25 Cities Where You Don’t Want to Get Sick

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Source: Doug Kerr / Flickr

5. Kingston, NY
> 30 day readmission rate: 17.6% (highest 10%)
> 30 day mortality rate: 13.3%
> Preventable hospitalizations: 58.1 per 1,000 patients (highest 25%)
> No. of physicians: 69.4 per 100,000
> Median household income: $62,790 (highest 25%)

Compared with the 24 other metro areas on this list, Kingston residents are exceptionally wealthy. The typical household earns $62,790 annually, well above the national median. By contrast, the poverty rate of 14.1% is in line with the national poverty rate. Also unlike most cities with poor-rated hospitals, Kingston residents do not report especially poor health outcomes. The area’s obesity rate of 27.2%, for example, is below the national rate.

Still, hospitals report high rates of readmission, mortality, and preventable hospitalization. In addition, Kingston hospitals, and the area’s health system more generally, also have far fewer medical professionals than most areas. For every 100,000 area residents, there are 69 primary care physicians, versus the national proportion of 76 doctors per 100,000 people. The number of area dentists, at just 34 per 100,000, is approximately half the nationwide ratio of 66 per 100,000 people.

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4. Hattiesburg, MS
> 30 day readmission rate: 17.9% (highest 10%)
> 30 day mortality rate: 13.2%
> Preventable hospitalizations: 63.3 per 1,000 patients (highest 25%)
> No. of physicians: 86.7 per 100,000 (highest 25%)
> Median household income: $46,765 (lowest 25%)

As the strong correlation between poverty and hospital quality metrics would suggest, unplanned readmission, mortality, and unnecessary hospitalizations may be harder to avoid in low-income communities. For example, low-income patients who cannot afford the medication their doctors prescribe often end up returning to the hospital. This scenario is likely relatively common in Hattiesburg, where 12.8% of residents do not have health insurance, and 19.8% of people live in poverty, each among the highest respective rates of all U.S. metro areas.

Hattiesburg area hospitals report the highest 30-day readmission rate in the nation, at 17.9%. More than 1 in every 4 patients admitted for heart failure return to the hospital inside 30 days, also the highest such rate of all metro areas.

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3. Jonesboro, AR
> 30 day readmission rate: 17.2% (highest 10%)
> 30 day mortality rate: 13.7% (highest 25%)
> Preventable hospitalizations: 68.2 per 1,000 patients (highest 10%)
> No. of physicians: 91.1 per 100,000 (highest 25%)
> Median household income: $41,717 (lowest 10%)

Hospitals in many of the metro areas on this list often struggle with greater demands on their resources. For one, their patients can be at greater risk of health conditions due to low income. Also, lower funding can lead to doctor shortages and obsolete equipment. Jonesboro is somewhat of an exception. For every 100,000 residents, there are 91 primary care physicians, 68 dentists, and 473 mental health providers — each proportion considerably higher than the respective national one.

While there does not appear to be a shortage of medical professionals in the area, the hospital system still appears relatively strained. Poor readmission, mortality, and preventable hospitalization rates are likely due in part to low incomes and poor health outcomes reported across the Jonesboro metro area population. The typical household earns $41,717 annually, one of the lowest median incomes in the nation. The area’s obesity rate of 36.8% is also seventh highest of all U.S. metros.

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2. Rocky Mount, NC
> 30 day readmission rate: 17.3% (highest 10%)
> 30 day mortality rate: 14.6% (highest 10%)
> Preventable hospitalizations: 59.2 per 1,000 patients (highest 25%)
> No. of physicians: 50.0 per 100,000 (lowest 25%)
> Median household income: $38,972 (lowest 10%)

Like nearly every metro area with the worst-rated health care systems, Rocky Mountain area hospitals serve relatively low-income communities. The typical household in the area earns $38,972 a year, one of the lowest median household incomes in the nation. Financial struggles often exacerbate existing health conditions and can increase the risk of future diagnoses, increasing the burden on medical systems. Individuals with low income can find it difficult to carry out doctor’s orders, be it exercise, food, or costly prescription drugs. Failing to follow through on recommended care can push up the likelihood of returning to the hospital. The 30-day readmission rate in Rocky Mount, at 17.3% of patients, is the fourth highest out of all metro areas. The 30-day mortality rate, at 14.6%, is also among the highest of all metro areas.

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1. Pine Bluff, AR
> 30 day readmission rate: 16.9% (highest 10%)
> 30 day mortality rate: 15.2% (highest 10%)
> Preventable hospitalizations: 60.4 per 1,000 patients (highest 25%)
> No. of physicians: 61.9 per 100,000
> Median household income: $37,076 (lowest 10%)

With among the nation’s highest readmission, mortality, and preventable hospitalization rates, hospitals in the Pine Bluff metro area are struggling more than any other metropolitan area health care system. Widespread poverty, poor health, and relatively few medical professionals serving the area help explain the ranking. Approximately 40% of adults in Pine Bluff are obese, the highest obesity rate of all metro areas. Over time, health issues such as obesity can drive up doctor visits, increase the risk of a range of conditions, and ultimately raise the burden on hospitals.

As is generally the case in cities with poorly-rated hospitals, likely because of the close correlation between health outcomes and financial status, Pine Bluff’s poverty rate of 21.8% is one of the highest poverty rates in the country. For every 100,000 people in the area, there are 62 primary physicians, versus the national proportion of 76 per 100,000 U.S. residents.