Special Report

The Least Healthy County in Every State

16. Kansas
> Least healthy county:
Wyandotte
> Pct. without health insurance: 21.5%
> Pct. limited access to healthy food: 13.6%
> Obesity rate: 37.8%
> 2015 unemployment rate: 6.9%

Nearly 38% of adults in Wyandotte County are obese, the second highest share of any county in Kansas and considerably higher than the 30% statewide obesity rate. Being overweight can significantly impact quality of life, and Wyandotte residents report worse health outcomes than state residents overall. On average, adults in the county report 3.6 mentally unhealthy days and 3.9 physically unhealthy days a month, each at least half a day more than is typical among state residents. Additionally, more than one in five adults in Wyandotte County say they are in fair or poor health compared to only 13.6% of Kansas adults.

17. Kentucky
> Least healthy county:
Harlan
> Pct. without health insurance: 19.4%
> Pct. limited access to healthy food: 9.9%
> Obesity rate: 36.6%
> 2015 unemployment rate: 13.9%

Like many of the least healthy counties in America, Harlan is one of the poorest. A typical household in Harlan County makes just $26,351 annually, less than half the $53,700 median household income nationwide. Harlan County’s 13.9% unemployment rate is one of the highest in the country, and the 42.6% of children who live in poverty is one of the worst child poverty rates nationwide. Financial distress has likely increased the difficulty of maintaining healthy habits and ultimately contributes to the county’s poor health outcomes. Just 59.9% of county adults regularly exercise, the lowest share in Kentucky. Similarly, 36.6% of adults are obese, significantly more than the 32.3% state rate, itself higher than the 27.0% national obesity rate.

18. Louisiana
> Least healthy county:
Madison
> Pct. without health insurance: 22.7%
> Pct. limited access to healthy food: 2.5%
> Obesity rate: 43.0%
> 2015 unemployment rate: 11.3%

Measuring both quality of life and life expectancy, Louisiana is one of the least healthy states in the country. Not surprisingly, the state’s least healthy county — Madison — has some of the lowest quality of life and highest mortality figures in the country. On a national level, 6,600 years of life are lost due to premature death per 100,000 residents. In Madison, 12,073 years of life are lost. In the United States, 14% of adults report being in poor or fair health, while 35% of adults in Madison say the same, tied for 11th worst among the nation’s more than 3,000 counties.

19. Maine
> Least healthy county:
Washington
> Pct. without health insurance: 18.5%
> Pct. limited access to healthy food: 5.4%
> Obesity rate: 30.9%
> 2015 unemployment rate: 8.4%

Residents of Washington County report feeling in poor physical health an average 4.4 days each month, a full day more than is typical across Maine. Low exercise rates are likely contributing to such poor health outcomes. Only 71.7% of county residents exercise regularly, the smallest such share of any county in the Maine. Limited access to places for physical activity may be partially behind the low exercise rate. Less than 39% of county residents live in an area with adequate access to a park or recreational facility. By contrast, more than two-thirds of Maine residents have access to places for physical activity.

20. Maryland
> Least healthy county:
Baltimore City
> Pct. without health insurance: 12.8%
> Pct. limited access to healthy food: 1.2%
> Obesity rate: 34.3%
> 2015 unemployment rate: 8.7%

Nearly 20% Baltimore City residents report being in fair or poor health, a considerably higher share than the corresponding state rate of 13%. While in many states the least healthy county is rural and relatively safe, Maryland is an exception. Baltimore City, Maryland’s least healthy county, is entirely urban — and relatively dangerous. There are 1,449 violent crimes reported per 100,000 each year in the area, the third highest rate of any U.S. county. Baltimore’s economy is also not especially strong, which can contribute to lower incomes and hinder public programs and services supporting health. Baltimore’s unemployment rate of 8.7% exceeds the state and national rates.