Special Report

The Least Healthy City in Every State

36. Lawton, Oklahoma
> Pct. without health insurance:
> Pct. food insecure: 14.5%
> Obesity rate: 33.5%
> 2014 unemployment rate: 4.8%

Lawton is the least healthy city in one of the least healthy states. About 34% of Lawton residents were obese, about 6 percentage points higher than the nationwide obesity rate. A potentially related measure, 31.4% of residents were physically inactive, 4.1 percentage points higher than the national average. Oklahoma had the third highest smoking rate of any state, and Lawton’s smoking rate of 29.7% was even higher. In Lawton, more than one in five residents report fair or poor health, which is 4 percentage points higher than the proportion of Americans reporting less than optimal levels of health.

37. Grants Pass, Oregon
> Pct. without health insurance:
> Pct. food insecure: 5.5%
> Obesity rate: 25.1%
> 2014 unemployment rate: 9.6%

Education is a major determinant of a population’s health. Without a high school diploma, workers are less likely to find jobs with higher incomes which often support healthier lifestyles. Just over 67% of ninth graders in Grant Pass are expected to graduate high school, even lower than Oregon’s graduation rate, which itself was the second lowest the country. Oregon residents are relatively fit. About 16% of residents reported physical inactivity, the second lowest share of all states. In Grants Pass, however, residents are far less active, with a whopping 63% of residents reporting no physical activity whatsoever in their spare time.

38. Johnstown, Pennsylvania
> Pct. without health insurance:
> Pct. food insecure: 6.7%
> Obesity rate: 31.9%
> 2014 unemployment rate: 6.9%

Pennsylvania is a fairly healthy state. While Johnstown is its least healthy city, it is about as healthy as the rest of the nation. In Johnstown, 27.9% of residents were physically inactive, in line with the 27.0% of physically inactive Americans. Likewise, 17% of Johnstown residents reported fair or poor health, again, in line with the share of Americans who reported poor health. Health insurance is very important to a population’s health, as insured individuals are more likely to seek preventive care. In Johnstown, about 92% of residents are insured, higher than the nation’s 85.5% insured rate. Still, area residents exhibited some unhealthy behaviors, as can be seen by the area’s high incidence of alcohol-related deaths. Nearly half of all driving deaths in Johnstown are alcohol-related compared to 31% across the country.

39. Providence-Warwick, Rhode Island
> Pct. without health insurance:
> Pct. food insecure: 4.5%
> Obesity rate: 28.6%
> 2014 unemployment rate: 7.5%

Providence-Warwick is the only metro area in Rhode Island, so it is both the healthiest and least healthy city in the state. Compared to the rest of the country, the metro area is in pretty good shape. Only 9.1% of residents are physically inactive, significantly less than the 27.0% of Americans who do not exercise regularly, and one of the lowest proportions compared with all U.S. metro areas. Health insurance is important to a population’s health. Insured people have better access to medical care and are more likely to have potentially overlooked health conditions diagnosed during routine checkups. Only 9.0% of Providence-Warwick residents do not have health insurance, significantly lower than the national uninsured rate of 14.5%. However, area residents have a smoking habit — one-fifth of area adults smoke, on par with the rest of the nation.

40. Florence, South Carolina
> Pct. without health insurance:
> Pct. food insecure: 8.2%
> Obesity rate: 36.0%
> 2014 unemployment rate: 7.5%

Exercise and access to physical activity locations such as parks and recreation centers are important to a population’s health. Only 61.6% of Florence residents had adequate access to such locations, compared to the 71% in South Carolina. This is especially poor relative to the national average of 85%. Potentially related, Florence’s 36% obesity rate leads the state average by 4.3 percentage points and the national by about 7.7 percentage points. Children are among the most vulnerable to poor economic conditions, which in turn can lead to unhealthy behaviors that often carry on into adulthood. As many as 32.1% of Florence’s children live in poverty, which is 10.1 percentage points higher than the national child poverty rate. A healthy job market also factors into the physical health of a city’s population, as access to jobs affords more residents healthy lifestyles. Last year in Florence, 7.5% of the workforce were unemployed, versus the national unemployment rate of 6.2%.