THUMBS DOWN to county health rankings that place Somerset County at the end of the pack, and highlight how poverty and inequality go a long way in determining one’s health.

Fortunately, the ranking is not going unaddressed.

The Greater Somerset Public Health Collaborative held its the first-ever forum this week, with about 90 people attending.

The last-place ranking, which was released in March along with an annual national study, was not a surprise — Somerset County has ranked near the bottom in prior years.

And, the rankings track closely with the county rankings for median income and poverty rates, which also have Somerset in the bottom two or three.

It’s that connection between poverty and health that poses the biggest challenge for Somerset County and the other counties at the bottom of the rankings, Piscataquis and Aroostook. (Kennebec County ranked as the eighth-healthiest county.)

People in high-poverty areas are more likely to have poor health habits, such as unhealthy diets, lack of exercise and high smoking rates.

That makes residents of places like Somerset County more likely to be overweight or obese, and to suffer from chronic conditions, including heart disease, high blood pressure and diabetes.

What’s more, counties that are both large and rural — including the three at the bottom of Maine’s health rankings — typically have less access to health care, because the distance between population centers, and the low incomes translate into fewer providers.

That means residents are less likely to get the ongoing, preventative care they need to stave off debilitating conditions.

Indeed, Somerset County has, for the state, higher-than-average rates of smoking, obesity and physical activity, and lower-than-average numbers of primary care physicians, mental health providers and dentists.

The good news is that Maine is a very healthy state, so a low ranking here is better than a high ranking in many other states.

But it is clear that being born in Somerset County makes you less likely to live a healthy life than if you were born in Cumberland or Sagadahoc counties.

The reasons for that gap are complex and seem almost intractable.

But the gap still is inexcusable, and it calls for innovative programs that bring more health providers to the region, and provide solid health education to residents.

Some of that is already underway, but the local organizations doing the work need ongoing logistical and financial support to make it work for the long term.

The gap is also another reason that a comprehensive and clear economic development plan is necessary to rebuild the rural Maine economy.

That is the best way to fight poor health outcomes, along with all the other issues that stem from poverty and near-poverty.

THUMBS UP to Upper Kennebec Valley Memorial High School in Bingham, which was honored recently for its work in getting low-income students to college.

Valley was the highest ranking among four Maine schools cited by Newsweek for “Beating the Odds,” a list of 500 schools deemed the best at preparing students from low-income backgrounds for college.

At Valley, 100 percent of the students qualify for free and reduced price lunch — a key indicator of a school’s socioeconomic challenges — yet last year it sent 12 of its 15 graduates to college.

A college degree remains the best ticket out of poverty and into the middle class, yet poor kids seeking higher education still face many barriers.

For students whose parents did not go to college, higher education may not even seem like an option, and, even if it does, the process can seem arduous and confusing.

High schools in poor areas can help students overcome these obstacles, and if they are having trouble, perhaps they can look toward Valley for guidance.