A study released earlier this month indicates that despite public-health and education efforts, Liberty County residents need to clean up their health behaviors.

The study, conducted by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, ranks each of the 156 counties in Georgia on factors such as health outcomes, health behaviors, clinical care, social and economic factors and the physical environment.

Liberty ranks last in the health-factors category, which encompasses behaviors, clinical care, socioeconomics and the physical environment. Long ranks well comparatively — coming in at No. 47.

Researcher Karen Odegaard, a community engagement specialist with the Population Health Institute, said the study aims to highlight areas that need improvement and call local leaders to action.

“The point of the County Health Rankings is to really show us that where we live, learn, work and play — all of that influences health …,” Odegaard said. “We’re really trying to demonstrate here that health is more than what happens in the doctor’s office, and it really matters.”

The purpose for looking at health factors, such as behaviors and environments, is to capture a sense of today’s health.

“Health factors are the things that influence the health outcomes, so we can look at the health factors ranking and have a sense of tomorrow’s health in the community,” Odegaard said. The health outcomes can be predicted by the behaviors.

Interestingly, while Liberty ranks last for health behaviors, it is No. 49 for health outcomes — but Long is No. 90.

The study, which compiles data from a number of state and national agencies, identifies adult obesity and children in poverty as areas that need attention in both counties.

Obesity is a high priority for the Coastal Health District, according to spokeswoman Sally Silbermann. In 2010, Liberty County kicked off the We Can! Program, which provides resources and materials to encourage children ages 8-13 to maintain a healthy weight.

Adult smoking also is an area identified for Liberty; its rate of 31 percent exceeds both the state level of 19 percent and the national benchmark of 14 percent.

Silbermann said her department does take the data into account, but added that smaller population sizes in rural areas can result in great fluctuations each year.

However, smoking cessation is a priority for the health department, which offers Freshstart smoking-cessation classes to groups and organizations that request them.

Researchers also identified excessive drinking as an issue for Liberty, with a rate of 21 percent compared with 8 percent nationally and 14 percent statewide.

When asked whether the transient military-related population may skew the data, Odegaard said the onus is on local officials to help identify causation, which can help leaders plan ways to encourage behavior changes.

“Health in a community is everyone’s responsibility,” Odegaard said. “Everybody has a role to play. … It’s not just health care that influences health, and it’s not just the public health department in your county who influences health, but business, government, education and the community as a whole all play a role.”

The ratio of residents to primary-care physicians in Liberty County also is an area to explore. Currently, the ratio of 3,461-to-1 is more than three times higher than the state’s ratio of 1,024-to-1. Nationally, the rate is 631-to-1.

Long’s areas of focus include its rate of uninsured residents — 26 percent, compared with 21 percent statewide and 11 percent nationwide — and preventable hospital stays. It had a hospitalization rate of 117 for ambulatory-care sensitive conditions per 1,000 Medicare enrollees, almost double the state’s rate of 68.

Limited access to wholesome foods is another issue for Long; according to the study, 47 percent of the county’s population is low-income and does not live within 10 miles of a grocery store. In Liberty, 24 percent meet this category, compared with 10 percent statewide.