By the numbers, the outlook seems bleak for many of those who call Lake County home, thanks to an often toxic mix of disease, poor nutrition, unhealthy habits and barriers to obtaining health care.
The average death rate in Lake County is about twice the state average, at 1,234 per 100,000 people, according to a report by the state Department of Public Health. Lake County ranked dead last of the state's 58 counties.
The reasons — cancer, stroke, drug abuse, accidents, heart disease, liver failure, suicide, guns — reveal a constellation of ills at rates disproportionate to the rest of the state, reflecting the county's rural culture and geography, as well social determinants like poverty, unemployment and substance abuse.
"It really is overwhelming," says Lake County Public Health Officer Karen Tait.
But rather than be intimidated, policy makers and service providers are taking a methodical approach to distill priorities and improve the wellness of the county's 64,000 residents. It is resulting in new programs that focus on better eating, exercise, smoking cessation, and mental and emotional well-being — underpinnings of good health with the potential to impact a broad range of medical problems.
There's a special effort to target children through families and schools, the incubators of healthy life choices; to take advantage of locally-grown fruits and vegetables as part of a nutritious diet; to move employers to support healthier, happier workforces; and to create public help centers to streamline access to health care and assistance in communities where need is high and availability limited.
The goal is to make it easier for people to make changes — even by taking baby steps — that will result in healthier, longer lives.
"We can't make all this right; it's just not something government can do," Tait said. "It takes individual motivation and choices and actions that people do on a daily basis to really make a difference."
But the obstacles are numerous, encompassing high rates of illness and the kinds of behaviors that lead to disease, like smoking and excessive drinking, as well as social ills that correlate to poor health, both physical and mental.
Rates of death by heart disease, stroke, lung and prostate cancers in Lake County are about twice the state average, according to the state's annual County Health Status Profile, which examined death rates in each county over a three-year period from 2009 to 2011.
Deaths by liver disease, lower respiratory disease and firearms in Lake County run at rates about 2 1/2 times the state average.
Suicides, traffic fatalities and accidental deaths are at least triple the state average.
Drug-induced deaths occur at a rate about 4 1/2 times the average rate for all counties in California.
Nearly a quarter of the adult population in Lake County smokes, according to the Robert Wood Johnson Foundation, whose own national health rankings put Lake County last in the state.
The foundation found 22 percent of Lake County residents drink excessively, while about one-third of the population has what's considered a "healthy weight."
But Tait and others say health measures reflect underlying socio-economic conditions that have many local residents living on the margins.
; The U.S. Census Bureau reports an average median household income of $39,525 in Lake County for the years 2007 to 2011, compared to $61,632 for California.