For the seventh straight year, a study by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation has ranked Forsyth County as the healthiest county in Georgia.

The ranking, released on Tuesday, took into account health outcomes, health behaviors, clinical care, social and economic factors and physical environment.

“I think it really does speak to, I would say, the strength of the people in the county, as well as the infrastructure of support that is there to support health,” said Carolyn Booker, director of patient care at Northside Hospital Forsyth. “Even from the standpoint of the way which green space is used within the county and different walkways, I will say that there is always something happening here in Forsyth County related to some type of 5K, some type of run, some type of activity, you name it.”

Forsyth County was joined by two neighbors in the Top 5 as Oconee, Cherokee, Fayette and Gwinnett counties finished second through fifth, respectively. The five counties with the poorest health were Warren, Twiggs, Quitman, Clay and Miller counties, all in rural areas of the state, particularly on the south half of Georgia’s border with Alabama.

In addition to being the healthiest in the state, Forsyth was first in health outcomes and third in health factors.

Health outcomes took into account factors like premature death, those in poor or fair health, poor physical and mental health days and low birth weight. In all of those factors, except low birth weight, Forsyth County was at or below the average for top national performers and the state of Georgia.

For low birth weight, Forsyth County’s 7 percent was slightly above the top performers’ 6 percent but below the state’s average of 10 percent.

Forsyth County was also first in the health outcomes’ categories of length of life and quality of life.

In health factors, Forsyth County finished third behind Oconee and Fayette counties.

Categories looked at for the health factors were: health behaviors, which Forsyth County was ranked first; clinical care (seventh); social and economic factors (second); and physical environment (39th.)

Health behaviors took into account physical inactivity and access to exercise opportunities.

Laura Pate, marketing and community relations manager for the Forsyth County Parks and Recreation Department, said the department offers several ways for members of the community to stay in shape.

“As far as parks are concerned, we offer three recreation centers with fitness areas and inside walking trails, also with basketball courts, so those are great amenities for the community to come in, work out and get fit,” she said. “We have over 50 miles worth of trails, and that’s anything from the Big Creek Greenway … to nature trails to mountain biking trails. So, we offer a lot of opportunities for people to stay active.”

Pate said the parks also host to a variety of youth sports, which give kids a foundation in health.

Booker said for clinical care, there is a renewed interest in preventative care to avoid issues before they require hospitalization, such as programs through the hospital’s sports medicine network.

“The hospital model now is actually focusing in on helping people to stay healthy versus just treating illness,” Booker said. “We have a lot of programs that actually assist in that focus.”

In those categories, Forsyth did lag behind in the ratios of primary care physicians, dentists and mental health providers. The population of Forsyth and the closeness to Fulton County, which had comparably lower scores, may partly explain the significant drop.

Bookers said part of health care is tackling those problems as they arise.

“Under no circumstance would anyone, especially from a health care perspective, rest on any type of a laurel,” she said. “Suffice to say that you’re always looking to improve. I think the benefit of having the Northside Hospital system within this county is that they are constantly looking at the need and striving to bring in the appropriate physician presence.”

The physical environment score – which was a factor of air pollution, drinking water violations, severe housing problems, driving to work alone and long commutes while driving alone – was noticeably lower than other scores but the statewide trend generally showed higher scores for northeast and southeast Georgia.

The severe housing problems part of the study – a percentage of households with at least one issue of overcrowding, high housing costs, lack of kitchen facilities or lack of plumbing facilities – was a major focus for those who performed the study.

“Our homes are inextricably tied to our health,” said Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, in a news release. “It’s unacceptable that so many individuals and families face barriers to health because of what they have to spend on housing. This leaves them with fewer dollars to keep their families healthy. Imagine the stress and pain that come with unplanned moves. We are all healthier and stronger together when everyone has access to safe and affordable housing, regardless of the color of their skin or how much money they make.”