This is the first year the national County Health Rankings have included D.C. when comparing overall health in nearly every county in all 50 states. The study, published by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, measures how healthy people are and how long they live.
It takes into account rates of adult obesity and premature deaths, as well as other factors, like high school graduation rates in determining the healthiest places to live.
When compared with counties around the country, it found the rate of premature death in D.C. is twice the national benchmark and rates of adult smoking are higher here.
"In the adult smoking and obesity rates that may mean if the county or the District is high in those areas maybe we can make sure that we are having healthy food in our schools, that they are bringing back activity for the children," says James Marks, senior vice president of the Health Group at the Robert Wood Johnson Foundation.
Howard County tops the list as the healthiest place to live in Maryland, followed by Montgomery County. But the statistics are much different not very far away.
"The southern part of Virginia and some of the western counties have some of the highest early death rates and some of the highest rates of disease," says Pat Remington, project director for County Health Rankings.
Marks says the national rankings are meant to be used as a tool for counties to see where they need to improve to achieve good health.