COEUR d'ALENE - A University of Wisconsin study says Kootenai County is pretty darn healthy compared to the rest of Idaho.

Its neighbor, Shoshone County, not so much.

The survey - released by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation for the second consecutive year - places Kootenai County as the seventh healthiest county, while Shoshone County lingers at second to last.

"I would say it's getting better," said Steve Hirst, jogging 14 miles Tuesday on the Centennial Trail in preparation for Ironman Coeur d'Alene in June. "Since Ironman came up here I think more people here have been more motivated to be healthier."

Could be better, though. Too often the 51-year-old runner sees 20- and 30-somethings who appear unhealthy, which is "a little disconcerting," he said.

But what makes healthy, according to the survey?

More than just heart rates.

The rankings looked at factors in four categories: Health behavior, clinical care, social and economic factors, as well as the physical environment.

Those broke down rates of adult smoking, adult obesity, excessive drinking, and teenage births; the number of uninsured adults, availability of primary care providers and preventable hospital stays.

It also weighed high school graduation rates, college attendance, poverty, community safety and air pollution levels and access to healthy foods.

The report compares counties within states, but does not compare them to counties in other states. In Idaho, 42 of 44 counties were ranked.

Madison County was ranked the healthiest, while Lewis County was the poorest of health.

The rankings are meant as an indicator so areas can determine what is affecting the health of their residents and what needs to be improved, UW Associate Dean for Public Health Dr. Patrick Remington said in a press release.

"We all need to be aware of how our behavior is linked to our personal health," said Lora Whalen, Panhandle Health District director, in a press release on the results. "There's always room for improvement. This helps us zero in on the areas where it's needed the most."

Generally, the healthiest of Idaho's 42 ranked counties are clustered in the center and southeast of the state; the least healthy counties are in the north and south of Idaho.

Despite the rest of North Idaho's rankings. Kootenai County's physical surroundings encourage physical activity, some residents said Tuesday.

What helps too is a prevalent young, college population, lakes in which to swim, and outdoor recreation opportunities, said Justin Newnhan, not to mention a little vanity.

"Nobody wants to be the guy at the lake wearing a T-shirt when it's 95 degrees out," the 23-year-old said.

But the rate of adults without health insurance also climbed since last year in all five counties. It ranges from 16 percent in Shoshone County to 22 percent in Boundary County.

And obesity rates dropped slightly in Bonner, Boundary and Benewah counties, but increased 1 percentage point in Kootenai and Shoshone counties. Shoshone County's 30 percent obesity rate is 4 points higher than the state's rate.

Smoking rates decreased slightly in Bonner, Shoshone and Boundary counties, although Shoshone's 27 percent rate is 9 points higher than the state's overall smoking rate.

The County Health Rankings used vital statistics and data from the Centers for Disease Control and Protection and the National Center for Health Statistics, as well as the U.S. Census, the American Community Survey and other national research organizations.

Info: www.countyhealthrankings.org