The Least Healthy States

10. Indiana
> Pct. obese: 31.4% (8th highest)
> Cardiovascular deaths per 100,000: 278.3 (12th highest)
> Physicians per 100,000: 101.6 (13th lowest)
> Pct. visiting dentist in 2012: 62.6% (17th lowest)

Like many of the nation’s least healthy states, Indiana residents tend to have bad habits that put them at higher risk of poor health. The state was among the 10 worst for smoking, physical activity and obesity. As the obesity rate has increased in recent years, so has the percentage of adults with diabetes. The state also had among the worst rates of cancer deaths per capita. Indiana’s median household income was nearly $5,000 lower than that of the nation in 2012. Public health funding per person was just $44.04, lower than all but two other states and less than half the national average funding of $92.32 per person.

9. Tennessee
> Pct. obese: 31.1% (10th highest)
> Cardiovascular deaths per 100,000: 309.3 (7th highest)
> Physicians per 100,000: 122.4 (18th highest)
> Pct. visiting dentist in 2012: 61.4% (14th lowest)

Unhealthy behavior is a problem in Tennessee. Nearly 25% of the adult population were smokers last year, the highest rate in the United States. Physical inactivity is also a problem in the state, where 28.6% of residents were inactive, among the worst rates in the nation. The state’s adult residents were among the most likely in the country to suffer from heart disease or to have had a heart attack. Like many other unhealthy states, Tennessee also had a high poverty rate, which America’s Health Rankings notes can increase the odds of chronic diseases, while also lowering life expectancy. Nearly 18% of Tennessee residents lived in poverty last year versus 15.9% nationwide. Also, more than 26% of children in Tennessee lived in poverty as of 2012, among the highest rates in the nation.

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8. South Carolina
> Pct. obese: 31.6% (7th highest)
> Cardiovascular deaths per 100,000: 277.6 (13th highest)
> Physicians per 100,000: 105.9 (18th lowest)
> Pct. visiting dentist in 2012: 59.6% (8th lowest)

Access to quality clinical care is a problem for many South Carolina residents. Almost 10% of infants in South Carolina suffered from low birth weight in 2011. This often occurs when expectant mothers do not receive adequate medical care. Additionally, South Carolina had fewer than 48 dentists per 100,000 residents in 2011, while less than 60% of residents visited the dentist last year. By contrast, there were 62 dentists per every 100,000 people nationwide, and 67.2% of adults visited the dentist in 2012. Many state residents are quite poor. South Carolina’s median household income was just $44,401 in 2012, versus $51,017 nationally. Also, the state’s 9.4% unemployment rate last year was one of the highest in the United States.

7. Oklahoma
> Pct. obese: 32.2% (6th highest)
> Cardiovascular deaths per 100,000: 330.5 (3rd highest)
> Physicians per 100,000: 82.7 (3rd lowest)
> Pct. visiting dentist in 2012: 58.9% (7th lowest)

In addition to high adult obesity and smoking rates, common factors in America’s least healthy states, Oklahoma also had among the worst rate of drug deaths between 2008 and 2010. While Oklahoma’s smoking rate remains high, it has improved significantly from 26.1% of adults in 2011 to 23.3% last year. In 2011, there were 76.9 preventable hospitalizations for every 1,000 Medicare recipients, eighth most in the nation. Such hospitalizations often arise when individuals do not address medical issues early on because they may lack appropriate access to care. As of 2011, there were fewer than 83 primary care physicians per 100,000 people, less than almost every other state.

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6. Kentucky
> Pct. obese: 31.3% (9th highest)
> Cardiovascular deaths per 100,000: 299.8 (8th highest)
> Physicians per 100,000: 102.5 (14th lowest)
> Pct. visiting dentist in 2012: 60.3% (10th lowest)

More than 28% of adults in Kentucky were smokers last year, the highest rate in the nation. Between 2008 and 2010, the state had the highest rate of cancer deaths, with about 227 deaths per 100,000 residents. Lung cancer deaths are particularly common in Kentucky, likely due to high smoking rates, according to the American Cancer Society. Kentucky’s poor state of health may be partly related to lack of exercise as nearly 30% of residents did no regular physical activity. In 2012, more than 31.3% of Kentucky residents were obese, among the highest rates in the country. The relatively high poverty rate, which last year was close to 20%, is likely another factor contributing to the state’s poor health. Kentucky may stand to benefit from the Affordable Care Act. The state’s new health insurance exchange has provided coverage for a greater percentage of its population than that of any other state.