11. Kahului-Wailuku-Lahaina, Hawaii
> Premature death rate: 275.0 per 100,000
> Adult obesity rate: 22.9%
> Adult smoking rate: 13.3%
> Median household income: $72,268
The Kahului-Wailuku-Lahaina metro area is the least healthy of the two metro areas in Hawaii.
The city’s premature death rate of 275 per 100,000 residents is greater than the rate in the Honolulu metro area of 270 premature deaths per 100,000 residents, yet less than the national rate of 336 per 100,000 Americans. Various health behaviors may contribute to the slight health disparities between the two metro areas. In Kahului, 13.3% of adults smoke, more than Honolulu’s smoking rate of 11.2%.
Differences in wealth may also partially explain the health disparities. The typical household in Kahului earns $72,268 a year, less than $80,513, the median household income in Honolulu yet far more than $57,617, the national median income.
12. Pocatello, Idaho
> Premature death rate: 390.7 per 100,000
> Adult obesity rate: 27.8%
> Adult smoking rate: 15.9%
> Median household income: $48,429
The least healthy city in a relatively healthy state, Pocatello is the only metro area in Idaho with worse health outcomes than the U.S. as a whole. Some 391 in every 100,000 Pocatello residents die before age 75 every year, far more than the statewide premature death rate of 307 per 100,000. Some 16.9% of adults in the metro area report being in fair or poor health, the largest share of cities in the state.
While Pocatello has the worst health outcomes in Idaho, behaviors in the metro area are comparatively healthy. Just 18.7% of adults in the city do not exercise, less than the state inactivity rate of 20.2% and the second smallest share of any city in Idaho. Just 27.8% of adults in the city are obese, the second smallest share of any Idaho metro area and less than the state obesity rate of 28.6%.
13. Danville, Illinois
> Premature death rate: 494.6 per 100,000
> Adult obesity rate: 34.2%
> Adult smoking rate: 18.0%
> Median household income: $45,481
Just 71.8% of the Danville metro area population has adequate access to opportunities for physical activity, the smallest share in Illinois. Inadequate access to exercise facilities may partially contribute to the city’s high inactivity rate. Some 28.1% of Danville adults do not exercise, and 34.2% are obese, each the largest share of any city in Illinois.
Lack of healthy behaviors among Danville adults likely contributes to the poor health outcomes in the area. While 17.2% of adults throughout Illinois report being in fair or poor health, 18.9% of adults in Danville do — the largest share of any city in the state. Every year, 495 in every 100,000 residents in the metro area die before age 75, the highest premature death rate in Illinois and far above the state rate of 324 premature deaths per 100,000 residents.
14. Terre Haute, Indiana
> Premature death rate: 461.9 per 100,000
> Adult obesity rate: 32.4%
> Adult smoking rate: 21.2%
> Median household income: $46,951
Terre Haute is a metro area of approximately 170,000 residents located about 70 miles west of Indianapolis. The typical household earns $46,951 a year, less than the median household income of $52,314 for Indianapolis as a whole and the fourth least of any city in the state. Some 15.5% of residents live in poverty, more than the state and national poverty rates of 14.1% and 14.0%, respectively.
People earning higher incomes have greater access to health care, can afford healthier food, may have more time to exercise, and have better health outcomes overall. In Terre Haute, 29.1% of adults do not exercise and 21.2% smoke, respectively the largest and third largest such shares in Indiana. For every 100,000 residents in Terre Haute, 462 die before age 75, far more than the premature death rate of 392 per 100,000 residents for Indiana as a whole and the second highest of any city in the state.
15. Davenport-Moline-Rock Island, Iowa
> Premature death rate: 330.2 per 100,000
> Adult obesity rate: 31.9%
> Adult smoking rate: 16.3%
> Median household income: $52,590
The poorest and least healthy city in Iowa, the Davenport-Moline-Rock Island metro area is a city of approximately 383,000 residents located on the Iowa-Illinois border. The typical household in Davenport earns $52,590 a year, less than the median household income of $56,247 for Iowa as a whole and the lowest of any city in the state. Some 14.5% of residents live in poverty, far higher than the state poverty rate of 11.8%.
While the relationship is complicated, poorer areas tend to have worse health outcomes. Adults in Davenport report an average of 3.5 mentally unhealthy days and 3.4 physically unhealthy days a month, each the most of any city in Iowa. For every 100,000 residents in Davenport, 330 die before age 75, a higher premature death rate than Iowa’s as a whole of 313 per 100,000 residents and the second most of any metro area in the state.