LEWISTON — For the second time in two years, Franklin County has gotten less healthy.

The western Maine county moved down two spots this year in the County Health Rankings & Roadmaps, an annual report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Franklin is now ranked 10th for health outcomes among Maine’s 16 counties, down from eighth place last year.

Franklin County was ranked sixth as recently as 2017. It was No. 1 in 2010, the first year of the rankings.

A number of things factor into a county’s ranking, including how well or how poorly other counties do by comparison. Joe Hinton, a researcher for the Rankings & Roadmaps program, said Franklin County’s rate of premature deaths increased when other counties’ rates did not, and that may have been enough to drop Franklin’s ranking two spots.

He said Franklin’s top five reasons for early death were cancer, heart disease, respiratory disease, unintentional injury or accidents and suicide. Drug overdoses are included as injury or accident.

Cumberland County ranked first for the third year in a row. Washington County came in last for the fourth year.

Oxford County ranked sixth and Androscoggin County 12th, the same spots they held last year.

Maine county rankings

1. Cumberland
2. Sagadahoc
3. Knox
4. York
5. Hancock
6. Oxford
7. Kennebec
8. Franklin
9. Lincoln
10. Waldo
11. Penobscot
12. Androscoggin
13. Somerset
14. Piscataquis
15. Aroostook
16. Washington

ltice@sunjournal.com