Special Report

The Least Healthy City in Every State

16. Wichita, Kansas
> Pct. without health insurance:
> Pct. food insecure: 8.8%
> Obesity rate: 30.3%
> 2014 unemployment rate: 5.2%

Safe communities are often healthy communities as well. In Wichita, the least healthy metro in Kansas, 568 violent crimes were reported in 2013, contributing to a rate well above corresponding state and national rates. Living in unsafe neighborhoods is associated with higher stress levels and other poor health factors, which can accelerate aging and lead to a higher incidence of premature death. In Wichita, an estimated 7,420 years are lost per 100,000 residents each year due to preventable deaths, well above both the state and national estimates. Wichita also reported 512 cases of chlamydia per 100,000 residents, also much higher than the comparable state and national rates. Higher occurrences of sexually transmitted diseases are more common among people leading unhealthy lifestyles.

17. Bowling Green, Kentucky
> Pct. without health insurance:
> Pct. food insecure: 2.7%
> Obesity rate: 30.6%
> 2014 unemployment rate: 5.9%

Few metro areas have worse health outcomes than the Bowling Green, Kentucky metropolitan area. Each year, an average of 8,058 years of life are lost due to premature death per 100,000 residents, compared to the 6,622 years lost on a national level. Nearly 20% of adults reported fair or poor health compared to 16% of all adults nationwide. A lack of exercise in the metro area is likely contributing to the poor health outcomes. Just 67% had access to physical activity locations compared to 85% of adults nationwide. Also, nearly 37% of the area’s population are physically inactive — about 10 percentage points higher than the national share.

18. Monroe, Louisiana
> Pct. without health insurance:
> Pct. food insecure: 17.6%
> Obesity rate: 34.2%
> 2014 unemployment rate: 0.1%

According to a recent study, residents of communities with high income inequality are more likely to die before the age of 75. While researchers do not agree over the reasons behind the poor health in such areas, they agree that inequality exacerbates poor health outcomes beyond the effects of low income levels alone. In Monroe, the 80th percentile incomes were more than seven times greater than the 20th percentile incomes, the widest such income gap not just in Louisiana but of any U.S. metro area. Each year, an estimated 9,355 years are lost per 100,000 area residents, higher than the statewide incidence of premature death of 9,131 per 100,000 Louisianans, which was the fourth highest state figure.

19. Lewiston-Auburn, Maine
> Pct. without health insurance:
> Pct. food insecure: 2.9%
> Obesity rate: 31.3%
> 2014 unemployment rate: 5.5%

While Lewiston-Auburn, located in the southern part of Maine, is the least healthy metro area in the state, it is actually relatively average compared to the rest of the nation. Lewiston area residents reported 3.7 physically unhealthy days in the past 30, compared to an average of 4.0 per month across the country. The metro area had a slightly higher adult obesity rate than the national rate, at 31.3% versus 28.3%, which may be one of the reasons it fares worse than other Maine metro areas. Higher obesity rates often correspond with many other negative health indicators.

20. Cumberland, Maryland
> Pct. without health insurance:
> Pct. food insecure: 15.6%
> Obesity rate: 28.0%
> 2014 unemployment rate: 7.3%

The Cumberland metropolitan area is interesting because while half of it is located in Maryland, one of the healthiest states, the other half is in West Virginia, one of the least healthy states. The metro area, which includes Allegheny County in Maryland and Mineral County in West Virginia, is worse than the national averages by most measures of health behavior and outcomes. Socioeconomic factors may have had a significant impact on outcomes in the region. More than 15% of the area’s residents did not have adequate access to healthy food because of income restraints, which is nearly three times the national share. Education levels often correlate strongly with healthy behavior. In Cumberland, just 52.4% of adults had at least some college education, about 10 percentage points below the national rate.