Worst States for Lyme Disease

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9. Wisconsin
> Incidence of Lyme disease: 26.0 per 100,000 residents
> Confirmed cases: 1,504 (4th highest)
> Pct. population rural: 29.8% (19th most)
> Pct. adults physically active: 78.9% (16th highest)

Wisconsin is one of two Midwestern states to have a higher than average incidence of confirmed Lyme disease cases, along with Minnesota. The incidence of Lyme disease per 100,000 people increased from 22.7 in 2015 to 26.0 in 2016. The increase of 3.3 cases per 100,000 was one of the largest in the country.

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8. Connecticut
> Incidence of Lyme disease: 34.6 per 100,000 residents
> Confirmed cases: 1,238 (7th highest)
> Pct. population rural: 12.0% (11th least)
> Pct. adults physically active: 79.6% (13th highest)

Connecticut — the first U.S. state to have documented cases of Lyme disease — had one of the largest drops in incidence, but still surpassed all but seven other states in contraction rates. The reported cases of Lyme disease dropped from 52.2 confirmed cases per 100,000 people in 2015 to 34.6 per 100,000 the following year. That drop was second only to Massachusetts, where incidence fell by more than 40 cases per 100,000 people, knocking it off the list of the worst states for Lyme disease.

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7. New Jersey
> Incidence of Lyme disease: 37.3 per 100,000 residents
> Confirmed cases: 3,332 (2nd highest)
> Pct. population rural: 5.3% (2nd least)
> Pct. adults physically active: 76.7% (25th highest)

Some 5.3% of New Jersey residents live in rural areas, the second smallest rate of any state. Yet state residents were still among the most likely to contract Lyme disease, with 37.3 residents per 100,000 diagnosed with the disease in 2016. Still, this was a notable improvement from 2015, when 43.9 residents for every 100,000 contracted Lyme disease.

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6. Delaware
> Incidence of Lyme disease: 41.1 per 100,000 residents
> Confirmed cases: 391 (13th highest)
> Pct. population rural: 16.7% (18th least)
> Pct. adults physically active: 73.9% (10th lowest)

Delaware’s incidence of confirmed Lyme disease cases increased significantly in 2016, from 35.3 cases per 100,000 residents in 2015 to 41.1 cases per 100,000 residents — one of the sharpest increases nationwide. The increase may have been the result of Delaware’s campaign to increase public awareness of the disease. If previously some people who contracted the disease were unaware and never diagnosed, many more are now better informed of the symptoms and more likely to be correctly diagnosed.

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5. Rhode Island
> Incidence of Lyme disease: 50.6 per 100,000 residents
> Confirmed cases: 535 (11th highest)
> Pct. population rural: 9.3% (7th least)
> Pct. adults physically active: 75.9% (19th lowest)

Rhode Island is just one of a handful of states on this list in which the incidence of Lyme disease dropped from 2015 to 2016. In those years, Rhode Island’s incidence rate declined from 53.4 cases to 50.6 cases per 100,000 people. For comparison, the overall U.S. incidence of reported Lyme disease cases declined from 8.9 cases per 100,000 in 2015 to 8.1 per 100,000 in 2016.