Hamilton County ranked in the top-25 healthiest counties in Tennessee in a new national survey but also was listed among the five worst counties in the state for environmental factors such as air pollution.
But local officials said the dirty-air numbers were based on statistics that most counties don't track. That puts those that do - like Hamilton County - at a disadvantage, said Bob Colby, director for the Chattanooga-Hamilton County Air Pollution Control Bureau.
"The fact of the matter is, most of the 95 counties in Tennessee don't have any ozone monitors or any particulate monitors," Colby said Wednesday. "For the last six years, we've been able to say our air quality is better than it's ever been."
The healthiest county in Tennessee was Williamson County near Nashville and the least healthy was Benton County in western Tennessee, according to health outcomes rankings compiled by the Robert Wood Johnson Foundation and the University of Wisconsin School of Medicine and Public Health. This is the second year the rankings have been released.
Tennessee Health Commissioner Susan Cooper said the rankings are a "handy tool to get a snapshot of where you are."
She said even the lowest-ranked counties have strong points, and the highest have room for improvement.
"Someone has to be first and someone has to be 95th," she said.
The rankings allow public health leaders and residents to see how their counties compare with others. Researchers hope the results will prompt public policy and business decisions that will improve health.
The rankings factor in tobacco use, obesity levels, access to health care and healthy food, education, employment, safety and air quality, according to the foundation.
With 40 percent of children in poverty and a 14 percent unemployment rate, Grundy County ranked 94th of Tennessee's 95 counties. That's better than last year, when Grundy ranked dead last.
In the Northwest Georgia Health District, five counties improved from last year and five got worse, district spokesman Logan Boss said.
Among those, Catoosa improved from 39 to 34; Dade worsened from 54 to 63; and Walker dropped from 88 to 106, he said.
"These rankings are health snapshots in time and, since they're just two years apart, do not indicate trends," he said.
The data "confirms that much of what influences our health happens outside of the doctor's office," he said.
Among the findings:
* Of Georgia's 156 counties, Walker ranked 52nd for socioeconomic factors, based partly on a homicide rate of five deaths per 100,000 population, compared to a state rate of eight.
* Walker's 29 percent smoking rate and 20 percent adult obesity rate exceeded state averages of 20 percent and 28 percent, respectively.
* On the plus side, the chlamydia rate per 100,000 population was 185, compared to 447 for the state.
Ali Donahue, marketing director for the Northwest Georgia Health Care Campaign, said she was surprised by the disparity between neighbors Whitfield and Murray counties.
They ranked 39th and 107th, respectively, she said.
"There's some underlying disconnect," she said. "We're clearly not all there."
Donahue said the campaign last month received a CDC grant to start identifying areas on which public health policy should focus.
"This is that next step to really push forward," she said.