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WASHINGTON (USA TODAY) — Almost one out of five U.S. families live in housing with severe problems, such as overcrowding, insufficient cooking and bathing facilities or costs above 50% of family income, according to a new report measuring the nation's healthiest and least-healthy counties.

"It sounds like it could be the 1800s or a Third World country," said Abbey Cofsky, senior program officer at the Robert Wood Johnson Foundation, which partnered with the rankings program at the University of Wisconsin Population Health Institute. "But there are places in the United States where that is still an issue — something that so many of us take for granted."

Housing was one of several new measures in this year's County Health Rankings & Roadmaps, released today. They also included commute time, access to exercise opportunities and injury-related deaths.

This year, the rankings' fifth, researchers found:

•About 76% of workers drive to work alone, in part because of limited public transit systems and neighborhoods without sidewalks or safe crosswalks. This contributes to obesity and pollution.

•About 30% of commuters drive more than 30 minutes each way to work — mostly in the East. This contributes to traffic accidents and personal stress.

•About 59 people per 100,000 die from an unintentional or intentional injury each year, but in healthy counties, it shrinks to 49 people, and in about 10% of U.S. counties, it grows to 105 people.

•About 77% of people have access to exercise opportunities, such as a park or recreation center, but in the worst counties, only 19% of people do.

The rankings compare health and well-being markers in the healthiest and least-healthy counties in each state. By doing so, organizers hope to spark conversations and partnerships to provide better access to health care, education, housing and recreation as communities look at well-being as a whole.

"Communities are really appreciating the breadth of factors," said Bridget Catlin, director of the rankings program at the University of Wisconsin Population Health Institute. "They're forming partnerships that weren't necessarily there before."

Some of the rankings haven't changed or improved much in the five years of the program's existence:

•Twice as many teens give birth in the least-healthy counties as do in the healthiest counties.

•The percentage of children living in poverty went down in the 1990s but rose from 18% in 2007 to 23% in 2012. Twice as many children live in poverty in the least-healthy counties as in the healthiest counties.

•16% of adults were considered obese in 1995, and 28% were in 2010.

•Violent crime has decreased by 50% in the past 20 years but has increased in the past two years.

•The premature death rate — or those who die before they turn 75 — is twice as high in the nation's unhealthiest counties as in its healthiest.

Although the researchers don't expect huge changes overnight, they have seen some improvements. Smoking has decreased from 21% in 2005 to 18% in 2012, in part because communities created smoking bans, cessation programs, advertising campaigns focused on stigma and cigarette taxes. Preventable hospitalizations have decreased about 20% from 2003 to 2011, sparked in part by community education programs, health fairs and business leaders who brought wellness programs into the workplace.

"What we're trying to do is highlight for the counties areas where they're doing well and areas for improvement," Cofsky said.

Community leaders may visit the rankings' website to learn about evidence-based solutions for education, poverty, poor health, isolation and transportation.

Community leaders prioritized areas that often come second: They made sure there were parks for physical activity, they created community gardens, they added health clinics for low-income neighborhoods and they educated people about nutrition and well-being.

So how did the Tampa Bay area fare? 10 News has listed below where the Bay area counties fell on the lists within the state.

Overall Rankings in Health Outcomes - The overall rankings in health outcomes represent how healthy counties are within the state. The ranks are based on two types of measures: how long people live and how health people feel while alive.

  • Citrus #44
  • Hardee #23
  • Hernando #50
  • Highlands #37
  • Hillsborough #31
  • Manatee #22
  • Pasco #42
  • Pinellas #35
  • Polk #28
  • Sarasota #8

Overall Rankings in Health Factors - The overall rankings in health factors represent what influences the health of a county. They are an estimate of the future health of counties as compared to other counties within a state.

  • Citrus #36
  • Hardee #58
  • Hernando #35
  • Highlands #44
  • Hillsborough #24
  • Manatee #20
  • Pasco #26
  • Pinellas #18
  • Polk #37
  • Sarasota #4

CLICK:Interactive maps of rankings

WTSP contributed to this story.

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