Douglas County citizens are some of the healthiest people in the state of Kansas, according to the annual County Health Rankings report by the Robert Wood Johnson Foundation and the University of Wisconsin.

For the second year in a row, Douglas County ranked as the eighth healthiest Kansas county. Riley County and Johnson County were first and second. Decatur and Woodson counties were next to last and last.

The study uses 35 measures that include health behaviors, social and economic factors and physical environment to gauge how healthy a county’s citizens are.

“The big picture view for me is there is a lot that goes into figuring out the health in our community,” said Dan Partridge, director of the Lawrence-Douglas County Health Department. “This goes beyond the normal framework when people think about health. Health happens at a lot of different places.”

Lawrence does well compared to the rest of the state in a number of areas: high school graduation, fewer children in poverty, less air pollution, no drinking water violations and fewer teen births — 13 last year compared to an average of 40 across the state.

But its rankings fall with high numbers of violent crime and sexually transmitted infections, severe housing problems and excessive drinking, according to the report.

“When you look at us as opposed to the rest of the herd, violent crimes, sexually transmitted infections (and) housing problems are the largest outliers going in the wrong direction,” Partridge said. “We can point to some easy causal factors

An interesting finding is that while Douglas County’s social and economic factors’ ranking dropped from 35 to 45, the actual measures for that category improved or were unchanged.

For instance, the 2015 report said the high school graduation was up 4 percentage points, to 88 percent, violent crimes were down from 403 to 387, and the ratio of children in single family homes dropped from 31 percent to 28 percent.

Partridge said the county is being measured against other counties, and if they improve more than Douglas, it pushes the county down.

“We can be getting better, but if we are not getting better faster than other counties, then we fall behind,” he explained.

In addition, under health factors, the county did better than the statewide averages in several measurable areas, but Partridge said there is much room for improvement.

For example, adult smoking was 16 percent in Douglas County compared to 18 percent statewide, a number that needs to come down more, Partridge said.

“The affects of tobacco are still one of the largest causes of preventable diseases in Douglas County,” Partridge said. “It’s a very significant health disease.”

Partridge said he was concerned about vaping or smoking e-cigarettes that may help keep people smoking tobacco, even when they perceive they are eliminating some of the health negatives associated with doing so.

“Some people are portraying it as a way to quit smoking, but look who is making the product,” Partridge said. “I think it is intended to be an addiction enabler.”

Another health behavior number that needs to come down gauges obesity. In Douglas County, 25 percent of citizens are considered obese, and the obesity level statewide is 30 percent, the report said.

At the same time, about 18 percent of Douglas County citizens are inactive, while 24 percent of Kansas citizens are inactive, according to the report.

One percent equals 800 people in Douglas County, Partridge said.

“If 800 people started exercising, what is the trickle-down effect?” he asked. “Eight hundred people feel better, and the cost of health care goes down. There is tremendous benefit in that one percent.”