Fresno, Tulare and Kern counties again are among the unhealthiest places in California, according to the fifth annual County Health Rankings released Wednesday.
Similar to last year, Fresno ranked 46th, Tulare 47th and Kern 54th among the 57 California counties analyzed. The rankings are part of national research by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Health Foundation.
The report evaluates nearly every county in the nation on 29 factors that influence health among broad categories that include smoking, employment, physical inactivity and access to healthy foods.
Fresno County ranks poorly in social and economic factors, with 40% of children in poverty compared to the statewide average of 24%, though air quality improved by 27% compared to 2013, according to the study.
The rankings underscore the importance for communities to help children grow up healthy, said Keith Bergthold, executive director of Fresno Metro Ministry.
"By creating environments in which people have healthy choices like recreation centers, bicycle and pedestrian-oriented streets and healthy food, communities can provide opportunities that promote better health," he said.