In a nationwide and statewide "county health ranking," in which U.S. counties' health was measured by indicators such as mortality, alcohol use and access to health care, Marion improved slightly from a year ago, but still fell in the bottom half among Florida's 67 counties.
The county ranked 44th for mortality and morbidity rates and 39th in other heath-related behavior. In 2012, Marion ranked 48th for mortality and morbidity and 44th in other health-related behavior.
The improvement appears to be mostly due to other counties declining, not Marion County improving.
The research was overseen by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. This is the fourth such annual report.
St. Johns County ranked healthiest in Florida for mortality and morbidity; Union County was the worst. Those rankings were the same as in 2012.
Some of the health-related issues that caused Marion County's poor showing were:
• Adult smoking: Twenty-two percent of Marion adults reported they smoked tobacco. That's 3 percentage points greater than the Florida average and 9 percentage points greater than the national average.
• Access: The ratio of Marion County's population to primary care doctors was 1,927:1. That was greater than Florida's average of 1,439:1 and the nation's 1,067:1.
• Obesity: Among Marion County adults, 32 percent were identified as obese, compared with Florida's average of 26 percent and the national average of 25 percent.
• Exercise: Among Marion County adults, 28 percent reported they had no leisure time activity. Florida's average was 24 percent. The national average was 21 percent.
Among social and economic factors, such as education, children in poverty and unemployment, Marion County ranked 52nd.
Among Marion County children, 30 percent live in poverty, compared with Florida's average of 25 percent and the national average of 14 percent.
Heart of Florida Executive Director Kerrie Jones Clark said she wasn't surprised Marion County's poor health ranking had remained about the same since a year ago. She said the societal problems that caused many of them to begin with still remain.
Clark said the relatively low number of primary physicians in Marion County, the 25 percent of residents who have no health insurance, and the high unemployment and number of poor are the primary reasons Marion County lags in the health rankings.
Heart of Florida provides medical care predominantly to the county's poor, uninsured or under insured.
Clark said that to improve the county's overall health, Heart of Florida is trying to recruit more health care providers. But local officials need to bring more jobs — the kind that provide health insurance — to the area.
Heart of Florida is predicting 38,000 patient visits this year.
United Way of Marion County President Maureen Quinlan said if the county's overall ranking is to improve, it will take an across-the–board effort among the county's social, medical and business institutions.
Taking the county's high obesity and low physical activity standings as an example, Quinlan said part of the solution is to encourage employers to encourage employees to exercise — and for the media to report more about healthy living.
"But when you're talking about changing habits, it's very difficult," Quinlan said, adding that many people will never stop unhealthy habits.
But through United Way's focus on family health, economics and education, things can get better, she said.
"If you're going to see a notable change in some areas, it's going to take 10 years. You're not going to see it overnight," Quinlan said.
Also contributing to the county's health problem was a changing society, she said. Employers don't sponsor organized sports the way they once did, and an abundance of technology encourages people to live more sedentary lives than they previously did.
"And the demands of life have really changed," she said.
Ben Marciano, executive director of the Frank DeLuca YMCA, said part of the answer is innovative partnerships like the one announced Monday between his organization and the nonprofit Munroe Regional Medical Center.
Marciano described the YMCA and Munroe as similarly focused on improving and managing the health of the community.
Although the details are still being worked out, the partnership will include health screenings, risk assessments, health and wellness education classes, nutritional counseling, support groups, chronic disease management programs, therapies and on-site medical services, specializing in preventative and wellness care.
Marciano said some of the county's problems stem from a lack of alternatives.
"There's not a lot for families and kids to do in our community, so they get mixed up in bad behavior," he said.
To help alleviate some of that problem, the YMCA allows one-third of its members to join the family health facility at reduced or free rates.
Part of the effort should be geared toward getting people with unhealthy lifestyles to start attending facilities like the YMCA, he said.
Many people are afraid they can't perform the exercises and get healthier, Marciano said. To address that, the YMCA offers beginner classes and creates groups of people with similar health issues, such as diabetes or weight, and similar goals so as to create support groups and encourage people to remain active.
The partnership with Munroe will include cooking workshops to show people how to eat healthy and do so economically.
The partnership will also include health screenings and risk assessments to help members determine what health problems and challenges they face.
"With 50 percent of diseases, the answer is exercise, diet and nutrition," he said, "but the hardest part is (for people) to walk through the door."
Contact Fred Hiers at 867-4157 or firstname.lastname@example.org.