NATCHEZ — The Miss-Lou smokes too much, doesn’t exercise enough and often doesn’t see a doctor when it should.

At least, that’s what can be inferred from the fourth-annual county health rankings, a study by the Robert Wood Johnson Foundation and the University of Wisconsin that ranks the wellness of counties based on lifestyle choices — such as rates of smoking, alcohol use and exercise — and factors such as access to clinical health care, social and economic well-being and the physical environment.

Of Mississippi’s 82 counties, Adams County was ranked No. 66 in terms of overall health; Wilkinson County was 79; Jefferson County was 74; and Franklin County was 60.

That’s actually a slight improvement for Adams County; last year it was ranked 73.

According to the study, 26 percent of Adams Coun ty’s residents are in “poor or fair” health. Twenty-four percent of adults smoke, 37 percent are obese and 40 percent can be considered physically inactive.

Twenty-two percent of the population is uninsured, and the rate of primary care physicians is a ratio of 1,344 to 1.

In Concordia Parish — which was ranked No. 59 of Louisiana’s 64 parishes — the numbers aren’t much better.

Twenty-two percent of the parish population is considered to be in “poor or fair” health, 22 percent smoke and 33 percent are considered obese. Thirty-three are considered physically inactive.

The uninsured make up 23 percent of the parish’s population, and the ratio of primary care physicians to patients is 3,470 to 1.

“We have a rural population who are economically depressed, and so they don’t always seek health care when they should,” said Kenneth Stubbs, a Concordia Parish resident and Natchez-based internist.

“Smoking and obesity are the number one and two most common causes of diseases — we have a lot of pre-morbid conditions that lead to illness.

“We are underserved in number of providers, and all of that adds up to poor health outcomes.”

The area’s health might be improved with general increases in health literacy and education about health habits, Stubbs said.

“Most people know that smoking and obesity are bad for you, but often when you speak to a person who is obviously obese about their weight, many will say, ‘I am fine, I am good,’” he said. “People don’t have any self-awareness of their weight.”

State Health Officer Mary Currier said community leaders in every county should adopt policies that help make healthy choices the easy choices for residents.

“We all have a stake in creating a healthier community, and no single sector alone can tackle the health challenges in any given community,” she said.

Stubbs said locally policies that could encourage area health include having public facilities available to the community so residents can have access to areas that provide them with opportunities for up to 150 minutes a week of moderate physical activity.

“This falls back on our leaders to follow through with the recreation plans for the community that voters approved several years ago,” Stubbs said.

“Ultimately, (physical exercise and education) is how we are going to tackle all of the health care problem — unless people start developing healthy lifestyles, we will never be able to give them enough insurance.”