A report released Wednesday found Philadelphia to be the unhealthiest of Pennsylvania's 67 counties.
It's also worse than state averages when it comes to child poverty, violent crime and the availability of green space — all of which researchers believe are entwined with individual health.
The 2013 County Health Rankings from the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute considered more than two dozen possible predictors of health.
Researchers found one of the most dramatic predictors to be where a person lives in terms of geography, culture and class.
"Of course money makes a big difference," said Ed Coyle of Society Hill, one of the highest-income zip codes in Philadelphia.
"I think culture plays a big part, too," said University of Pennsylvania student Christina Ward. "I'm from Colorado, which is the healthiest state, and we have a strong culture of exercise and fitness."
Lisa Williams, who lives near McPherson Square Park in one of the city's lowest-income zip codes, agreed.
"In the black community, a lot of people don't believe in doctors — especially the older generation," she said. "I still know people that have never gone to the hospital because they can't afford it or they don't trust it will help them."
She emphasized the importance of education in seeking out preventative care before health problems snowball.
"If you teach kids from an early age a healthy lifestyle and put them on the right track, they know when something's not right and go to the doctor before something becomes an emergency," she said.
The County Health Rankings further noted access to outdoor spaces can greatly improve health.
"I don't feel safe going out, especially at nighttime," said Mirna Santiago, who also lives near McPherson Square.
In contrast, Coyle said he enjoys riding his bike, jogging, swimming at the local YMCA and playing golf.
"If I lived in a neighborhood where there was a high level of crime, I'd probably be more cautious about what about what I do, where I go and who's around me," he said.
Residents of both neighborhoods had nearly identical responses when asked whether money plays a role in access to health care and quality treatment.
"No money, no healthcare," Coyle said succinctly.
Williams echoed the sentiment – verbatim – about an hour later in a neighborhood five miles away.
"And with no healthcare, you're going to be suffering," she added.
A tale of two surgeries
Ward, who is also a sponsored Ultimate Frisbee player, had hip surgery less than two weeks ago.
"I went through student health and received excellent care," she said. "They referred me to an orthosurgeon at 8th and Spruce, and the surgery went great. I'm lucky to go to Penn."
In contrast, one woman in Kensington, who declined to give her name, said she recently needed a root canal to remove infected tissue from inside two of her teeth.
"My insurance covered my teeth being pulled, but not a root canal," she said. "They'd rather me walk around with no teeth than pay for treatment."
By the numbers