Special Report

The Least Healthy County in Every State

Source: JERRYE AND ROY KLOTZ MD / Wikimedia Commons

6. Colorado
> Least healthy county: Costilla
> Population without health insurance 15.8%
> Population with limited access to healthy food 6.1%
> Obesity rate: 22.1%

Adults in Costilla County, Colorado, report an average of 4.8 physically unhealthy days and 4.4 mentally unhealthy days per month. Statewide, adults report an average of 3.4 physically unhealthy days and 3.6 mentally unhealthy days a month. Poor health outcomes are often the result of unhealthy behavior, and adults in Costilla County are more likely to smoke and less likely to lead active lives than adults both state and nationwide.

Financially insecure Americans can afford fewer healthy options related to diet and lifestyle, and as a result, poorer Americans are often less healthy than those with greater financial resources. With an annual median household income of $26,610, Costilla County is the poorest in Colorado.

Source: JJBers / Flickr

7. Connecticut
> Least healthy county: Windham
> Population without health insurance 6.0%
> Population with limited access to healthy food 11.6%
> Obesity rate: 29.2%

Connecticut is a relatively healthy state, and even in Windham County, the least healthy county in the state, residents typically report better health outcomes and behaviors than most Americans. For example, the county’s 16.4% adult smoking rate of is higher than the state’s rate of 13.4% but lower than the national rate of 17.0%. Additionally, Windham County residents are more likely to receive regular and preventative medical care as just 6.0% of the population lacks health insurance, compared to 11.0% of the U.S. population.

Still, Windham County’s 29.2% obesity rate is higher than the U.S. obesity rate of 28.0% and the highest of any county in Connecticut.

Source: JERRYE & ROY KLOTZ MD / Wikimedia Commons

8. Delaware
> Least healthy county: Kent
> Population without health insurance 6.9%
> Population with limited access to healthy food 13.3%
> Obesity rate: 33.6%

Kent County is the least healthy of the three counties in Delaware. Over one-third of county adults are obese, the largest share in the state and well above the 28% nationwide obesity rate. Regular exercise is one way to reduce the risk of obesity, and in Kent County, 30.3% of adults are never physically active in their free time, the largest share in the state and well above the 26.1% inactivity rate across Delaware as a whole. The county’s high inactivity rate may be partially attributable to a lack of access. Just 62.0% of the county’s population has access to places for physical activity like parks or gyms compared to 86.3% of Delaware residents.

Source: Excel23 / Wikimedia Commons

9. Florida
> Least healthy county: Putnam
> Population without health insurance 17.2%
> Population with limited access to healthy food 20.4%
> Obesity rate: 37.9%

Smoking is the leading cause of preventable death in the United States, and in Putnam County, Florida, one in every four adults are smokers. In comparison, just 17.0% of American adults and 15.5% of Florida adults smoke. The high smoking rate likely partially explains the greater incidence of premature death in the county. There are 524 deaths before age 75 for every 100,000 people in the county, far more than the premature death rate across Florida as a whole of 332 per 100,000.

Unhealthy areas are often also poor, and Putnam County is no exception. Some 27.0% of the county population lives below the poverty line, compared to the respective 16.1% and 15.1% state and national poverty rates.

Source: Robbie Honerkamp / Wikimedia Commons

10. Georgia
> Least healthy county: Clay
> Population without health insurance 17.2%
> Population with limited access to healthy food 29.3%
> Obesity rate: 30.7%

Nearly 40% of Clay County, Georgia, residents live in poverty, well more than double the state and national poverty rates of 17.8% and 15.1%, respectively. Low-income Americans have fewer options relating to healthy diets and lifestyle, and as a result, are often more likely to report poor health outcomes. In Clay County, adults are more likely to be obese than the typical adult in Georgia. They also spend more time on average than adults statewide in poor physical or mental health.

A large share of Clay County adults also report some bad habits. For example, more than one in four adult residents are smokers, compared to 17.9% of adults in the state and 17.0% of adults nationwide.