Oldham County has the state's best health outcomes, according to the Robert Wood Johnson Foundation.
The findings were released in the foundation's annual Health County Rankings report.
Owsley County, located in Eastern Kentucky, ranked last for overall health outcomes on the list of 120 counties.
The rankings examine quality of life, healthy behaviors, clinical care, physical environment, and social and economic factors.
Attica Scott, community coach for the foundation and a candidate for state House, said where we live matters to our health.
"We're still individual counties with individual needs that we must address," she said.
Oldham ranked below the overall state's rankings in many areas, including obesity, smoking and physical inactivity. While 70 percent of Kentucky's residents have access to exercise opportunities, RWJF found, 89 percent of Oldham residents have such access. The county also has higher rates of alcohol-impaired driving deaths, at 44 percent compared with 29 percent in Kentucky overall.
Unlike Oldham, Owsley County ranked higher than the state's average in several categories. Kentuckians living in Owsley have a smoking rate of 29 percent compared with the state's rate of 23 percent. The county also has a higher obesity rate, at 37 percent compared with 32 percent for the state. And Owsley has an uninsured rate of 20 percent, according to the report.
Scott said the rankings are a call to action. She also said where counties land on the list may not tell the whole picture.
"Even if you rank No. 1, there's still work to do," she said. "If you are in Kentucky, where we have 120 counties, and you rank 20, you still have areas of strength. And so it's important to lift up those areas of strength as well."
Jefferson County, which encompasses Louisville, ranked 28th for health outcomes. The county is shown to have strengths in the percentage of residents with access to exercise opportunities and some college education, according to RWJF.
Jefferson also has strengths for the number of health care providers per person. The report indicates the county could improve in several areas, including reducing the percentage of violent crimes and sexually transmitted diseases.
Rounding out the top three counties are Boone and Spencer. The bottom three include Perry and Wolfe counties.