Worst States for Lyme Disease

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4. New Hampshire
> Incidence of Lyme disease: 51.8 per 100,000 residents
> Confirmed cases: 691 (10th highest)
> Pct. population rural: 39.7% (11th most)
> Pct. adults physically active: 79.4% (14th highest)

No state had a greater increase in the incidence of Lyme disease than New Hampshire. There were 51.8 reported cases per 100,000 residents in 2016, 19.0 more cases per 100,000 residents than the year before. The total number of Lyme disease cases increased from 436 to 691 in that timeframe, a more than 50% increase.

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3. Pennsylvania
> Incidence of Lyme disease: 70.3 per 100,000 residents
> Confirmed cases: 8,988 (the highest)
> Pct. population rural: 21.3% (20th least)
> Pct. adults physically active: 76.0% (21st lowest)

Pennsylvania had 8,988 confirmed cases of Lyme disease in 2016, by far the highest total of any state. That figure is higher than the next four highest states combined. Pennsylvania accounts for more than one-third of total confirmed Lyme disease cases in the United States. However, due to Pennsylvania’s relatively high population, it ranks behind two other states in incidence rate of the disease, at 70.3 per 100,000 residents in 2016.

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2. Vermont
> Incidence of Lyme disease: 78.1 per 100,000 residents
> Confirmed cases: 488 (12th highest)
> Pct. population rural: 61.1% (2nd most)
> Pct. adults physically active: 80.5% (8th highest)

Vermont has a large rural population, and is known for its outdoor activities, such as hiking, camping, and backpacking. This, and the fact that the state is in the midst of the blacklegged ticks’ habitat, means state residents are among the most likely in the country to contact Lyme disease.

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1. Maine
> Incidence of Lyme disease: 86.4 per 100,000 residents
> Confirmed cases: 1,151 (8th highest)
> Pct. population rural: 61.3% (the most)
> Pct. adults physically active: 78.6% (17th highest)

Maine’s incidence of confirmed Lyme disease cases of 86.4 per 100,000 residents in 2016 was by far the highest of any state. It was also more than 10 times higher than the national incidence rate of 8.1 cases per 100,000 residents. As the state with the greatest share of rural residents, many people in Maine are likely to be close to grassy and wooded areas where disease-carrying blacklegged ticks tend to live.