Some of the health behavior factors analyzed for the 2018 County Health & Roadmaps report, published on March 14. The report ranked Madison County the overall healthiest among 47 counties that were part of the study. (Data from County Health Rankings & Roadmap)

Madison County ranked healthiest county in Montana

Madison County was ranked number one in Montana in an annual comparative health report, published on March 14 by the University of Wisconsin Population Health Institute, with collaboration from the Robert Wood Johnson Foundation.

The ninth annual County Health Rankings and Roadmaps report lists Madison County number one in overall health in Montana. The researchers incorporated 35 different factors to determine the healthiest and least healthy counties, including length of life, access to care, and health impacting behaviors such as smoking and exercising. Nine Montana counties were not included in the report.

“Health factors in the County Health Rankings represent the focus areas that drive how long and how well we live, including health behaviors (tobacco use, diet and exercise, alcohol and drug use, sexual activity), clinical care (access to care, quality of care), social and economic factors (education, employment, income, family & social support, community safety), and the physical environment (air and water quality, housing & transit),” the report reads.

The report lists Madison, Gallatin, Jefferson, Carbon and Fergus counties as the top-five healthiest counties in the state, and Roosevelt, Glacier, Big Horn, Rosebud and Blaine counties as the least healthy.

The goal of the County Health Rankings report is to identify disparities in health across states and the nation, and to help leaders at all levels achieve health equity.

“Health equity means that everyone has a fair and just opportunity to be as healthy as possible,” the report reads. “This requires removing obstacles to health such as poverty and discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

Montana's health report reflected results nationwide, showing the White and Asian populations with an overall health advantage. “Across the U.S., values for measures of length and quality of life for Native American, Black and Hispanic residents are regularly worse than for Whites and Asians,” the report reads. “For example, even in the healthiest counties in the U.S., Black and American Indian premature death rates are about 1.5 times higher than White rates. Not only are these differences unjust and avoidable, they will also negatively impact our changing nation’s future prosperity.”

The report calls on community leaders to address avoidable differences in health. “Achieving health equity means reducing and ultimately eliminating unjust and avoidable differences in health and in the conditions and resources needed for optimal health by improving the health of marginalized groups, not by worsening the health of others,” the report reads. “Our progress toward health equity will be measured by how health disparities change over time.”

This full report includes recommendations for identifying where action is needed and information on actions that can be taken. The full report can be found at and appended to the online version of this news story at

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