Baltimore is the least healthy jurisdiction in Maryland followed by several Eastern Shore counties, according to an annual ranking that has changed little over the past several years despite improvements in some of the city's worst statistics.

Wealthier suburban counties such as Montgomery and Howard were ranked as the healthiest in the state.


The 2016 rankings by the Robert Wood Johnson Foundation and the University of Wisconsin show a striking gap in the rate of premature death between the healthiest and least healthy areas of the state. Those living in Baltimore lost three and a half times the number of years of life than those in Howard.

The findings were not surprising to public health officials in Baltimore who have sought for years to reduce disparities not only between the city and surrounding counties but between well off and disadvantaged neighborhoods within the city.

"This affirms what we know in public health to be true, that the currency of inequality is years of life," said Dr. Leana Wen, Baltimore's health commissioner. "Access to healthcare is important, but what determines how long someone lives and quality of life depends much more on things around them like access to housing and education and income inequality."

Wen pointed out that there have been big reductions in recent years in infant mortality rates and teen pregnancies and increases in the number of kindergarteners ready for elementary school. The years of life lost prematurely in the city has also ticked down a bit since last year -- all important barometers of public health, she said.

In all there were 16 counties in Maryland with improvements in the rate of premature death, while the rest were unchanged.

The rankings within the state were largely unaffected over time by an opioid epidemic that has fueled a dramatic uptick in premature deaths nationwide among 15- to 44 year-olds.

The rankings considered more than 30 factors in several categories including quality of life, which includes the number of days a person is physically and mentally well; healthy behaviors, including levels of drinking and exercising; access to medical care; and social and economic levels such as amounts of education and crime.

In Maryland, access to health care may be helping outcomes, said Dr. Howard Haft, deputy secretary for public health services at the Maryland Department of Health and Mental Hygiene. Maryland's uninsured rate dropped to 6.7 percent in 2015 from 10.1 in 2012.

"Maryland has much to be proud of in terms of seeing the benefits of increasing access to health insurance," Haft said. "More people are connected to primary care. As a result, preventable hospital stays are going down."

He added, "Despite these gains, much work remains to be done to reduce preventable chronic conditions and address the opioid crisis our communities are experiencing every day here in Maryland."

Researchers compiled the rankings for use by public health officials and others looking for ways to improve conditions in their communities.

"The County Health Rankings show us that where people live plays a key role in how long and how well they live," said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. "The Rankings allow local leaders to clearly see and prioritize the challenges they face — whether it's rising premature death rates or the growing drug overdose epidemic — so they can bring community leaders and residents together to find solutions."