31. New Mexico
> Healthiest county: Los Alamos
> Smoking rate: 11.2%
> Obesity rate: 19.9%
> Median household income: $101,934
While New Mexico is one of the least healthy states in the country, Los Alamos County, just northwest of Santa Fe, is one of the healthiest in the country. In Los Alamos, 156 people die before the age of 75 per 100,000 people annually, one of the smallest shares of U.S. counties and well below the corresponding premature death rates of 374 per 100,000 residents statewide and 333 per 100,000 people nationwide. A lower premature death rate may be partially attributable to greater access to medical care. Only 4% of county residents are uninsured — well below the state and national uninsured rates of 17.1% and 14.0%, respectively.
Healthy behaviors also likely play a role in the county’s low premature death rate. Adults in Los Alamos are less likely to smoke and more likely to have a physically active lifestyle than adults across the state.
32. New York
> Healthiest county: Nassau
> Smoking rate: 11.7%
> Obesity rate: 23.5%
> Median household income: $99,465
Nassau County is located in Long Island, adjacent to the Queens borough of New York City. The healthiest county in New York state, only 11% of county adults report being in fair or poor health, a far smaller share than the 16.2% share of adults statewide.
Residents are also less likely to engage in risky behaviors, which may partially explain positive health outcomes in the county. The incidence of sexually-transmitted disease is frequently used to gauge risky behavior in an area. In Nassau, there are only about 257 new cases of chlamydia annually for every 100,000 residents, about half the corresponding statewide STD rate. The typical adult living in the area is also less likely to smoke or drink excessively than the typical adult in New York state.
33. North Carolina
> Healthiest county: Orange
> Smoking rate: 15.6%
> Obesity rate: 23.3%
> Median household income: $59,290
While North Carolina is one of the least healthy states, residents of Orange County are healthier than most Americans on average. Just 16.7% of county adults get no exercise besides getting up and going to work, a smaller share than the national inactivity rate of 22.0% and the 24.0% statewide inactivity rate.
Active lifestyles are likely one reason why Orange County has the lowest rate of premature death in the state. In Orange County, 236 people die before the age of 75 per 100,000 people annually, far less than the state premature mortality rate of 363 deaths per 100,000 residents.
34. North Dakota
> Healthiest county: Stark
> Smoking rate: 16.0%
> Obesity rate: 29.6%
> Median household income: $72,099
In Stark County, North Dakota, adults report an average of only 2.4 physically unhealthy days and 2.7 mentally unhealthy days a month — each about half a day less than the comparable statewide averages. Life expectancy at birth in Stark County is 80.1 years, longer than the life expectancy of 79.3 years for North Dakota as a whole and 78.5 years nationwide.
Like many counties on this list, people in Stark County are relatively affluent. The typical county household earns $72,099 annually, more than the statewide median income of $60,557.
> Healthiest county: Delaware
> Smoking rate: 13.8%
> Obesity rate: 28.1%
> Median household income: $91,955
Life expectancy at birth in Delaware County is 81.1 years, well above the 77.4 year life expectancy statewide. Longer lives in the area are likely partially attributable to healthy behaviors. County adults are more likely to be physically active and less likely to smoke than adults across Ohio as a whole.
Favorable health outcomes are also often the result of access to exercise venues and medical care. In Delaware County, 89.4% of residents have access to places for physical activity such as parks or recreation centers, compared to only 83.2% of Ohio residents. Similarly, only 5.3% of county residents are uninsured compared to 9.9% of the state population.
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