Least Healthy City in Every State

Source: Thinkstock

Life expectancy varies by nearly 10 years across U.S. cities. While the United States is the global leader for health spending, it trails many much poorer nations in health outcomes. While a typical resident of San Jose, California has among the highest life expectancies in the world at 82.7 years, a typical resident of Gadsden, Alabama has the same life expectancy as someone living in Honduras — a country which spends 45 times less per person on health care than the United States.

Health outcomes can differ dramatically even within a single state. Within California, for example, there are such stark differences. While only 11.6% of adults in the San Jose-Sunnyvale-Santa Clara area report fair or poor health, more than 25% do in the Visalia-Porterville area. However, more than one in four adults in the Visalia-Porterville area report fair or poor health.

To determine the least healthy city in every state, 24/7 Wall St. reviewed measures of healthy behavior, clinical care, social and economic conditions, the physical environment and other factors in all U.S. metro areas. We constructed an index out of these factors that can capture the health of a city’s residents.

Click here to see the least health city in every state.

Click here to see the healthiest city in every state. 

While residents in these cities are the least healthy compared to the other cities in their state, they are not necessarily the least healthy of all residents statewide. Because of limited access to quality clinical care, poor social and economic conditions, and many other factors, people living in rural areas tend to be less healthy than those living in large cities. Consequently, by some measures, residents of even some of the least healthy metro areas in the country can lead longer, healthier lives than many Americans living in rural areas.

For example, one of the most important measures of an area’s health is the premature death rate. This rate measures the number of deaths of residents younger than 75 years old per 100,000 area residents. Only nine of the 50 cities on this list have a premature death rate higher than the national rate. The highest premature death rate of any metro area is in Beckley, West Virginia.

Smoking and obesity rates are among the most significant behavioral factors affecting a population’s health. As these rates rise, so does the increased risk of many preventable diseases as well as of premature deaths. The smoking and obesity rates in the majority of the cities on this list are higher than the nationwide rates.

Social and economic conditions can also affect the health of residents in a metro area. Because low-income or unemployed residents may not be able to afford adequate health care, the least healthy city in a state tends to be among the poorest. In all but 12 of the 50 cities on this list, the median household income is lower than the national median income. Also, in the majority of these cities, the unemployment rate is higher than the country.

To identify the least healthy city in every state, 24/7 Wall St. created an index modelled after an analysis conducted by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. The index rankings are based on overall health outcomes, a weighted composite of length of life, quality of life, and overall health factors. The health factors component is itself a weighted composite of healthy behaviors, clinical care, social and economic factors, and physical environment measures. All data used are for the most recent available year. The index was used to compare all U.S. metropolitan statistical areas as defined by the U.S. Census Bureau. Four states — Delaware, New Hampshire, Rhode Island, Vermont — have only one metropolitan statistical area. In these states, the sole metro area is listed by default.

Source: Thinkstock

1. Mobile, Alabama
> Premature death rate: 490.3 (per 100,000 residents)
> Adult obesity rate: 36.1%
> Adults without health insurance: 12.9%
> Median household income: $43,844

2. Anchorage, Alaska
> Premature death rate: 345.0 (per 100,000 residents)
> Adult obesity rate: 27.4%
> Adults without health insurance: 15.7%
> Median household income: $76,453

Source: Thinkstock

3. Lake Havasu City-Kingman, Arizona
> Premature death rate: 498.7 (per 100,000 residents)
> Adult obesity rate: 28.1%
> Adults without health insurance: 17.3%
> Median household income: $38,456

Source: Wikimedia Commons

4. Pine Bluff, Arkansas
> Premature death rate: 500.9 (per 100,000 residents)
> Adult obesity rate: 38.3%
> Adults without health insurance: 10.0%
> Median household income: $36,856

24/7 Wall St.
America’s Best (and Worst) Car Brands

Source: Thinkstock

5. Visalia-Porterville, California
> Premature death rate: 353.9 (per 100,000 residents)
> Adult obesity rate: 29.5%
> Adults without health insurance: 15.3%
> Median household income: $42,863

Source: Wikimedia Commons

6. Pueblo, Colorado
> Premature death rate: 401.9 (per 100,000 residents)
> Adult obesity rate: 26.3%
> Adults without health insurance: 9.1%
> Median household income: $41,974

Source: Thinkstock

7. New Haven-Milford, Connecticut
> Premature death rate: 290.8 (per 100,000 residents)
> Adult obesity rate: 26.3%
> Adults without health insurance: 6.7%
> Median household income: $61,646

Source: Thinkstock

8. Dover, Delaware
> Premature death rate: 379.0 (per 100,000 residents)
> Adult obesity rate: 33.2%
> Adults without health insurance: 7.4%
> Median household income: $55,169

Source: Wikimedia Commons

9. Homosassa Springs, Florida
> Premature death rate: 445.8 (per 100,000 residents)
> Adult obesity rate: 27.1%
> Adults without health insurance: 13.3%
> Median household income: $38,109

Source: Wikimedia Commons

10. Albany, Georgia
> Premature death rate: 480.3 (per 100,000 residents)
> Adult obesity rate: 35.9%
> Adults without health insurance: 17.8%
> Median household income: $36,805

Source: Thinkstock

11. Kahului-Wailuku-Lahaina, Hawaii
> Premature death rate: 288.1 (per 100,000 residents)
> Adult obesity rate: 22.4%
> Adults without health insurance: 7.7%
> Median household income: $64,563

Source: Thinkstock

12. Lewiston, Idaho
> Premature death rate: 384.6 (per 100,000 residents)
> Adult obesity rate: 32.4%
> Adults without health insurance: 12.8%
> Median household income: $44,993

Source: Wikimedia Commons

13. Danville, Illinois
> Premature death rate: 428.0 (per 100,000 residents)
> Adult obesity rate: 37.3%
> Adults without health insurance: 7.7%
> Median household income: $42,548

Source: Wikimedia Commons

14. Muncie, Indiana
> Premature death rate: 455.6 (per 100,000 residents)
> Adult obesity rate: 31.7%
> Adults without health insurance: 13.1%
> Median household income: $37,900

Source: Thinkstock

15. Davenport-Moline-Rock Island, Iowa
> Premature death rate: 343.4 (per 100,000 residents)
> Adult obesity rate: 30.9%
> Adults without health insurance: 8.0%
> Median household income: $51,263

Source: Thinkstock

16. Wichita, Kansas
> Premature death rate: 370.0 (per 100,000 residents)
> Adult obesity rate: 30.9%
> Adults without health insurance: 11.6%
> Median household income: $51,059

Source: Wikimedia Commons

17. Bowling Green, Kentucky
> Premature death rate: 415.5 (per 100,000 residents)
> Adult obesity rate: 30.9%
> Adults without health insurance: 9.8%
> Median household income: $43,396

Source: Wikimedia Commons

18. Hammond, Louisiana
> Premature death rate: 496.1 (per 100,000 residents)
> Adult obesity rate: 40.3%
> Adults without health insurance: 16.4%
> Median household income: $40,721

Source: Thinkstock

19. Lewiston-Auburn, Maine
> Premature death rate: 361.7 (per 100,000 residents)
> Adult obesity rate: 32.4%
> Adults without health insurance: 9.9%
> Median household income: $45,765

Source: Wikimedia Commons

20. Cumberland, Maryland
> Premature death rate: 379.3 (per 100,000 residents)
> Adult obesity rate: 29.4%
> Adults without health insurance: 5.9%
> Median household income: $37,276

Source: Thinkstock

21. Springfield, Massachusetts
> Premature death rate: 310.5 (per 100,000 residents)
> Adult obesity rate: 26.6%
> Adults without health insurance: 3.5%
> Median household income: $52,546

Source: Wikimedia Commons

22. Flint, Michigan
> Premature death rate: 437.8 (per 100,000 residents)
> Adult obesity rate: 36.0%
> Adults without health insurance: 6.6%
> Median household income: $41,879

Source: Thinkstock

23. Duluth, Minnesota
> Premature death rate: 338.9 (per 100,000 residents)
> Adult obesity rate: 26.8%
> Adults without health insurance: 5.9%
> Median household income: $47,574

Source: Thinkstock

24. Jackson, Mississippi
> Premature death rate: 453.2 (per 100,000 residents)
> Adult obesity rate: 33.8%
> Adults without health insurance: 12.1%
> Median household income: $45,366

Source: Wikimedia Commons

25. Joplin, Missouri
> Premature death rate: 452.1 (per 100,000 residents)
> Adult obesity rate: 32.3%
> Adults without health insurance: 14.4%
> Median household income: $41,562

Source: Thinkstock

26. Great Falls, Montana
> Premature death rate: 364.4 (per 100,000 residents)
> Adult obesity rate: 29.0%
> Adults without health insurance: 12.2%
> Median household income: $45,091

Source: Wikimedia Commons

27. Grand Island, Nebraska
> Premature death rate: 309.3 (per 100,000 residents)
> Adult obesity rate: 32.7%
> Adults without health insurance: 12.9%
> Median household income: $50,237

Source: Wikimedia Commons

28. Carson City, Nevada
> Premature death rate: 417.8 (per 100,000 residents)
> Adult obesity rate: 24.1%
> Adults without health insurance: 12.7%
> Median household income: $50,108

Source: Wikimedia Commons

29. Manchester-Nashua, New Hampshire
> Premature death rate: 279.4 (per 100,000 residents)
> Adult obesity rate: 27.3%
> Adults without health insurance: 8.3%
> Median household income: $70,906

Source: Wikimedia Commons

30. Vineland-Bridgeton, New Jersey
> Premature death rate: 409.2 (per 100,000 residents)
> Adult obesity rate: 33.6%
> Adults without health insurance: 12.4%
> Median household income: $50,603

Source: Thinkstock

31. Farmington, New Mexico
> Premature death rate: 383.7 (per 100,000 residents)
> Adult obesity rate: 30.3%
> Adults without health insurance: 17.9%
> Median household income: $48,824

Source: Wikimedia Commons

32. Elmira, New York
> Premature death rate: 350.8 (per 100,000 residents)
> Adult obesity rate: 31.9%
> Adults without health insurance: 5.2%
> Median household income: $49,685

24/7 Wall St.
America’s Most Segregated Cities

Source: https://www.flickr.com/photos/harriswalkerphotography/

33. Rocky Mount, North Carolina
> Premature death rate: 444.3 (per 100,000 residents)
> Adult obesity rate: 34.1%
> Adults without health insurance: 13.4%
> Median household income: $39,763

Source: Thinkstock

34. Bismarck, North Dakota
> Premature death rate: 355.6 (per 100,000 residents)
> Adult obesity rate: 30.4%
> Adults without health insurance: 7.2%
> Median household income: $62,375

Source: Wikimedia Commons

35. Springfield, Ohio
> Premature death rate: 462.2 (per 100,000 residents)
> Adult obesity rate: 30.4%
> Adults without health insurance: 9.3%
> Median household income: $43,011

Source: Wikimedia Commons

36. Lawton, Oklahoma
> Premature death rate: 439.2 (per 100,000 residents)
> Adult obesity rate: 34.9%
> Adults without health insurance: 14.0%
> Median household income: $46,283

Source: Wikimedia Commons

37. Grants Pass, Oregon
> Premature death rate: 405.3 (per 100,000 residents)
> Adult obesity rate: 26.3%
> Adults without health insurance: 11.8%
> Median household income: $37,447

Source: Thinkstock

38. Johnstown, Pennsylvania
> Premature death rate: 396.5 (per 100,000 residents)
> Adult obesity rate: 29.2%
> Adults without health insurance: 6.1%
> Median household income: $42,304

Source: Thinkstock

39. Providence-Warwick, Rhode Island
> Premature death rate: 309.9 (per 100,000 residents)
> Adult obesity rate: 27.0%
> Adults without health insurance: 6.1%
> Median household income: $56,267

Source: Wikimedia Commons

40. Florence, South Carolina
> Premature death rate: 513.5 (per 100,000 residents)
> Adult obesity rate: 36.3%
> Adults without health insurance: 12.8%
> Median household income: $40,673

Source: Thinkstock

41. Rapid City, South Dakota
> Premature death rate: 309.4 (per 100,000 residents)
> Adult obesity rate: 27.8%
> Adults without health insurance: 11.2%
> Median household income: $51,041

Source: Wikimedia Commons

42. Morristown, Tennessee
> Premature death rate: 477.9 (per 100,000 residents)
> Adult obesity rate: 29.8%
> Adults without health insurance: 13.2%
> Median household income: $39,822

Source: Wikimedia Commons

43. Odessa, Texas
> Premature death rate: 497.6 (per 100,000 residents)
> Adult obesity rate: 30.9%
> Adults without health insurance: 21.6%
> Median household income: $54,903

Source: Thinkstock

44. Salt Lake City, Utah
> Premature death rate: 307.4 (per 100,000 residents)
> Adult obesity rate: 25.4%
> Adults without health insurance: 13.6%
> Median household income: $61,529

24/7 Wall St.
America’s Most Hated CEOs

Source: Thinkstock

45. Burlington-South Burlington, Vermont
> Premature death rate: 265.2 (per 100,000 residents)
> Adult obesity rate: 22.7%
> Adults without health insurance: 4.0%
> Median household income: $62,175

Source: Thinkstock

46. Roanoke, Virginia
> Premature death rate: 396.2 (per 100,000 residents)
> Adult obesity rate: 28.9%
> Adults without health insurance: 10.8%
> Median household income: $50,056

Source: Thinkstock

47. Yakima, Washington
> Premature death rate: 341.1 (per 100,000 residents)
> Adult obesity rate: 29.1%
> Adults without health insurance: 16.0%
> Median household income: $43,956

Source: Wikimedia Commons

48. Beckley, West Virginia
> Premature death rate: 553.4 (per 100,000 residents)
> Adult obesity rate: 34.5%
> Adults without health insurance: 9.6%
> Median household income: $38,606

Source: Thinkstock

49. Milwaukee-Waukesha-West Allis, Wisconsin
> Premature death rate: 347.3 (per 100,000 residents)
> Adult obesity rate: 29.6%
> Adults without health insurance: 7.8%
> Median household income: $53,628

Source: Wikimedia Commons

50. Casper, Wyoming
> Premature death rate: 395.2 (per 100,000 residents)
> Adult obesity rate: 28.1%
> Adults without health insurance: 13.7%
> Median household income: $56,769