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Some of the variables that went into the rankings, such as low birth weight, infant mortality and teen pregnancy, directly relate to health outcomes. Others, such as access to primary care physicians, air quality and parks, are more indirect. "Everybody lives in an environment that helps them to be healthy or is detrimental to health," says the University of Wisconsin's Bridget Catlin, director of the county health rankings program. "It starts with a mother's health, her health behaviors during pregnancy, the care she gets during pregnancy and what environment a child lives in after birth. A parent can't feed a child healthy food if there's no healthy food to be found." And Perrin observes that "communities where it's not safe to be outside, where there aren't good parks, are really not good for kids."
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