The Mid-Hudson News Network and the Daily Freeman are reporting the annual county health rankings released March 14, found health outcomes and health factors have largely improved throughout the Hudson Valley. The health outcome ranking provides a snapshot of the current health of residents, while the health factor ranking is an assessment of the potential for residents to be healthy in the future. The counties were compared on 29 factors that impact health, including smoking, high school graduation rates, unemployment, physical inactivity, and access to healthy foods. Columbia, Greene, Dutchess and Orange counties all showed improved health outcomes in the past year. And Greene County improved its health factors, as well, while Columbia County's health factors remained the same. A notable exception to the trend was Ulster County. The national report by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation showed that Ulster's health outcomes fell sharply from 15th among the state's 62 counties to 28th this year. County Health Commissioner Dr. Carol Smith said a surge in opioid-related deaths was largely to blame for Ulster’s diminished ranking in health outcomes. At the same time, Ulster's health factors improved. Sullivan County's rankings stayed the same -- coming in next-to-last statewide, in 61st place. Only the Bronx was ranked lower. Read the full story in the Daily Freeman.