If you want to live in the healthiest county in the region, head north.
Collin County ranks No. 2 in Texas for overall health, followed by Denton at No. 3.
Williamson County, which includes parts of Austin, took the top spot in the County Health Rankings released Wednesday.
Tarrant was No. 37, and Dallas came in at No. 70 in the statewide rankings.
North Texas counties didn't fare as well in the air pollution category.
But compared with counties of similar size, Tarrant did fairly well in other categories, ranking mostly in the 30s, Tarrant County Public Health Director Lou Brewer said.
"We're not unhappy with that," she said. "It tells us that as a community, we have room for improvement. Health does not occur in a vacuum."
The report, released by the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation, offers a snapshot of the health of more than 3,000 counties and the factors that contribute to that outcome. The data, collected from 2000 to 2008, compare counties within each state rather than between states. Texas has 254 counties; 221 were ranked.
A map of Texas reveals that counties in the east and northeast are the least healthy, said Dr. Patrick Remington, associate dean for public health at the University of Wisconsin.
"Anything east of Dallas looks like it's pretty unhealthy," he said.
Tarrant County has been trying to address the factors that influence health, such as access to nutritious foods, Brewer said.
"We've been working on access to healthy foods through our community gardens and farmers markets," she said. "And we are looking for more opportunities to really grow those programs so we can increase access."
The rankings reveal each county's strengths and weaknesses.
While Tarrant County ranked fairly high for overall health, it came in 88th for social and economic factors, with 17 percent of children living in poverty.
Just why Denton and Collin counties ranked considerably higher in overall health is not clear. But the healthiest communities nationwide are urban or suburban and upper middle class, according to the report.
"As a trend when we see higher socio-economic areas, the health tends to be greater," Brewer said.
One thing all the counties have in common is a poor ranking in the physical-environment category, which includes air pollution, the number of liquor stores and access to healthful food.
"The map looks like Tarrant and Dallas counties and those 10 to 15 surrounding counties have some of the worst air quality in the nation," Remington said.
Brewer said Tarrant County's physical-environment ranking of 214 certainly caught her attention.
"We had some company there," she said. "We all know that in our metro area air quality is an issue."
Dallas ranked 217th, Denton 209th and Collin 192nd in the physical-environment category.
JAN JARVIS, 817-390-7664