Nathan Hake, left, of Mount Wolf, and Mark Lentz of Wrightsville speed down trail No. 5 at Rocky Ridge County Park on mountain bikes Wednesday. The men ride competitively for Cycle Works in Wrightsville. Taking advantage of county parks to exercise could help York County residents score better in the next annual County Health Rankings. The county ranked 19th in Pennsylvania this year. (John A. Pavoncello photo)

York County's health report card is a mix of As and Cs.

The county ranks 19th out of 67 Pennsylvania counties in overall health, according to the fourth annual 2013 County Health Rankings, released Wednesday and compiled by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.

The county's smoking, obesity and teen birth rates all exceed national benchmarks. And its number of fast food restaurants more than doubles the recommended benchmark.

The county also scored poorly in excessive alcohol consumption and sexually transmitted infections.

But its strength is in clinical care, which ranks No. 6 in the state and measures access to and quality of health care.

And with just 11

percent of the under-65 population without health insurance, York County matches the national benchmark.

In addition to its overall statewide ranking, York County ranked 19th in health outcomes and 16th in health factors out of all 67 counties.

Health outcomes are based on mortality and morbidity rates, which reflect length and quality of life. Health factors are based on health behaviors, physical environment, socioeconomic factors and access and quality of health care.

The numbers: Since 2010, York County has had a moderate improvement in teen birth rates, decreasing from 38 to 35 per 1,000 women aged 15 to 19.

But it's also gotten fatter, with adult obesity rates increasing from 29 to 32 percent.

Excessive drinking has stagnated since 2010, with 16 percent of adults reporting binge drinking in the past month, but that figure more than doubles the national benchmark.

The report measures the sexually transmitted inspection category with chlamydia rates, which have slightly increased from 262 to 284 cases per 100,000 people over the last four years in York County.

York's response: The Healthy York County Coalition is a joint effort aimed at improving the health of the community.

The annual report both guides and reinforces the coalition's efforts, said spokesman Kevin Alvarnaz, also the director of community health improvement for WellSpan Health.

He said York and Adams counties held a community health assessment last year, which addressed adult obesity, tobacco use, clinical depression and access to health care as major problems the coalition seeks to work on.

He said the area's abundance of fast food options and low activity rates correlate not just to obesity rates - one in five residents has been diagnosed with a depressive or anxiety disorder.

"There is a connection between all these factors," Alvarnaz said.

He said the coalition, in partnership with other organizations, creates programs like Eat Play Breathe - which aims to increase access to nutritious food and renovate local city parks - to address York County's health issues. But those initiatives take time to effect change.

"The health conditions that affect our community cannot be fixed overnight," he said.

Other efforts: He said a maternal and children's health task force, which would address the county's poor teen birth rate, is in its beginning stages.

Although clinical care is York County's strength, Alvarnaz said the coalition, in partnership with local health care institutions, continues to work on access and quality of care through initiatives that have increased access to health care and decreased the number of uninsured patients over the past five years.

"That's why we're doing so well in those areas," he said. "We'd love to be No. 1."

Where you live clearly affects your health, said Bob Woods, chairman of the coalition. York is adjacent to Lancaster and Dauphin counties, which were ranked No. 8 and No. 47 in the state, respectively.

He said smoking and obesity are the coalition's top health priorities.

"Be assured, we're doing what we can to try and have an impact on those issues and others as well," he said.

View the complete 2013 County Health Rankings at countyhealthrankings.org.

- Reach Mollie Durkin at mdurkin@yorkdispatch.com.