Special Report

The Least Healthy County in Every State

1. Alabama
> Least healthy county:
Wilcox
> Pct. without health insurance: 16.9%
> Pct. limited access to healthy food: 27.6%
> Obesity rate: 44.4%
> 2015 unemployment rate: 17.4%

Compared to the typical American, Alabama residents are not especially healthy. In Wilcox, the state’s least healthy county, residents report even worse outcomes than the state as a whole. An estimated 17,193 years are lost per 100,000 Wilcox residents annually due to preventable deaths, well above the comparable state figure of 9,545 years, which itself is far higher than the national estimate. Obese individuals are at a considerably greater risk of worse health outcomes than other people. This may be one major factor in Wilcox’s poor health outcomes, where 44% of adults are obese, versus the state obesity rate of 34%, and the national figure of 27%.

2. Alaska
> Least healthy county:
Kusilvak
> Pct. without health insurance: 28.6%
> Pct. limited access to healthy food: 44.1%
> Obesity rate: 34.4%
> 2015 unemployment rate: 23.7%

Like a number of other unhealthy areas, particularly in Alaska, Kusilvak is rural. Access to quality food, health care, and other services is frequently more challenging in sparsely populated areas. This is also the case in Kusilvak, where 44% of individuals do not have access to affordable, healthy food. Similarly, 29% of residents in the area do not have health insurance, a considerably higher uninsured rate than across the state and the nation.

3. Arizona
> Least healthy county:
Apache
> Pct. without health insurance: 23.6%
> Pct. limited access to healthy food: 43.8%
> Obesity rate: 32.8%
> 2015 unemployment rate: 16.0%

Habits and health outcomes vary considerably throughout Arizona. In Apache, the least healthy county in the state, an estimated 14,300 years of life are lost per 100,000 people each year due to preventable death, more than in any other county in the state. By comparison, 6,800 years of life are lost per 100,000 across Arizona as a whole. Considering that several health indicators in Apache are far worse than they are statewide, the county’s poor health outcomes may not come as a surprise. More than a quarter of county residents report a smoking habit and a third of all adults in the county are obese, each a considerably larger share than the comparable statewide figure. Apache is one of several predominantly American Indian communities that are among the least healthy in the country. American Indians are significantly more likely than the average American to suffer from extreme poverty and other conditions that can lead to poor health.

4. Arkansas
> Least healthy county:
Phillips
> Pct. without health insurance: 17.6%
> Pct. limited access to healthy food: 24.1%
> Obesity rate: 41.5%
> 2015 unemployment rate: 9.6%

Most of the least healthy counties in Arkansas, including Phillips County, are located near the state’s eastern border with Mississippi. Phillips residents, on the whole, are significantly less likely to have access to healthy food than the average American, and only 60% of adults exercise, compared to 77% of U.S. adults who do. Diet and exercise are crucial to preventing obesity, which is a leading indicator of many of the most common life-threatening illnesses. The adult obesity rate in Arkansas of 33% is quite high compared to the national rate of 27%. In Phillips County, an even higher 42% of adults are obese, one of the highest rates of any county in the United States.

5. California
> Least healthy county:
Kern
> Pct. without health insurance: 20.4%
> Pct. limited access to healthy food: 5.4%
> Obesity rate: 28.5%
> 2015 unemployment rate: 10.4%

Education and financial security are often major determinants of health. In Kern, California’s least healthy county, fewer than half of all adults have completed at least some college, well below the state and national rates. Also, one-third of children live in poverty in Kern, versus the nationwide child poverty rate of 22%. These poor socioeconomic factors have contributed to poor health outcomes. More than one in every five adults living in Kern assess their own health as poor or fair. By contrast, 14% of adults nationwide report feeling in similarly poor health.