Special Report

The Least Healthy County in Every State

11. Hawaii
> Least healthy county:
> Pct. without health insurance: 10.7%
> Pct. limited access to healthy food: 10.8%
> Obesity rate: 23.5%
> 2015 unemployment rate: 5.5%

Hawaii is among the national leaders in numerous measures of health and well-being. Residents of Hawaii County, the state’s least healthy area, are by no means the least healthy Americans. Still, area residents are slightly more likely than adults nationwide to report a low quality of life, and premature death is more common in the county than across the nation. Obesity, on the other hand, is far less common in the area. Of adults in the county, 23.5% are obese, well below the national rate, but still higher than the state’s 22.1% rate.

12. Idaho
> Least healthy county:
> Pct. without health insurance: 31.1%
> Pct. limited access to healthy food: 7.2%
> Obesity rate: 32.1%
> 2015 unemployment rate: 3.3%

One of the consequences of unhealthy habits is a lower life expectancy, and this is clear in Idaho’s least healthy county, Owyhee. Nationally, 6,600 years of life are lost on per 100,000 residents due to premature death, but in Owyhee nearly 8,100 years of life are lost annually. Rural populations are much more likely to struggle with health problems. People living outside of cities and suburban neighborhoods tend to lack access to healthy diet and exercise options as well as medical care. This is both because incomes tend to be lower, and resources tend to be spread farther apart in these areas. Idaho is a relatively rural state, with nearly 30% of the population living outside of cities or suburban neighborhoods. In Owyhee, 77% of the population lives in a rural area.

13. Illinois
> Least healthy county:
> Pct. without health insurance: 14.1%
> Pct. limited access to healthy food: 23.8%
> Obesity rate: 32.1%
> 2015 unemployment rate: 10.4%

Entirely rural, Pulaski is the least healthy county in Illinois. Rural areas have a smaller tax base and, consequently, fewer resources for public investment in health. In Pulaski, only 34% of the county’s population has adequate access to places for physical activity such as parks or recreational facilities, compared to 89% of state residents with access to such locations. People living in rural areas are also more likely than others to report certain unhealthy behaviors. In Pulaski, 19% of adults report a smoking habit, considerably more than the 15% of adults statewide who identify as smokers.

14. Indiana
> Least healthy county:
> Pct. without health insurance: 15.6%
> Pct. limited access to healthy food: 2.0%
> Obesity rate: 28.9%
> 2015 unemployment rate: 6.7%

An area’s economic vitality can dramatically impact the collective health of its residents. In Scott County, Indiana’s least healthy county, residents face high unemployment and poverty rates. At 6.7%, the county’s unemployment rate is higher than the 6.0% statewide jobless rate. Additionally, 27% of children in Scott County live in poverty, a considerably larger share than Indiana’s 21% child poverty rate. As unemployment and poverty can limit an individual’s ability to make healthy choices, such as maintaining a healthy diet and regularly visiting the doctor, health outcomes in Scott are poor. County residents report a higher average number of physically and mentally unhealthy days a month than Indiana residents as a whole. Also, a larger share of the county’s population reports less than optimal health than the corresponding share of adults across the state.

15. Iowa
> Least healthy county:
> Pct. without health insurance: 12.3%
> Pct. limited access to healthy food: 11.2%
> Obesity rate: 32.9%
> 2015 unemployment rate: 5.7%

Poverty can directly hinder a population’s ability to access healthier foods and exercise and afford medical care. In Iowa, which is one of the healthiest states, just 15.5% of children live in poverty. However, in Wapello, the state’s least healthy county, 22% of children live in poverty. On the whole, though, Wapello compares relatively favorably to many unhealthy counties. For example, county residents report approximately the same number of days in fair or poor health each month.