoitti said. “I think the nice thing about health rankings (is that they) look at the broad nature of health in our communities. It’s not just looking at physical health but all factors that influence health and well-being.”

However, she cautioned that comparing the county’s ranking from year to year may be misleading.

“There may not be very significant changes in the county’s ranking, but other counties may have had significant changes, which would’ve changed ours,” she said.

She said the report is definitely useful, though.

“It shows us where we’re doing well, and maybe where we want to make improvements,” she said. “It shows us where we need to ask more questions or get more information.”

For instance, according to this year’s report, 18 percent of adults in Union County smoke, compared to 17 percent in 2017.

Smoking is one of the main things Brogoitti and the public health department have been focusing on. The Robert Wood Johnson Foundation report indicates that the number of local adults who smoke hasn’t decreased very much, which strengthens the health department’s commitment to help them quit.

“It’s something we’re always working on and trying to prevent,” she said.

Recently, Brogoitti went to a meeting that cited different numbers in regard to adult smoking in Union County.

The data being used for the various reports may not be the most up to date, she said, so “it’s hard to know whether we’ve made improvements.”

She added that smoking may not the biggest tobacco-related challenge in Union County, noting that smokeless tobacco use here is high. Youth use is also a concern in the county.

The number of primary care physicians available to the public received a worse ranking than last year, likely due to losing physicians. According to the report, for every physician in the county, there are 1,290 patients. Last year, the ranking was 1,070 per physician.

Despite these numbers, “In the clinical care category we have actually improved a lot,” Brogoitti said. “The reality is, in our community and rural communities in Oregon, we have a workforce challenge.”

In previous interviews with The Observer, Grande Ronde Hospital staff have said they work really hard to recruit physicians to the area, but it’s not easy. Physicians may want to move here for the hospital, but their families do not want to live in a rural community.

Brogoitti said the overall health ranking of the county is really dependent on what the researchers perceive as “healthy.”

“It just depends on what your definition of health is,” she said. “It may be different than the community’s definition.”

She said years ago the community gathered for a health improvement informational meeting and the participants identified “economic health” as a county health factor.

“I really appreciate that about our community, that we understand it’s not just about physical health,” Brogoitti said. “If you don’t have decent housing or a steady job, that will affect our well-being.”

Overall, Brogoitti said, she believes the county is doing well.

“For the most part, we’re doing well compared to the rest of Oregon,” she said.

To see the report go to www.countyhealthrankings.org/app/oregon/2018/rankings/union/county/outcomes/overall/snapshot.