Special Report

The Least Healthy County in Each State

Hampden County, Mass.
> Pct. without health insurance:
> Pct. food insecure: 12.6%
> Obesity rate: 28.9%
> 2013 unemployment rate: 8.9%

Hampden County’s HIV prevalence of 440.6 people per 100,000 residents was far higher than the state rate. County residents were more likely to engage in negative health outcomes relative to the rest of Massachusetts. Almost 19% of Hampden residents smoked compared with 15.2% statewide, and nearly 29% of county residents were obese compared with 23.9% statewide. Also, 26.7% of residents in Hampden were physically inactive, compared with 21.4% throughout the state.

Wayne County, Mich.
> Pct. without health insurance:
> Pct. food insecure: 21.3%
> Obesity rate: 34.2%
> 2013 unemployment rate: 10.5%

With relatively high infant and child mortality rates, Wayne County ranked as the least healthy county in Michigan. The relatively high death rates were not the result of scarcity of medical care. With both the Detroit Medical Center and Henry Ford Health System, the county had 1,183 primary care physicians, or one for every 1,515 Wayne County residents. Wayne County’s HIV prevalence rate — the number of people diagnosed with HIV per 100,000 people — of 451 was more than two-and-a-half times the statewide rate of 169.

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Mahnomen County, Minn.
> Pct. without health insurance:
> Pct. food insecure: 14.0%
> Obesity rate: 30.8%
> 2013 unemployment rate: 5.7%

Mahnomen county had five primary care physicians, or one for every 1,107 residents, slightly better than the state rate of one for every 1,113 residents. County residents had relatively unhealthy habits, which contributed to relatively poor health outcomes. Not only was the 30.8% obesity rate higher than the 25.9% statewide rate, but also 35.4% of residents smoked, more than twice the statewide rate of 16.2%. Nearly 29% of county residents were physically inactive, compared with 19.3% statewide.

Quitman County, Miss.
> Pct. without health insurance:
> Pct. food insecure: 29.1%
> Obesity rate: 41.0%
> 2013 unemployment rate: 13.3%

No state had a higher percentage of residents reporting fair or poor health than Mississippi, at 21.5%. In Quitman County, 35.1% of residents rated their health as fair or poor. The county had only one primary care physician, likely contributing to the negative health ranking. Premature death was also far more likely in Quitman than elsewhere. Approximately 14,300 years of life were lost annually per 100,000 county resident due to premature death, well above the 10,031 state estimate, which was itself the highest such figure compared to all states.

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Pemiscot County, Mo.
> Pct. without health insurance:
> Pct. food insecure: 22.5%
> Obesity rate: 33.7%
> 2013 unemployment rate: 8.2%

About one in five Pemiscot County residents could not afford to see any of the five primary care physicians in the county. This was much higher than the statewide 13.9% of residents who could not afford to see a doctor. The difficulty in seeing a physician may have contributed to the relatively high infant mortality rates in the county. The infant mortality rate in the county — the number of infant deaths before the age of one per 1,000 live births — was 12.3 compared with 7.2 statewide.