Special Report

The Least Healthy City in Every State

6. Pueblo, Colorado
> Pct. without health insurance:
> Pct. food insecure: 16.0%
> Obesity rate: 26.5%
> 2014 unemployment rate: 7.3%

Colorado had the nation’s lowest obesity rate and lowest rate of physical inactivity, at 15.2% and 20.4%, respectively. But while Pueblo, the state’s least healthy metro area, also reported some relatively strong health measures, it fared very poorly in others. For example, while Pueblo’s obesity rate of 26.5% was well above the state’s rate, it was still lower than the national rate of 28.3%. Yet, the incidence of premature death in the area was abysmal. An estimated 5,756 years are lost annually per 100,000 people in Colorado, versus the national figure of 6,622. In Pueblo, however, 8,686 years are lost annually per 100,000 area residents due to premature deaths.

7. New Haven-Milford, Connecticut
> Pct. without health insurance:
> Pct. food insecure: 4.0%
> Obesity rate: 26.9%
> 2014 unemployment rate: 6.8%

Healthy behaviors and outcomes are closely associated with strong economic circumstances. Residents earning higher incomes can afford better health care, and those with higher levels of education often work in higher-paying jobs that also tend to lead to healthier lifestyles. Relatively high incomes in Connecticut largely explain the relatively strong health outcomes. And while 64.7% of New Haven area adults had completed at least some college — lower than the state share of 67% — it was still higher than the nationwide rate of 63%.

8. Dover, Delaware
> Pct. without health insurance:

> Pct. food insecure: 4.8%
> Obesity rate: 32.7%
> 2014 unemployment rate: 6.4%

Because Dover is the only metro area in Delaware, it is both the healthiest and the least healthy city in the state. Delaware ranks generally well in health measures. While the capital area’s population is not as healthy as the state’s population, it still fares better than the nation as a whole for several measures of health. For example, 14.7% of Dover adults reported fair or poor health. This was higher than the 12.4% of adults in Delaware who said the same, but better than the 16% of U.S. adults who reported less than optimal health. Uninsured people are less likely to have primary care providers or receive preventive care. As a result, health conditions often go undiagnosed or are diagnosed at a later stage. In Dover, just 8.9% residents did not have health insurance, far lower than the national uninsured rate of 14.5%.

9. Homosassa Springs, Florida
> Pct. without health insurance:
> Pct. food insecure: 9.2%
> Obesity rate: 29.2%
> 2014 unemployment rate: 8.5%

Compared with the least healthy areas in other states, residents of Homosassa Springs have exceptionally good access to health care services. For every doctor and for every dentist in the area, there are 559 and 882 people — the two ratios are significantly better than the respective statewide ratios. In addition, less than 14% of people did not have health insurance, versus 20% of Floridians, which was third highest uninsured rate of all states. Still, the Homosassa area is the least healthy in the state. Inline with the nation, about 16% of Floridians reported fair or poor health. In Homosassa Springs, 18.4% of adults reported such low levels of health. Relatively unhealthy behaviors likely contributed to the poor self-reported health in the area.

10. Macon, Georgia
> Pct. without health insurance:
> Pct. food insecure: 6.1%
> Obesity rate: 29.9%
> 2014 unemployment rate: 7.7%

Many Macon residents live in relatively poor social and economic environments, which likely contributed to the area’s distinction as Georgia’s least healthy metro area. An estimated 57.9% of current ninth graders are expected to graduate, far lower than the statewide graduation rate of 70.4%, which itself is nearly the lowest rate of all states. Last year, 7.7% of the area’s workforce was unemployed, higher than the state’s rate of 7.2%, which was the sixth highest compared to all states. Such factors are associated unhealthy behaviors as well as help lead to a higher incidence of premature death. In Macon, an estimated 10,059 years are lost per 100,000 people each year due to premature death, well above both the state and national levels. Macon is also one of only 11 metro areas where years lost to preventable death exceeded 10,000 years annually.