Minnesota's healthiest residents live in Lac qui Parle County on the state's western border, according to rankings released late Tuesday by the University of Wisconsin and the Robert Wood Johnson Foundation.
The least healthy place is Cass County in north-central Minnesota.
The second annual county health rankings include the share of residents who die before age 75, the share who say they are in fair or poor health, the number of days residents reported they were in poor physical or mental health, and the rate of low-birthweight infants.
The rankings also measure health inputs such as smoking rates, obesity and excessive drinking among adults, and the number of teenage births.
Eight of Minnesota's 10 healthiest counties are clustered south and west of the Twin Cities in an arc of affluent suburban and farming communities. But two, Marshall and Clearwater, are in the far northwest corner of the state.
Seven of the least healthy counties are in north-central Minnesota, a region that has struggled with high poverty and jobless rates. But two, Yellow Medicine and Cottonwood, are in southwestern Minnesota and one, Lake County, is in the Arrowhead region.
The report reveals huge gaps from one county to another. The rate of sexually transmitted infections, for example, was four times higher in Cass County than in Lac qui Parle. The teen birthrate in Cass County was three times that of Lac qui Parle County.
"The county health rankings help everyone see that much of what influences our health happens outside of the doctor's office, and where we live matters to our health," Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, said in a statement.
The rankings pit one county against another within a state, but do not compare across state lines. Researchers hope the results will help government, business and community leaders to make changes that improve the health of their residents.
Taryn Wobbema is a University of Minnesota journalism student on assignment for the Star Tribune.