Special Report

The Healthiest County in Every State

11. Hawaii
> Healthiest county:
Honolulu
> Pct. without health insurance: 6.7%
> Pct. food insecure: 12.8%
> Obesity rate: 21.9%
> 2014 unemployment rate: 4.1%

Hawaii’s health insurance coverage rate is better than in every state except for Massachusetts. In Honolulu County, the state’s healthiest area, the coverage rate of 93.3% is even higher. In addition to the peace of mind and medical care provided by insurance coverage, Honolulu residents also have relatively healthy behaviors. For example, 12.9% of adults smoke, lower than the statewide rate of 13.6%, which itself is nearly the lowest smoking rate of any state. County residents likely have relatively healthy diets and exercise habits as the obesity rate of 21.9% is also lower than the state and national rates.

12. Idaho
> Healthiest county:
Ada
> Pct. without health insurance: 14.5%
> Pct. food insecure: 14.8%
> Obesity rate: 24.5%
> 2014 unemployment rate: 4.1%

The urban Ada County is part of the Boise City metropolitan area and is the healthiest county in Idaho. The premature death rate of 260 deaths per 100,000 residents is lower than the 309 per 100,000 Idaho residents. Just 10.9% of Ada County adults report feeling in fair or poor health, a smaller share than the 13.8% of adults who report such poor health statewide.

High incomes and educational attainment may partially explain Ada County’s strong health outcomes. The typical household in the county earns $57,908 a year, about $10,000 more than the statewide median household income. Similarly, and perhaps the result of their proximity to Boise State University, 73.9% of Boise’s young working-age adults have gone to college, well above the state college attainment rate of 64.0%.

13. Illinois
> Healthiest county:
DuPage
> Pct. without health insurance: 10.8%
> Pct. food insecure: 9.3%
> Obesity rate: 23.9%
> 2014 unemployment rate: 5.6%

DuPage County is one of the five wealthy collar counties that surround the Chicago metropolitan area. The typical DuPage County household earns $80,037 a year, among the highest incomes in the nation. The county’s population is also among the most educated as 76.9% of adults have attended college — well above the state and national college attainment rates.

High incomes and educational attainment likely help DuPage County residents lead relatively healthy lifestyles. Just 11.6% of county adults smoke and only 23.9% are obese, each the smallest such shares in Illinois. Similarly, 98.9% of the DuPage County population has access to opportunities for physical activity, and only 18.3% of adults do not exercise, each better than the corresponding statewide 89.4% access and 22.2% inactivity rates.

14. Indiana
> Healthiest county:
Hamilton
> Pct. without health insurance: 9.6%
> Pct. food insecure: 10.0%
> Obesity rate: 25.1%
> 2014 unemployment rate: 4.1%

While Indiana is one of the least healthy states, Hamilton is one of the healthiest counties nationwide. Just 13.3% of Hamilton County adults smoke compared to 20.4% of all Indiana adults. Similarly, the county’s 25.1% obesity rate is much lower than the statewide 31.4% obesity rate.

Healthy behaviors among Hamilton County residents have likely contributed to relatively strong health outcomes. Only 10.9% of county adults report having fair or poor health, a much smaller share than the 16.6% of Indiana adults who assess their health so poorly. Each year, there are 207 premature deaths per 100,000 county residents, lower than the 382 deaths per 100,000 Indianians that occur annually.

15. Iowa
> Healthiest county:
Sioux
> Pct. without health insurance: 11.8%
> Pct. food insecure: 9.1%
> Obesity rate: 27.7%
> 2014 unemployment rate: 3.0%

Sioux County is the healthiest in Iowa. Yet, more than one-quarter of residents report completely sedentary lifestyles, higher than both the state and national levels of physical inactivity. Residents have worse access to exercise venues than their peers across the state and the nation. Perhaps as a consequence, the area’s obesity rate is also slightly higher than the national rate.

Despite the relatively poor physical health, there are 203 preventable deaths per 100,000 people each year, well below the premature death rates for the state and the nation — each higher than 300 per 100,000 people. Also, 11% of adults living in Sioux say they are in fair or poor health, lower than the percentages of adults reporting such low health levels statewide and nationally.

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