Special Report

The Least Healthy City in Every State

11. Kahului-Wailuku-Lahaina, Hawaii
> Pct. without health insurance:
> Pct. food insecure: 8.7%
> Obesity rate: 22.7%
> 2014 unemployment rate: 4.5%

The Kahului-Wailuku-Lahaina metro area is one of two in Hawaii, one of the healthiest states. Like in Hawaii, the smoking and physical inactivity rates in the Kahului area, at 15.4% and 17.1% respectively, were lower than the national rates. Perhaps as a result, the incidence of premature death and the obesity rates were also lower than the corresponding nationwide figures. In addition, while the metro area’s uninsured rate of 8.9% was higher than the statewide rate, it was well below the national rate of 14.5%. Still, area residents are the least healthy of any metro area in the state. More than one in five area adults reported a binge or heavy drinking habit, and nearly half of the area’s households reported at least one housing problem such as overcrowding or high costs — problems that can impede a healthy lifestyle.

12. Lewiston, Idaho
> Pct. without health insurance:
> Pct. food insecure: 4.1%
> Obesity rate: 32.3%
> 2014 unemployment rate: 4.6%

Despite relatively healthy habits, and a low share of adults reporting fair to poor health, the Lewiston metro area had a high incidence of premature death and is Idaho’s least healthy metro. Just over one in 10 area residents did not have health insurance, a better coverage rate than across the state and the nation. Also, less than 15% of Lewiston’s population participate in physical activity in their spare time, versus the state and national shares of 19.5% and 27.0%, respectively. Yet, and estimated 8,594 years are lost per 100,000 area residents annually due to premature death, well above both the state and national estimates of 6,046, and 6,622, respectively.

13. Danville, Illinois
> Pct. without health insurance:
> Pct. food insecure: 6.9%
> Obesity rate: 34.3%
> 2014 unemployment rate: 8.6%

More than 25% of adults in Danville are smokers, and more than 26% are physically inactive, each well above the respective state and national shares. These relatively poor habits among residents living in Illinois’s least healthy metro likely contributed to worse health outcomes. The incidence of premature death in Danville, measured at 8,656 years lost per 100,000 area residents annually was far worse than the state and national estimates. Also, Danville’s obesity rate of 34.3% was one of the highest rates of any U.S. urban area, while the state’s obesity rate of 27.3% was slightly lower than the nationwide rate of 28.3%.

14. Muncie, Indiana
> Pct. without health insurance:
> Pct. food insecure: 7.0%
> Obesity rate: 33.4%
> 2014 unemployment rate: 7.1%

More than 20% of adults in Muncie said they were in fair or poor health, versus around 16% of Indianans. At least some respondents reporting such poor health were likely smokers, as more than 25% of area adults reported a smoking habit, in contrast with the statewide rate of 22.8%, itself the fifth highest of all states. The share of area residents with access to locations of physical activity, at just over 75%, was slightly higher than the statewide share. However, compared with 85% of Americans reporting such access, Muncie residents had relatively poor exercise opportunities. Partially as a result, more than one in three areas residents were obese, higher than the state’s obesity rate of 31.3%.

15. Sioux City, Iowa
> Pct. without health insurance:
> Pct. food insecure: 9.6%
> Obesity rate: 31.9%
> 2014 unemployment rate: 4.4%

Iowa is one of the healthier states in the country, with just 11.2% of adults reporting fair or poor health in 2015 compared to 16% of the country’s adults. Consequently, while the Sioux City metropolitan area is unhealthy relative to the other metros in the state, it is still healthier than the rest of the country. Just 12.4% of adults were in fair or poor health, higher than the state’s share but still lower than the national share. Residents, however, participate in some less-than-healthy behaviors. The metro area had slightly higher obesity and smoking rates than the comparable national rates.