According to the County Health Rankings and Roadmaps report, of Washington’s 39 counties, Thurston County is the 6th healthiest in the state. Topping the list is San Juan County. Second healthiest is King County. Pierce County ranked 19th. Lewis and Mason counties landed near the bottom of the list at 27th and 28th, respectively.

The annual rankings are produced by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. They take into account quality of life (mental and physical health days, low birthweight, and overall health), health behaviors (including smoking, obesity, physical inactivity, and excessive drinking), clinical care (including the number of dentists, physicians and mental health providers compared to the number of county residents), social and economic factors (including level of education, income inequality, and unemployment), and other factors like housing conditions and air and drinking water pollution.

The study also ranked each county by the average length of life of its residents. Thurston ranked 6th, Pierce ranked 21st, Lewis ranked 30th, and Mason ranked 32nd. King County residents, on average, live longer than residents of any other county.

In a statement, the Department Director of Thurston County Public Health and Social Services, Schelli Slaughter, said that the county is taking action to continue improving the health of its citizens.

“As we move forward, it will be important to focus more on how we can address health equity in our county. We see differences in peoples’ health based on a range of characteristics including where someone lives, whether they have a disability, how much money they make, as well as gender and ethnicity,” Slaughter said. “To move our ranking up, our Department and community needs to understand and discuss these differences, then take action to change them for the better.”

Click here to view the full rankings.