An annual study that ranks public health for more than 3,000 counties in the United States lists Cumberland County as the least healthy county in New Jersey for the fourth consecutive year.

The study puts Cumberland County last in five of the six measurable categories involving mortality, morbidity, health behaviors, social and economic factors, physical environment and clinical care.

“Well, frustrating,” said Cumberland County Health Officer George Sartorio. “That’s probably the key word. There’s a lot of people doing a lot of good work, and we’re not seeing the result at this time that we would like to see.”

Released on Wednesday, the County Health Rankings & Roadmap study by the Princeton-based Robert Wood Johnson Foundation and the University of Wisconsin also once again lists South Jersey as the least healthy region in the state.

While Cumberland County is ranked 21st, the study ranks Salem County as number 20, Atlantic County number 17 and Cape May County number 16. The study lists Ocean County as the eighth healthiest county in New Jersey.

The statistics show little improvement in South Jersey from the 2012 study. The rankings for Salem and Atlantic counties remain the same, while Cape May County dropped from its 15th-place standing. Ocean County’s health ranking improved from its 11th-place finish.

The study measures the health of nearly all counties in the nation and ranks them within states. Study officials said the statistics come from a variety of national and state data resources and are standardized and combined by using what they call “scientifically-informed weights.”

Some of the study’s national findings include no decrease in child poverty rates since 2000; violent crime decreasing by almost 50 percent in the past 20 years; the counties where people do not live as long and do not feel as well having the highest rates of smoking, teen births, physical inactivity and preventable hospital stays; and teen birth rates being more than twice as high in the least healthy counties than in the healthiest counties.

Some of the findings for South Jersey show that:

* Cumberland and Atlantic counties exceed the state percentage of adults who report being in poor or fair health.

* Cumberland, Atlantic, Cape May and Ocean counties exceed the state percentage of adults who smoke.

* Cumberland County has a lower high school graduation rate than the state average.

* Cumberland, Atlantic, Cape May and Ocean counties exceed the state percentage of children living in poverty.

* The majority of restaurants in Cumberland and Cape May counties are fast-food eateries that serve relatively unhealthy fare.

Sartorio said Cumberland County is working to improve its overall health. Part of that involves a new community health advisory board that will provide “additional eyes and ears to give us more ideas about where we should be going,” he said.

“You definitely want to see improvement,” Sartorio said. “That is the purpose for being here, to improve the public health and welfare.”

Atlantic County Health Officer Patricia Diamond said she believes there are many variables that make it difficult compare health issues in different counties.

Atlantic County is working to provide funding so physicians can provide more tobacco education to their patients, she said. Another program provides vouchers for people to buy fresh fruits and vegetables, she said.

An especially important initiative involves helping mothers get appropriate pre- and post-birth medical attention, Diamond said, and getting health information to the public via members of the clergy.

“It’s an ongoing process,” she said.

One problem is that annual health rankings only started coming out after the national economy slumped, Diamond said. Some of the rankings are likely influenced by related social and economic problems, she said.

“We have been struggling for a while,” Diamond said.

More information about the study can be found at www.countyhealthrankings.org.