Special Report

The Least Healthy County in Every State

21. Massachusetts
> Least healthy county:
> Pct. without health insurance: 5.0%
> Pct. limited access to healthy food: 5.3%
> Obesity rate: 28.5%
> 2015 unemployment rate: 7.8%

Massachusetts is by many measures one of the healthiest states in the country. State residents exhibit very healthy behavior, as they are less likely to smoke, die from drinking and driving, transmit sexually transmitted diseases, or avoid exercise than Americans nationwide. The county of Hampden, however, compares unfavorably to national statistics in each of these behavioral factors. Perhaps for this reason, Hampden residents spend a full day on average more than the typical american feeling physically unwell each month.

22. Michigan
> Least healthy county:
> Pct. without health insurance: 15.8%
> Pct. limited access to healthy food: 4.0%
> Obesity rate: 33.5%
> 2015 unemployment rate: 10.0%

Some economic indicators, such as unemployment and poverty rates, are closely associated with health outcomes. Nearly 40% of Wayne county residents live in Detroit, one of the most economically depressed cities in the country. Indeed, 10% of the county workforce is in need of a job, and more than 35% of children in Wayne live in poverty. Such poor economic conditions can reduce access to proper nutrition, to health care, and ultimately yield some of the worst health outcomes in the state. More than 10% of children born in Wayne have a low birthweight, the largest share in Michigan. Even more distressing, one of every 100 children in the county dies before turning one year old, the highest infant mortality rate in Michigan.

23. Minnesota
> Least healthy county:
> Pct. without health insurance: 14.2%
> Pct. limited access to healthy food: 19.5%
> Obesity rate: 28.6%
> 2015 unemployment rate: 5.6%

While Minnesota is one of the more healthy states in the country, Mahnomen County bucks the trend. Approximately 22% of county adults report fair or poor health, double the 11% of Minnesota adults reporting similar poor health. Also, 11,029 years of life are lost to premature death per 100,000 residents each year, more than twice the statewide figure of 5,071 lost years per 100,000 Minnesotans. The White Earth Reservation includes all of Mahnomen County as well as portions of other counties, and American Indians comprise 41.7% of the county’s population. Reservations have unique legal status and are often considered risky places to invest. They tend to offer far fewer jobs, and the pressures to conform to Western norms have their own consequences. Due to these and numerous other factors, American Indians are far more likely than the average American to face serious health issues.

24. Mississippi
> Least healthy county:
> Pct. without health insurance: 20.6%
> Pct. limited access to healthy food: 19.9%
> Obesity rate: 46.6%
> 2015 unemployment rate: 15.8%

Holmes is the least healthy county in a particularly unhealthy state. Over 10,000 years are lost annually due to premature death in Mississippi, more than in any other state in the country. In Holmes, premature death is even more common with over 13,600 years lost annually to preventable deaths. Unhealthy habits play a major role in such negative outcomes. More than a quarter of county residents report a smoking habit, the largest share of any county in the state. Economic conditions also play a factor. Well over half of all children in Holmes live in poverty, and one in every five county residents is low income and does not live close to a grocery store. These proportions are considerably higher than the respective state and national rates.

25. Missouri
> Least healthy county:
> Pct. without health insurance: 13.8%
> Pct. limited access to healthy food: 4.4%
> Obesity rate: 33.8%
> 2015 unemployment rate: 9.0%

People in poverty are more likely to be malnourished, suffer from poor mental health, and die prematurely. In Pemiscot, more than 40% of children live below the poverty line, compared to a statewide child poverty rate of 21%. The inability to regularly afford food is a major obstacle to proper nutrition, and 23.1% of Pemiscot residents struggle to afford food each year, the second highest share in the state. Additionally, more than 14% of county residents report frequent medical distress, one of the highest rates of any county in the state and the country as a whole. Overall, 16,183 years of life are lost to premature death per 100,000 residents in Pemiscot each year, nearly the highest incidence of premature death in the nation.