THUMBS DOWN to the findings of a study released this week ranking Somerset County 15th out of 16 Maine counties, and in the bottom 10 percent nationally, for overall health.

It should be no surprise that the rural “rim” counties of Piscataquis, Somerset, Washington and Aroostook filled out the bottom quarter of the rankings in Maine. The study, by the Robert Wood Johnson Foundation, based the rankings on such factors as access to health care, smoking, obesity, housing, poverty levels and educational attainment, and those four counties typically score low in those categories. But the study adds to the reasons to address those factors.

It is less than a two-hour drive from Skowhegan, the county seat of Somerset County, to Ellsworth, its counterpart in Hancock County, Maine’s top-ranked county for overall health. Yet the difference in health outcomes is wide, and becomes wider the farther north one lives in Somerset County. The fact is, people born in rural parts of Maine have the deck stacked against them, with regards to health, compared with people born in similar circumstances just a short drive away. That shouldn’t be.

Fortunately, some good things are happening. The Jackman Community Health Center has improved its services in the last few months, and recently added dental service, and it may soon offer mental health and hospice services. In late 2012, a dental clinic opened in Bingham.

There is also hope in the form of telemedicine to deliver services in remote and underpopulated areas.

As this study shows, you can add health care to the challenges facing rural Maine, along with economic development and the maintenance of infrastructure, both of which are also related to population and distance. There is a need for these rural areas to work together to find solutions to the similar problems they face.

THUMBS UP to the Franklin County fire departments that will meet next month to see if there is a regional solution to a widespread staffing shortage.

More than 90 percent of Maine fire departments are made up entirely or mostly of volunteers, and those willing and able to volunteer are running slim. In the last decade, according to the Maine State Federation of Firefighters, the number of firefighters has fallen from about 12,000 to 7,700.

Maine’s aging population is cutting down on the number of people who can handle the physical demands of firefighting. Also, fewer people work in the communities where they live, leaving them unavailable to respond to fires during the day. At the same time, training requirements for firefighters are on the rise, and fewer people can set aside the time to meet them.

Those factors are not likely to change any time soon. Next month’s meeting in Franklin County is a good step toward figuring out how to deal with them.