Least Healthy City in Every State

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Source: Beatmastermatt / Wikimedia Commons

41. Rapid City, South Dakota
> Premature death rate: 302.1 per 100,000
> Adult obesity rate: 27.2%
> Adult smoking rate: 15.5%
> Median household income: $51,097

Rapid City is one of two metro areas in South Dakota and, for a number of reasons, it is the least healthy of the two. Still, Rapid City is actually healthier than several U.S. cities. For example, adults in Rapid City are less likely to be obese, smoke, and are more likely to be physically active than the typical American. Adults in the city also report some of the lowest physically and mentally unhealthy days per month of U.S. cities. Only 12.6% of adults report they are in fair or poor health, well below the 16.0% of adults that report the same nationwide.

The premature death rate is usually a strong indicator of health of a community, and in Rapid City, the premature death rate falls considerably below the national rate. For every 100,000 residents, 302 die before age 75, which is less than the national rate of 336 premature deaths for every 100,000.

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42. Memphis, Tennessee
> Premature death rate: 460.0 per 100,000
> Adult obesity rate: 33.1%
> Adult smoking rate: 20.3%
> Median household income: $49,809

Violent crime and poverty can induce mental and physical stress, discourage physical activity, and contribute to worse health outcomes overall. There were 1,082 violent crimes reported per 100,000 residents in the Memphis metro area in 2016, the highest violent crime rate in Tennessee and the third highest of any U.S. city. Additionally, some 30.1% of children in the city live in poverty, the highest child poverty rate of cities in the state and far higher than the national rate of 20.0%.

Memphis reports some of the worst health outcomes nationwide. Some 11.0% of babies are born with low birthweight, the largest share of cities in Tennessee and the 11th largest share of cities nationwide. Every year, 460 in every 100,000 residents die before age 75, the third highest premature death rate of cities in Tennessee and far above the national rate of 336 premature deaths per 100,000 Americans.

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43. Texarkana, Texas
> Premature death rate: 489.9 per 100,000
> Adult obesity rate: 34.9%
> Adult smoking rate: 19.3%
> Median household income: $42,513

There are 25 metro areas in Texas, and Texarkana is the least healthy for a variety of reasons. Of area adults, 34.9% are obese and 19.3% smoke, both the largest shares of cities in the state. Only 50.6% of adults have access to a recreational facility or park, the lowest share in the state. This likely plays a role in the 34.6% of adults who are physically inactive, which is the largest share of cities in the state and the third largest share of U.S. cities. Overall, Texarkana has one of the highest premature death rates in the nation. For every 100,000 residents, 490 die before age 75, the highest rate in the state and the 17th highest nationwide.

Source: Thinkstock

44. Salt Lake City, Utah
> Premature death rate: 310.5 per 100,000
> Adult obesity rate: 25.3%
> Adult smoking rate: 9.5%
> Median household income: $68,196

While Salt Lake City is the least healthy metro area in Utah, residents are better off than the average American by a number of health metrics. While the smoking rate of 9.5% is the highest of any metro area in the state, it is still far less than the national smoking rate of 17.0%. Similarly, 7.5% of babies in Salt Lake City are born with low birthweight, the largest share in the state yet less than the 8.0% national figure.

Some 12.2% of adults report fair or poor health, the largest share in Utah and less than the 16.0% national share. Every year, 311 in every 100,000 residents die before age 75, the highest premature death rate of cities in Utah but still below the national rate of 336 premature deaths per 100,000 Americans.

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45. Burlington-South Burlington, Vermont
> Premature death rate: 275.6 per 100,000
> Adult obesity rate: 21.7%
> Adult smoking rate: 13.0%
> Median household income: $66,367

Burlington-South Burlington is the only metro area in Vermont, which makes it the least healthy city by default. City residents, however, are better off than state residents as a whole in a number of health metrics. Just 10.5% of residents report fair or poor health, less than the 12.5% state figure and the fifth smallest share of any metro area nationwide. Similarly, just 17.5% of adults report no leisure-time physical activity, and only 21.7% are obese — far lower than the state and national inactivity and obesity rates. Every year, 276 in every 100,000 residents die before age 75, less than the state premature mortality rate of 291 per 100,000 Vermont residents and the national rate of 336 per 100,000 Americans.