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There was a slight improvement in premature deaths for the county. The measure is defined as the number of years of potential life lost before age 75 per 100,000 people. For example, if someone dies at the age of 65, that adds 10 years to the total. Premature death decreased from 11,011 years in 2015 to 11,000 years in 2016. Scotland County adults engage in excessive drinking less — at 12 percent — compared to their counterparts statewide, at 15 percent. Doctor-to-patient ratios have improved, especially in mental health. For 2016, the ratio was 620 patients per mental health provider, down from 680 patients per provider last year. In addition, many Scotland County residents can’t afford to visit those medical professionals, instead waiting until their condition is unbearable and they have no choice but to visit the costly Emergency Department. Those living below the poverty line also may not have the money for nutritious foods and often don’t have time for exercise because of work. It’s no coincidence that the counties that continually fall near the bottom of the rankings have high poverty rates, health officials said. Raynor said the report helps local health officials identify factors that are making it difficult for residents to maintain a healthy lifestyle. “The good news is that the County Health Rankings are an important springboard for conversations on how to expand opportunities for all of our citizens to be healthy and have become an important tool for local communities working to build a better culture of health,” Raynor said. “We know from the Rankings, Scotland County needs to do more to reduce the infant mortality rate, reduce teen pregnancy and reduce obesity and diabetes among children and adults.” Scotland County Health Department is currently working on a plan to reduce infant mortality and improve birth outcomes. The county recently received $60,000 in state funding for that purpose. “We anticipate this funding will be ongoing in coming years. The Health Department’s Child Health and Maternity Clinics which began nearly a year ago should have a positive impact on the reduction of infant mortality and improved birth outcomes over the next few years.” Scotland County Health Department is also taking part in an effort called Active, Healthy Living Partnership that will focus on obesity and heart disease. “With these new initiatives, I am convinced that we can, in conjunction with our community partners, have a very positive impact on our health rankings here in Scotland County,” Raynor said. Full results can be found at countyhealthrankings.org.