UPPER DELAWARE RIVER VALLEY — The fifth annual County Health Rankings, which measure the health outcomes and impacts of practically all of the counties in the United States, were published on March 16, and once again Sullivan County is second from last in New York State. Sullivan placed 61 out of 62 counties, ahead of only Bronx.

Some nearby counties, such as Westchester and Rockland, are near the top of the list, but the very best is Livingston County in the Finger Lakes region.

Some of the differences between the two: the adult smoking rate in Sullivan is 26%, in Livingston it is 17%; the measure of excessive drinking is 19% in Sullivan, the figure for Livingston is 11%; teen births are 31 per 1,000 females aged 15 to 19 in Sullivan, in Livingston, the figure is 12.

Some measures, however, aren’t that different from place to place. For instance, 29% of the population in both counties is obese.

Why does it matter? According to the people who publish the report, The Robert Wood Johnson Foundation and the University of Wisconsin Public Health Institute, people who live in one of the healthier counties tend to live longer. A press release about the rankings explains, “The least healthy counties have twice the death rates and twice as many children living in poverty and teen births as the nation’s healthiest counties.”

The rankings estimate how many years might be lost due to premature death, which is judged as any death that occurs before 75 years of age. In Sullivan, there are 7,799 potential years lost; in Livingston, the number is 4,701.

There is a feature on the rankings for each county that suggests areas that counties might wish to investigate to improve the health situation. Regarding Sullivan County, the suggested areas to look at include adult smoking, adult obesity and the ratio of primary care physicians to residents, which in Sullivan is one to 2,136. In top performing counties, the ratio is one to 1,051.

Other areas that might be good to investigate: the high unemployment rate, the low high school graduation rate and housing problems.

Across the river in Pennsylvania, the ranking paints a better picture in Wayne and Pike counties. In terms of health outcomes, Wayne County ranks 29 out of a total of 67 counties, and Pike County ranks 11. The years that might be lost due to premature death total 6,647 in Wayne and 5,761 in Pike.

Nationally, the rankings show that there have been improvements in some areas regarding health. For instance, the teen birth rates have decreased about 25% since 2007, and smoking rates dropped from 21% of the population in 2005 to 18% in 2012.

This year, the ranking added some new measures into the mix of situations that impact housing, such as measuring overcrowded households. According to the national rankings, almost one in five households are overcrowded, pose a severe cost burden, or lack adequate facilities to cook, clean, or bathe.

Also, the rankings record the percentage in the counties of residents who drive to work alone, which nationally is more than 75%; and among those workers, 33% drive longer than half an hour each day, contributing to physical inactivity, obesity and air pollution.

Another area getting attention this year is access to mental health providers. According to the ranking, the availability of mental health providers in the healthiest counties in each state is 1.3 times higher than in the least healthy counties.