St. Clair County nudged its way up the state ranking of healthiest counties after years of being declared on life support, according to a national report.

The county is now ranked 88th overall out of the 102 counties in Illinois, a jump from 94th last year, according to the fourth annual report from University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation.

The report examines a host of factors to determine the rankings, ranging from health care access, teen birth rates, poverty, education levels and even the density of liquor stores in a county.

While St. Clair's ranking has improved, neighboring Madison County has dropped 75th to 83rd. St. Clair County is the lowest ranked county in the metro-east, while Clinton County is ranked the healthiest at 15th.

Communities can use the health rankings to look at specific drivers of health and outcomes, and make plans and take action to improve health, according to Elissa Bassler, of the Illinois Public Health Institute, a nonprofit group that promotes partnerships to work on health issues such as obesity and physical education in schools.

St. Clair County Director of Community Health Mark Peters said the rankings bump follows a concerted effort by the county health department, schools and organizations to improve the health of residents.

Unhealthy habits, such as smoking, excessive drinking and sexually transmitted infections, placed the county second worst in the state in 2011 in terms of unhealthy behavior. Since then, St. Clair County's health behavior ranking improved to 90th in 2012 and dropped slightly to 93rd this year.

"It wasn't a total shock to us, but nobody wants to be ranked close to dead last," Peters said. "We decided, though, that at least we're not dead yet so let's move forward. We have been able to see in subsequent years ... some progress."

Peters said it was hard to tell whether county-spearheaded programs have spurred the rankings improvement but notes he has seen "tremendous momentum" from partners for the effort, such as churches starting community gardens or walking clubs.

This summer the county will also begin turning federally assisted housing units into smoke-free buildings in Belleville and Centreville, Peters said. The residents share the same ventilation system meaning second-hand smoke can currently enter neighboring units. About 60 percent of the public housing residents favored the change, according to a county survey.

The plan is part of a multi-pronged approach to improving community health and is paid for through a $1.1 million federal grant. The grant also will provide money to create safe routes for kids to walk or bike to school, and help schools develop comprehensive wellness policies.

St. Clair County's ranking is partially weighed down by a category judging social and economic factors. The county ranked 98th when comparing children living in poverty, violent crime rates, unemployment and similar factors.

Nationally, the report shows unhealthy counties have higher rates of childhood poverty compared to healthy counties. The child poverty rate is 31 percent in St. Clair County and 20 percent in Madison County. The state's overall child poverty rate is 21 percent.

A growing amount of research shows a person's hometown can greatly affect their health, Peters said.

"They have been able to show depending on where you live can be a pretty good indicator of how long you will live," Peters said. "You can go 10 miles away in one county and see the lifespan change anywhere from 10 to 20 years just because an impoverished community has less access to care, less access to quality food or activities."

The five least healthy counties are all in southern Illinois: Alexander, Gallatin, Edwards, Franklin and Pulaski. The five healthiest counties in Illinois are Douglas, Jo Daviess, Woodford, Mercer and Henry counties.

2012 2013

Clinton 17 15

Monroe 13 21

Randolph 35 43

Bond 70 62

Madison 75 83

St. Clair 94 88

Source: University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation.

The Associated Press contributed to this article. Contact reporter Daniel Kelley at dkelley@bnd.com or 618-239-2501. County health rankings