The Most Unhealthy Counties in America

10. Pearl River, Miss.
> Premature deaths (years of life lost per 100,000): 12,162 (16th highest)
> Percent reporting fair or poor health: 22% (77th highest)
> Unemployment: 10.9%
> Children in poverty: 32% (87th highest)
> Largest municipality: Picayune

Pearl River County stands out as particularly unhealthy compared to the rest of the country in a number of categories. Perhaps most striking is the vast number of residents dying prematurely. Of the 1,000 counties in the report, Pearl River ranks 16th worst in this category. The residents’ unhealthy lifestyle contributes to their poor health. Thirty-two percent of adults in the region smoke — the country’s fifth-highest rate. At 63%, the county also has one of the highest rates of fast-food restaurants among all restaurants. Additionally, the county has one of the highest rates of preventable hospital stays among medicare enrollees.

9. Russell, Ala.
> Premature deaths (years of life lost per 100,000): 11,929 (21st highest)
> Percent reporting fair or poor health: 23% (71st highest)
> Unemployment: 10.5%
> Children in poverty: 36% (34th highest)
> Largest municipality: Phenix City

Alabama’s Russell County is among the country’s most unhealthy regions in a number of areas. Its obesity rate of 39% is one of the nation’s highest, as is its physical inactivity rate of 37%. Nearly one in every two households with children in Russell is a single parent household, and 36% of children in the county are living in poverty — among the country’s highest rates. In addition to all of this, 64% of restaurants in the county serve fast food, reflecting a generally unhealthy environment.

8. Scioto, Ohio
> Premature deaths (years of life lost per 100,000): 11,262 (44th highest)
> Percent reporting fair or poor health: 26% (27th highest)
> Unemployment: 12.8%
> Children in poverty: 32% (84th highest)
> Largest municipality: Portsmouth

On average, residents of Scioto, Ohio, report being physically unhealthy 7.1 days out of each month — the second-highest rate in the country. They also report being mentally unhealthy 6.2 days each month, which is the fifth-highest rate in the country. As is the case with many other counties on this list, Scioto has a number of particularly unhealthy behavioral traits. For example, 36% of residents are smokers — the country’s highest rate. The county also has among the highest rates of preventable hospital stays among medicare enrollees.

7. Cabell, W.V.
> Premature deaths (years of life lost per 100,000): 11,787 (26th highest)
> Percent reporting fair or poor health: 21% (131st highest)
> Unemployment: 8.1%
> Children in poverty: 35% (tied for 39th highest)
> Largest municipality: Huntington

Cabell’s health failings are numerous and perhaps most apparent in the high rate of births with low weight. The county ranks among the worst in the country in that category with more than 11% of babies born with low birth weight. The county also has relatively high rates for the number of days residents report being physically unhealthy and mentally unhealthy each month at 4.8 and 4.7, respectively. Additionally, 14% of adults in the area are diabetic, which is among the nation’s highest rates.

6. Halifax, N.C.
> Premature deaths (years of life lost per 100,000): 11,680 (31st highest)
> Percent reporting fair or poor health: 29% (11th highest)
> Unemployment: 13.2%
> Children in poverty: 37% (tied for 26th highest)
> Largest municipality: Roanoke Rapids

According to the CDC’s Behavioral Risk Factor Surveillance System, nearly one in every three residents in Halifax County reports being in fair or poor health. The county has the fifth-highest rate of infants born with low birth weight in the country at 13.5% — a strong indicator of poor health. The county also has an obesity rate of 39%, which is one of the country’s highest. A whopping 37% of adults in Halifax report lacking social or emotional support — the highest rate in the nation.