Special Report

The Healthiest County in Every State

1. Alabama
> Healthiest county:
> Pct. without health insurance: 12.1%
> Pct. food insecure: 10.7%
> Obesity rate: 31.3%
> 2014 unemployment rate: 4.5%

Alabama is one of the least healthy states in the country. Across the state, 21.1% of adults report being in fair or poor health, nearly the largest share of all states. The average resident reports feeling physically unhealthy for 4.6 days each month, the second most of any state population. In Shelby County, the healthiest county in Alabama, residents are about as healthy as the average American. Just 13.8% of adults report being in fair or poor health, and they feel in poor physical health for 3.6 days each month on average — compared to the corresponding national figures of 14.0% and 3.5 days per month. High incomes in Shelby County likely contributed to the relatively good health outcomes. County households earn $69,432 a year, the highest median household income of any Alabama county.

2. Alaska
> Healthiest county:
> Pct. without health insurance: 17.3%
> Pct. food insecure: 11.1%
> Obesity rate: 27.0%
> 2014 unemployment rate: 5.1%

Alaska is by far the largest and most sparsely populated state in the country. Rural dwellers, who make up more than one in three Alaskans, often report more unhealthy habits and poor health outcomes. The opposite is true in more urban areas, which may explain the relatively better health of Alaskans living in Juneau, the state’s capital and healthiest county. Fewer than one in 10 Juneau residents report fair or poor health, lower than both the state and national proportions of people reporting such low levels of health.

Relatively high incomes may also help county residents stay healthy. Juneau’s median annual household income of $80,835 is higher than the state median of $70,898, itself nearly the highest of all states in the country.

3. Arizona
> Healthiest county:
> Pct. without health insurance: 19.8%
> Pct. food insecure: 15.9%
> Obesity rate: 22.2%
> 2014 unemployment rate: 5.9%

By many measures of well-being, the rural parts of Arizona are much less healthy than the state’s urban areas. In Maricopa County, a part of the Phoenix-Mesa-Scottsdale metropolitan area, 97.6% of the population lives in an urban environment. It is also the healthiest county in the state.

In Maricopa County, 15.1% of adults smoke and 22.2% are obese, shares slightly better than the statewide 15.7% smoking and 23.5% obesity rates. For every 100,000 county residents, 295 die before the age of 75, a lower incidence of premature death than the state.

4. Arkansas
> Healthiest county:
> Pct. without health insurance: 18.0%
> Pct. food insecure: 13.9%
> Obesity rate: 28.4%
> 2014 unemployment rate: 4.6%

Arkansas residents as a whole have some of the nation’s worst health outcomes and least healthy behaviors. As in many other relatively unhealthy states, residents of Arkansas’ healthiest county, Benton, do not fare particularly well compared to the nation. The percentages of Benton adults who are obese and who smoke, while lower than the statewide rates, are higher than the national obesity and smoking rates of 17% and 27%. Similarly, the 17.1% of area adults who report being in fair or poor health is better than the statewide percentage, but still far worse than the 14.0% of adults nationwide who report such low health levels.

Benton residents are financially well-off. The child poverty rate, for example, of 16.2% is well below the state and national rates of 26.3% and 22.0%.

5. California
> Healthiest county:
> Pct. without health insurance: 11.9%
> Pct. food insecure: 11.9%
> Obesity rate: 18.1%
> 2014 unemployment rate: 4.3%

The factors and behaviors that contribute to good health — including access to medical care and healthy foods, frequent exercise, and so on — can often be expensive. As a result, the healthiest areas in every state are often home to some of the nation’s wealthiest individuals. Marin, California is one such county. The typical area household earns $94,549 annually, far higher than both the state and national medians. Only 11.9% of adults do not have health insurance, and 2% report limited access to food, each well below the comparable state and national rates. Also, while 16.7% of Californians report no physical activity whatsoever, only 10.8% of Marin adults report such sedentary lifestyles — a lower rate than the nation.

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