Survey says suburbs, islands are home to healthiest denizens

The researchers examined two dozen factors that influence health, such as poverty, education levels, rates of smoking, and even the percentage of restaurants in a region that serve fast food.

Bridget Catlin, the project’s director, said they found that urban and rural areas tended to have the most health problems, including higher rates of smoking, physical inactivity, children living in poverty, and unemployment. “When it comes to health, suburbs rule,’’ Catlin said.

Norfolk and Middlesex counties, near Boston, have some of the healthiest residents, according to the findings, released Tuesday by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. Residents in the healthier counties of Dukes (Martha’s Vineyard) and Nantucket had more access to recreational facilities than did their counterparts in Hampden and Suffolk counties.

Similarly, 93 percent of Martha’s Vineyard residents and 87 percent of those in Nantucket graduated from high school, compared with Hampden’s 70 percent high school graduation rate, and Suffolk’s 62 percent.

Having a higher percentage of restaurants that serve fast food appeared to have a negative influence on health, but not as strong as the researchers had expected, Catlin said.

And although other studies have found clear links between high obesity rates and poor health, the new report did not find as strong a correlation between the two. But it did find a link between some key factors that contribute to obesity, such as lack of physical activity and poor health, Catlin said.

“It’s what is making us obese that counts: unhealthy eating and lack of exercise,’’ she said.

The report calculated health rankings based on data from several sources, including the census, Medicare claims, and a national telephone health survey conducted by federal health officials.

One reason that the report may not have found a strong link between fast food and poor health is because it measured the prevalence of fast-food restaurants where people live and not where they work, said Caroline Apovian, professor of medicine and pediatrics at Boston University School of Medicine, and director of the Nutrition and Weight Management Center at Boston Medical Center.

“It depends on where you spend most of your time,’’ Apovian said. “You may live in one county, but you may work in another. That speaks to the efforts to make the workplace more healthy, with fitness centers and better food.’’

Apovian is paid to serve on the nutrition advisory boards of several fast-food restaurant chains to help them create more healthy food offerings.

Geoff Wilkinson, senior policy adviser to Massachusetts’ commissioner of public health, said he hopes the study helps residents better understand that several key factors that affect their well-being are things they can control, such as smoking and exercise.

“What influences our health is far more than our access to health care, but the conditions in which we live,’’ Wilkinson said.

“Over 40 percent of premature deaths are due to behaviors, principally the ones measured in this report - tobacco use, unsafe sex, alcohol, and poor diet and exercise,’’ Wilkinson said.

Recognizing that, he said, the state health department is distributing federal grants to five regions to encourage 48 cities and towns to pool their resources and create healthier options for residents, such as recreational areas and safer routes for children to walk to school.

The five regions, representing almost 1 million people, are in the Berkshires; Worcester; the Gardner and Fitchburg area; the region including Haverhill, Lawrence, and Methuen; and on the North Shore, including Lynn, Salem, Peabody, and Beverly.

Kay Lazar can be reached at klazar@globe.com. Follow her on Twitter @GlobeKayLazar.