Special Report

The Least Healthy City in Every State

31. Farmington, New Mexico
> Pct. without health insurance:
> Pct. food insecure: 13.6%
> Obesity rate: 30.2%
> 2014 unemployment rate: 6.3%

Farmington has the sixth highest uninsured rate of any metro area in the country, and the third highest outside of Texas. Uninsured individuals are less likely to receive routine checkups, which can catch conditions in their earliest stages. And about one-fourth of Farmington residents were uninsured, likely contributing to worse health outcomes. There were 93.9 deaths from injuries per 100,000 people in New Mexico, highest of any state. In Farmington, the injury death rate was more than five times as high, at 533 deaths per 100,000 people. This likely contributed to the high incidence of premature death in Farmington, estimated at 9,220 years lost per 100,000 people annually, well above the state and national estimates. In measures of physical health such as smoking and obesity rates as well as inactivity, Farmington trailed the nation only slightly. In Farmington, 22.7% of residents smoke, 30.2% are obese, and 23.2% are physically inactive, compared to the national shares of 20.0%, 28.3%, and 27.0%, respectively.

32. Elmira, New York
> Pct. without health insurance:
> Pct. food insecure: 6.0%
> Obesity rate: 30.7%
> 2014 unemployment rate: 6.3%

Almost 92% of Elmira residents have health insurance. Having health insurance allows for better access to medical treatment and increases the likelihood conditions will be diagnosed and treated early. Despite Elmira having one of the top 25 insured rates of any metropolitan area, residents still had unhealthy behaviors and poor health outcomes, and the area is New York’s least healthy city. It lags just behind New York and the nation, with a 30.7% obesity rate compared to 28.3% nationwide, and a 23.4% smoking rate compared to a 20.0% national smoking rate. Besides New York City, Elmira had the lowest high school graduation rate of any city in New York. High school education is especially important to the overall health of a population, as a diploma can allow for jobs with higher incomes that afford healthier lifestyles.

33. Rocky Mount, North Carolina
> Pct. without health insurance:
> Pct. food insecure: 6.1%
> Obesity rate: 34.8%
> 2014 unemployment rate: 8.6%

North Carolina is similar to the rest of the country in general measures of health. The health of its cities vary, however, and Rocky Mount is the least healthy, largely due to relatively unhealthy behaviors and a poor economic environment. Rocky Mount’s obesity rate was 34.8%, 6.5 percentage points higher than the national level. Lack of exercise may have contributed to the obesity rate, as 31.4% of Rocky Mount residents were physically inactive. By contrast, only a quarter of North Carolina’s residents were physically inactive. The economic climate of Rocky Mount is also in poor shape. The area’s 8.6% unemployment rate last year was the highest of any city in North Carolina. Rocky Mount also had a 32.2% child poverty rate, again the highest in the state, and higher than the comparable national percentage.

34. Bismarck, North Dakota
> Pct. without health insurance:
> Pct. food insecure: 6.9%
> Obesity rate: 29.3%
> 2014 unemployment rate: 2.8%

Bismarck is the least healthy city in an otherwise very healthy state, and it is generally in better shape than the rest of the country. Cities across North Dakota have fairly uniform levels of healthy behaviors, but Bismarck reported far worse health outcomes. Health insurance is important to a population’s health, and at about 92%, Bismarck’s insured rate is about 7 percentage points higher than the rest of the country’s. Child poverty is another important indicator of current health and a good predictor of future health. North Dakota had the second lowest child poverty level in the country, and at 11.8%, Bismarck also had one of the lowest child poverty rates of any metro area. Bismarck shares many healthy behaviors with the rest of North Dakota, but loses more years of potential life than any other city in the state. In Bismarck, 7,513 years of potential life per 100,000 people are lost by those who die before age 75. This is 1,125 more years lost than the estimated incidence of premature death for North Dakota.

35. Springfield, Ohio
> Pct. without health insurance:
> Pct. food insecure: 7.0%
> Obesity rate: 30.1%
> 2014 unemployment rate: 5.6%

Ohio is about as healthy as the nation. A poor social and economic environment accounts for Springfield’s status as the least healthy city in Ohio. An important indicator of current and future population health is the prevalence of child poverty, as lifestyle habits developed in childhood are likely to carry into adulthood. About 28% of Springfield children live in poverty, 6 percentage points higher than the national share. While Springfield’s high school graduation rate was similar to the national rate, area residents were less likely to have completed at least some college compared to most Americans. In other measures of healthy behavior such as obesity and physical inactivity, Springfield is on par with Ohio and the rest of the country.