Many of the influences on personal health and lifespan are found where we live, learn, work and play.

County Health Rankings, a U.S. report released by The Robert Wood Johnson Foundation in February, is the first collection of reports to rank the overall health of every county in all 50 states.

Each county is ranked within the state on how healthy people are and how long they live.

Russell County ranked 71st health behaviors but the county still managed to rank 31st in the state for health outcomes and 21st for mortality rates.

 "We have a lot of risk factors but we're doing pretty well with outcomes," said local physician Richard Miles, MD PSC. "We could do better with healthy behaviors."

While many local restaurants have chosen to be smoke free businesses Russell County hospital continues to have onsite designated smoking areas.

"We are one of the only hospitals that isn't completely smoke free," said Dr. Miles.

In Russell County, Adult obesity and smoking are two of the major unhealthy behaviors affecting the rate of disease and treatment needed.

 "Russell County is the 70th poorest county in the U.S.," said Dr. Miles. "People delivering healthcare are doing a good job."

Still, like many other rural communities, Russell County is in need of additional healthcare providers.

"We need primary care doctors," said Dr. Miles. "People tend to use the emergency room for their primary care."

He said the problem is that fewer doctors are choosing to serve as primary care physicians and instead choose a specialty and practice in more urban areas.

"We need more health care and more access to the community," Dr. Miles said. "Nurse Practitioners are an option. We need them and we need to work with them."

Still, he said, Kentucky needs more doctors trained and willing to come out to work in rural areas.

People, no matter where they live, should have the best possible opportunity to be healthy.

"Studies show by 2018, we're going to be 35% behind on the number of doctors needed to serve in rural areas," said Dr. Miles.

Health living habits are key to preventing disease and premature death.

"Quality of life is much better with practicing healthy living," said Dr. Miles. "The best prevention is eating right and being physically active."

On that front, Russell County has an advantage. The report ranked the county first in the state for physical environment demonstrating low pollution and access to healthy foods in the area.

"One thing that helps us is the physical environment," Dr. Miles said. "We live in a beautiful area."

Last Thursday, a group of health professionals and environmental educators attended Connecting Children with Nature: A Health Perspective at Wolf Creek National Fish Hatchery.

The forum, comprised of experts from across the state and local officials, discussed an effort to educate and instill in youngsters the advantages of spending time outdoors.

 "Seventy percent of the population is low on Vitamin D because we are not outside," said Christine Weyman, Medical Director, Lake Cumberland District Health Department. "Vitamin D is essential for your immune system and your immune system is the foundation of health. We need our Vitamin D, so we need to get outside."

She said getting outside in the sun for 10 - 15 minutes a day helps the body to produce vitamin D.

Dr. Weyman said LKDHD has also conducted a survey beginning in Pulaski County that shows 35 percent of kindergarteners are overweight and 20 percent of them are considered obese.

She said they plan to study children in other counties and expect similar findings.

"Modern conveniences hinder our healthy life choices," said Dr. Weyman. "We're walking less, biking less and depending on transportation."

In Kentucky, seventy percent of women and fifty-five percent of men are overweight. Nationally, the amount of obese adults is forty five percent.

"We need to make sure that health is factored into land use and development when rethinking state and local planning," said Christopher Smith, Public Health Prevention Specialist, CDC.

The group discussed how to encourage residents to use available parks and recreation areas and the need to plan for greenways in future development.

"Sustainability and healthcare go hand in hand," said Patrick. "Sustainability has a major effect on health."

She said children are losing contact with nature and research has shown that time outdoors is beneficial to the overall health of kids.

Patrick discussed, Let's Go Outside, a cooperative program presented by the U.S. Fish and Wildlife Service and Kentucky Association of Environmental Education.

The program offers ideas for safe family activities outdoors through educators and local medical providers.

Some activities suggested are: catch lightening bugs in your back yard, collect rocks or leaves of interesting colors and shapes, and fish in a local stream, lake or pond.

"We believe in getting kids outdoors to help children with physical and mental health," said Environmental Education/Outreach Specialist, WCNFH, Amanda Patrick. "We're interested in helping families be healthy and learn about the environment."

The County Health Rankings report is available at www.countyhealthrankings.org