> Least healthy county: Petersburg City
> Pct. without health insurance: 16.5%
> Pct. limited access to healthy food: 12.7%
> Obesity rate: 38.3%
> 2015 unemployment rate: 10.6%
Virginia has one of the lowest violent crime rates, at 200 incidents per 100,000 state residents. In Petersburg City, the state’s least healthy county, 560 violent crimes are reported per 100,000 people annually, higher than the state and national rates. Not only does violence often reflect poor economic conditions in an area, but also individuals who feel unsafe in their community are at greater risk of adverse health outcomes. The area’s unemployment rate of 10.6% is double the state’s jobless rate and well above the national jobless rate of 6.2%. Of adults living in Petersburg, more than one-quarter report being in poor or fair health, a far higher share than adults of the state or nationwide.
> Least healthy county: Ferry
> Pct. without health insurance: 23.6%
> Pct. limited access to healthy food: 22.8%
> Obesity rate: 27.4%
> 2015 unemployment rate: 11.7%
Financial distress is closely tied to adverse health outcomes. In Ferry, Washington’s least healthy county, 11.7% of workers are unemployed — nearly double both the state and national rates. With no cities or suburban areas, Ferry is 100% rural. Residents of rural areas tend to have lower incomes and are more likely to live in poverty. The availability of health services is also lower in these areas. In Ferry, there is only one primary care physician for every 1,900 people, well below the state and national proportions. Similarly, 23.6% of area residents do not have health insurance versus the statewide percentage of 15.9%.
48. West Virginia
> Least healthy county: McDowell
> Pct. without health insurance: 20.2%
> Pct. limited access to healthy food: 2.4%
> Obesity rate: 40.1%
> 2015 unemployment rate: 12.9%
More than one-third of adults in West Virginia are obese, the third highest rate of all states. In McDowell, the state’s least healthy area, the obesity rate is even higher, at two in every five adults. Also, more than 30% of area adults smoke, well above the statewide smoking rate of 23.9%, which is the highest of all states. Overweight individuals and tobacco users are at greater risk of disease and poor health outcomes, and the two factors may explain the considerably high incidence of premature death in McDowell. An estimated 20,157 years of life are lost per 100,000 people in the area annually due to preventable deaths, more than double the state estimate, which itself is nearly the highest compared with other states. Widespread poverty is likely at the root of the area’s poor health outcomes. Of children in McDowell, 46.2% live in poverty, the highest share of any county in the the state.
> Least healthy county: Menominee
> Pct. without health insurance: 17.0%
> Pct. limited access to healthy food: 18.4%
> Obesity rate: 41.0%
> 2015 unemployment rate: 13.1%
Rural areas, which frequently have fewer services to offer and smaller tax bases to support public institutions, are home to the least healthy people in a number of states. Menominee is no different. The 100% rural county is the least healthy in Wisconsin. More than 18% of area residents do not have access to affordable, quality food, several times higher than the statewide percentage of 4.8%. The Menominee economy is also struggling. Of area workers, 13.1% are unemployed and 44.2% of children in the county live in poverty, each considerably higher than the corresponding state and national rates. Weak socioeconomic factors such as these contribute to poor health outcomes. The incidence of premature death in Menominee is higher than in the vast majority of U.S. counties, and 28.2% of adults report a low quality of life, double the state and national shares.
> Least healthy county: Fremont
> Pct. without health insurance: 21.0%
> Pct. limited access to healthy food: 4.8%
> Obesity rate: 26.0%
> 2015 unemployment rate: 5.2%
Wyoming’s least healthy county is Fremont, which is home to part of the Wind River Indian Reservation. More than one in every five county residents identifies as American Indian, far higher than the statewide and national proportions. Residents of reservations frequently struggle far more than others with poverty and poor access to services. Since poor, minority, young women are the most likely to have unwanted pregnancies, the prevalence of teen births in an area often reflects poor social and economic conditions. In Fremont, the teen birth rate is 66 for every 1,000 teen women, considerably higher than the state and national rates. Compared to residents across the state, people in Fremont are more likely to struggle to afford food as well.
For the state’s least healthy county, Fremont residents have relatively healthy habits. The smoking and excessive alcohol use rates are in line with or lower than the state and national shares.