The Most Obese County in Every State

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26. Montana
> Most obese county:
Big Horn
> County obesity rate: 36.7%
> Statewide obesity rate: 24.6%
> Pct. of adults who exercise regularly: 70.8%
> Share of adults reporting fair or poor health: 22.3%

While Montana’s 25% obesity rate is roughly 2 percentage points lower than the national obesity rate, Big Horn County’s obesity rate of nearly 37% exceeds the national rate by roughly 10 percentage points. As in many counties with high obesity rates, diabetes is relatively common in Big Horn. Roughly 13% of county adults have diabetes compared to a statewide diabetes rate of just under 9%. Big Horn County contains parts of both Crow and Northern Cheyenne American Indian reservations, and 64.4% of the population is American Indian, a population that tends to struggle with obesity.

27. Nebraska
> Most obese county:
Thurston
> County obesity rate: 40.8%
> Statewide obesity rate: 29.5%
> Pct. of adults who exercise regularly: 69.6%
> Share of adults reporting fair or poor health: 22.9%

More than two in five Thurston County adults are obese, the highest obesity rate of Nebraska counties and one of the highest in the United States. Obesity is linked to many adverse health outcomes and can lead to a shorter life expectancy. For every 100,000 residents in Thurston County, 13,034 years of potential life are lost to premature death annually. This is more than twice the incidence of premature death per capita in Nebraska, where 5,815 years of life per 100,000 residents are lost prematurely each year.

28. Nevada
> Most obese county:
Pershing
> County obesity rate: 32.4%
> Statewide obesity rate: 25.4%
> Pct. of adults who exercise regularly: 76.9%
> Share of adults reporting fair or poor health: 19.0%

Pershing County’s entirely rural environment may contribute to its 32.4% obesity rate, the highest in Nevada. Just 22.6% of county residents have access to places for physical activity, about one-fourth the corresponding statewide share. While obese individuals are at greater risk of adverse health outcomes that can eventually lead to an untimely death, Pershing County actually has a lower incidence of premature death than Nevada as a whole. For every 100,000 county residents, 5,877 years of potential life are lost annually to premature death, much less than the 7,036 years of potential life lost per 100,000 Nevada residents.

29. New Hampshire
> Most obese county:
Belknap
> County obesity rate: 30.7%
> Statewide obesity rate: 27.3%
> Pct. of adults who exercise regularly: 77.7%
> Share of adults reporting fair or poor health: 11.9%

Apart from its high obesity rate, Belknap County is in line with the New Hampshire by many measures of health. In both the county and the state, about 12% of adults report feeling in fair or poor health. Similarly, residents of both the county and the state report feeling physically unwell for about three days a month and mentally unwell for 3.4 days.

30. New Jersey
> Most obese county:
Cumberland
> County obesity rate: 33.6%
> Statewide obesity rate: 24.7%
> Pct. of adults who exercise regularly: 72.3%
> Share of adults reporting fair or poor health: 21.1%

Cumberland County’s 33.6% obesity rate is much higher than New Jersey’s 24.7% obesity rate. Obesity is associated with a number of adverse health issues, such as cardiovascular disease, stroke, and diabetes, and can ultimately lead to shorter life spans. For every 100,000 Cumberland residents, close to 8,000 years are lost due to preventable untimely deaths. The rate is much higher than the incidence of premature death across the state.