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Maui County — Maui, Molokai, Lanai and Kahoolawe — ranks healthiest in Hawaii while Hawaii County — the Big Island — is the least healthy county in the state.

Honolulu came in second, followed by Kauai.

That’s according to the sixth annual County Health Rankings,  by the and the University of Wisconsin .

The rankings also compare the health of most counties across the country using local-level data.

The factors that influence health include education, housing, violent crime, jobs, diet and exercise.

Here are some study takeaways that apply nationally:

• The healthiest counties in each state have higher college attendance, fewer preventable hospital stays and better access to parks and gyms.
• The least healthy counties in each state have more smokers, more teen births and more alcohol related car crash deaths.
• Violent crime rates are highest in the South.
• One out of four children in the U.S. lives in poverty.
• Unemployment rates are 1.5 times higher in the least healthy counties in each state as they are in the healthiest counties.