Special Report

The Least Healthy City in Every State

21. Springfield, Massachusetts
> Pct. without health insurance:
> Pct. food insecure: 5.6%
> Obesity rate: 27.4%
> 2014 unemployment rate: 6.8%

Massachusetts was the first state in the country to have near-universal health care. Since health insurance is one of the key determinants of health outcomes, it is not surprising that Springfield, the least healthy metropolitan area in the state, is still relatively healthy by national standards. Just 3.9% of metro area residents did not have health insurance in 2013, compared to 14.5% of Americans. While the metro area had a higher than average rate of reported days of poor mental health, it had fewer days of poor physical health than the national average, as well as fewer years of life lost due to premature death per capita.

22. Flint, Michigan
> Pct. without health insurance:
> Pct. food insecure: 9.0%
> Obesity rate: 36.9%
> 2014 unemployment rate: 7.8%

Nearly 19% of adults living in Flint reported fair or poor health versus 14.3% of Michigan residents and 16% of all Americans. At least some of the adults reporting less than optimal health were likely among the area’s obese population, which made up nearly 37% of residents. This was far higher than the state’s obesity rate of 31.6% and in stark contrast with the national rate of 28.3%. Less than 10% of Flint residents did not have health insurance, although the strong coverage has not significantly lowered the incidence of premature death. An estimated 9,092 years are lost per 100,000 people each year due to premature deaths, versus the state and national estimates of 7,218 and 6,622.

23. Duluth, Minnesota
> Pct. without health insurance:
> Pct. food insecure: 7.6%
> Obesity rate: 27.4%
> 2014 unemployment rate: 5.2%

Minnesota is the healthiest state in the country by a number of measures. Just 10.5% of adults reported fair or poor health, the lowest of all states. Similarly, the incidence of premature death, at an estimated 5,038 years lost per 100,000 people annually, was the lowest of all states. While the Duluth metro area is the state’s least healthy, its residents are still healthier than many Americans. For instance, while 18.0% of area adults smoked — higher than the state’s smoking rate of 16.2% — it was still lower than the nationwide smoking rate of 20.0%.

24. Gulfport-Biloxi-Pascagoula, Mississippi
> Pct. without health insurance:
> Pct. food insecure: 15.8%
> Obesity rate: 32.0%
> 2014 unemployment rate: 7.5%

Mississippi is one of the least healthy states in the country, and the Gulfport-Biloxi-Pascagoula metropolitan area, located near Gulf of Mexico, is by most measures just as unhealthy. Nationally, an annual average of 6,622 years of life are lost due to premature death. In the Gulfport region, more than 9,300 years are lost due to premature deaths per year. Like the state as a whole, the metropolitan area struggles with obesity, which has one of the strongest relationships with overall health. While 28.3% of the nation’s adults were obese, 34.1% were in the Gulfport area.

25. St. Louis, Missouri
> Pct. without health insurance:
> Pct. food insecure: 6.1%
> Obesity rate: 33.2%
> 2014 unemployment rate: 6.3%

St. Louis is slightly less healthy than Missouri as a whole, and far less healthy than the United States. In St. Louis, 29.7% of residents smoked compared to 22.6% in Missouri and 20.0% in the rest of the country. Similarly, 33.2% of St. Louis residents were obese compared to 30.9% across Missouri and 28.3% across the nation. St. Louis had an impressive graduation rate, with 89.9% of high schoolers graduating compared to an 80.0% high school graduation rate across the country. Education is important to physical health as it provides access to higher-paying jobs that can support healthier lifestyles. This, coupled with an active job market, can significantly improve the health of a city. Last year, 6.3% of the St. Louis workforce were unemployed, which was slightly above the state unemployment rate of 6.1%.