Saratoga County ranked as the "healthiest" county in New York State

Drug overdose deaths more common in suburbs than inner cities, rural areas

"CHR.org is a nationally recognized organization, and these numbers are extremely helpful for county-wide initiatives like Healthy Harrison", Nardelli said.

The authors of the foundation's annual report from its County Health Rankings and Roadmaps program noted a dramatic uptick in premature deaths in the USA due largely to "unintentional injuries", which include accidental drug overdoses and vehicle crashes.

In health outcomes, Travis County from ninth overall in 2016 to fifth this year. Madison County's high school graduation rate is 83 percent, one percentage point down from in 2016, according to the rankings. In Boone County, malignant neoplasms is the leading cause of premature death with about 86 percent; suicide is the lowest with 14 percent.

Saratoga County's top spot isn't surprising.

In those categories Forsyth ranked higher than the top performers and the state average for: adult smoking rates, healthy food availability, newly diagnosed sexually transmitted diseases, teen births, percent of residents with some college, children in poverty, children in single-parent homes and injury deaths. Jackson County, which includes the core of Kansas City, Mo., came in 61st out of 115 counties.

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The report said 8 percent of the county's population remains uninsured, slightly lower than the state average of 9 percent.

"Well this is a sad day indeed", Dr. Deborah McMahan, the county health commissioner, said in an email response.

Premature death has increased most among people aged 15 to 44. All in all, the report looks at more than 30 individual health factors including income inequality, housing, jobs, education and more. For the two primary indicators, the county ranked 44th in health outcomes - down five steps - and 53rd in health factors - down nine. "We continue to show strong health outcomes".

Erie County comes in at No. 50 overall on the 2017 list of New York's 62 counties, but clinical care alone jumps to No. 10.

Alcohol consumption is also a strike against the county.

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From 2013 through 2015, 114 people died in Carroll, a rate of 23 deaths per 100,000 people, a rate Carroll shares with Calvert, Worchester and Baltimore counties, despite differing population levels.

In exploring West Virginia's premature death trends from 1997 to 2014, the Foundation found seven counties (Berkeley, Gilmer, Jefferson, Mineral, Monongalia, Morgan and Ohio) have seen improvements in premature death rates, while 21 have seen worsening rates and the rest saw no change.

A focus of the 2017 report is an 85 percent nationwide spike in premature deaths attributed to drug overdoses, the highest rates of which are found in suburbs.

It's "easier to prevent" young people from becoming disconnected than to "try to reengage young people who have dropped out of school or gone without work for some time", Givens said.

In a number of states, the least healthy county also overlaps at least one Native American reservation, where poor economic conditions, unhealthy behaviors, and the resulting negative health outcomes are far more common than elsewhere.

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