It's a five-hour drive from Manassas Park to Galax — but in terms of life expectancy, the two cities are 25 years apart.

Residents of Manassas Park, a city of about 16,500 people in the Washington suburbs, live to 91 years old on average. But residents of Galax, a city of about 6,600 people in Southwest Virginia, typically live to just 66.

That wide gap in life expectancy reflects the disparities in health outcomes in Virginia, according to the latest County Health Rankings from the Robert Wood Johnson Foundation, one of the nation’s largest public health philanthropic organizations.

For years, wealthy localities in Northern Virginia like Loudoun, Arlington and Fairfax counties have had the best health outcomes in the state, while poor communities such as Petersburg, south of Richmond, and Galax and Covington in Southwest Virginia have some of the worst.

Health outcomes represent how long people live and how healthy people feel. They can be affected by health behaviors like smoking, diet and drug use; access to medical care; social and economic factors such as education and income; and physical environment like air quality.

The Robert Wood Johnson Foundation drew its data from a variety of sources including the National Center for Health Statistics and the U.S. Centers for Disease Control and Prevention.

The rankings help localities understand how various factors affect people’s health, according to the report. It said “connected and supportive communities, good schools, stable jobs, and safe neighborhoods” are the foundation for achieving a long and healthy life.

Poverty, lack of access to grocery stores and smog or other pollution can all exacerbate negative health outcomes.

Differences in health outcomes “do not arise on their own,” the report said. “Often, they are the result of policies and practices at many levels that have created deep‐rooted barriers to good health.”

These include "unfair bank lending practices, school funding based on local property taxes, and discriminatory policing and prison sentencing,” the report states.

The report emphasizes “stable and affordable housing as an essential element of healthy communities.”

“Our homes are inextricably tied to our health,” Dr. Richard Besser, president and CEO of the foundation, said in releasing the report.

“It’s unacceptable that so many individuals and families face barriers to health because of what they have to spend on housing.”

Health Outcomes

JURISDICTION: RANKING

Loudoun: 1

Arlington: 2

Fairfax: 3

Falls Church City: 4

Alexandria: 7

Fairfax City: 16