Worst States for Lyme Disease

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14. Virginia
> Incidence of Lyme disease: 11.6 per 100,000 residents
> Confirmed cases: 976 (9th highest)
> Pct. population rural: 24.5% (22nd least)
> Pct. adults physically active: 77.7% (23rd highest)

The number of confirmed Lyme disease cases in Virginia fell from 1,102 in 2015 to 976 in 2016. Still, the state still had one of the highest incidences of Lyme disease anywhere in the country. Blacklegged ticks, the only kind that carries Lyme disease, are found in wooded and grassy areas. Even though most states have a higher percentage of their populations living in rural areas than Virginia, the state still ranks among the worst for Lyme disease.

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13. New York
> Incidence of Lyme disease: 13.3 per 100,000 residents
> Confirmed cases: 2,623 (3rd highest)
> Pct. population rural: 12.1% (12th least)
> Pct. adults physically active: 74.6% (13th lowest)

Though a low percentage of New York’s population lives in rural areas where ticks are likely to be found, the state is in the center of the blacklegged ticks’ habitat in the Northeast. New York state had over 2,600 reported cases of Lyme disease in 2016, accounting for more than 10% of all cases nationwide.

12. West Virginia
> Incidence of Lyme disease: 16.2 per 100,000 residents
> Confirmed cases: 297 (14th highest)
> Pct. population rural: 51.3% (3rd most)
> Pct. adults physically active: 70.8% (6th lowest)

More than half of West Virginia’s residents live in rural areas, where Lyme disease-carrying ticks are likely to be found. The number of confirmed Lyme disease cases in West Virginia has risen significantly in the last few years, increasing from 112 in 2014 to 243 in 2015 and to 297 in 2016.

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11. Maryland
> Incidence of Lyme disease: 21.2 per 100,000 residents
> Confirmed cases: 1,274 (6th highest)
> Pct. population rural: 12.8% (13th least)
> Pct. adults physically active: 77.8% (22nd highest)

Maryland had 1,274 confirmed cases of Lyme disease in 2016, the most in the state since 2009. Some 21.2 Maryland residents per 100,000 had a confirmed case of the disease in 2016, though just 12.8% of the population lives in a rural area where ticks are more likely to be found.

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10. Minnesota
> Incidence of Lyme disease: 23.6 per 100,000 residents
> Confirmed cases: 1,304 (5th highest)
> Pct. population rural: 26.7% (25th most)
> Pct. adults physically active: 80.2% (9th highest)

More than 80% of adults in Minnesota report getting some physical activity in their leisure time, one of the higher rates in the nation. As the Land of 10,000 Lakes, Minnesota has lots of space for outdoor activities in rural areas. It is likely that many Lyme disease cases in the state came from people spending their leisure time outdoors.