Least Healthy City in Every State
16. Wichita, Kansas
> Premature death rate: 388.7 per 100,000
> Adult obesity rate: 33.5%
> Adult smoking rate: 18.5%
> Median household income: $53,663
The typical household in the Wichita metro area earns $53,663 a year, less than the median household income of $54,935 for Kansas as a whole. Additionally, 14.0% of city residents live in poverty, above the 12.1% state poverty rate.
The income disparity between Wichita and Kansas may partially account for the health disparities between the city and the state. Some 24.9% of adults in Wichita do not exercise, and 33.5% are obese, each the second largest share of any Kansas metro. Wichita also has the highest smoking rate of cities in the state, with 18.5% of adults reporting a smoking habit. Smokers are more than 25 times as likely to get lung cancer than non-smokers, and are at a greater risk of dying prematurely. Every year, 389 in every 100,000 residents die before age 75, far above the state premature death rate of 346 per 100,000 residents.
17. Bowling Green, Kentucky
> Premature death rate: 428.4 per 100,000
> Adult obesity rate: 32.7%
> Adult smoking rate: 20.2%
> Median household income: $45,649
Rural areas face unique health problems and are often less healthy than urban areas. While the Bowling Green metro area is the least healthy city in Kentucky, residents are better off than the majority of residents of the relatively rural state according to a number of health metrics. While the city’s premature death rate of 428 deaths per 100,000 residents is the highest of any metro area in Kentucky, it is still lower than the state rate of 467 premature deaths per 100,000 residents. Additionally, while the city’s 32.7% obesity rate is the second highest of any Kentucky metro area, it is still below the 33.7% state obesity rate.
18. Monroe, Louisiana
> Premature death rate: 472.2 per 100,000
> Adult obesity rate: 34.9%
> Adult smoking rate: 22.5%
> Median household income: $38,004
Monroe is the least healthy city in one of the least healthy states. Adults report an average of 4.4 mentally unhealthy days and 4.2 physically unhealthy days per month, each the most of any city in the state. Some 20.3% of Monroe adults report fair or poor health, the second largest share in Louisiana.
A number of environmental and socioeconomic factors may contribute to the negative health outcomes in Monroe. The typical household in Monroe earns just $38,004 a year, the lowest median household income in Louisiana and the seventh lowest nationwide. Poorer areas tend have less access to exercise opportunities like parks and gyms, and just 68.8% of Monroe residents have access to locations for physical activity — the smallest share of cities in the state. Violent crime can also induce physical and mental stress, discourage physical activity, and contribute to worse health outcomes overall. In 2016, there were 1,187 violent crimes reported per 100,000 residents in Monroe, the highest violent crime rate nationwide.
19. Lewiston-Auburn, Maine
> Premature death rate: 356.6 per 100,000
> Adult obesity rate: 33.9%
> Adult smoking rate: 18.8%
> Median household income: $49,081
The Lewiston-Auburn metro area is the least healthy of the three metro areas in Maine. Some 23.9% of adults in the city do not exercise, and 33.9% of adults are obese, each the largest share in Maine and above the national inactivity rate of 23.0% and obesity rate of 28.0%. . Metro area adults report an average of 4.3 mentally unhealthy days per month, the most of the three cities in Maine. Every year, 356 in every 100,000 Lewiston residents die before age 75, far more than the state premature death rate of 328 deaths per 100,000 Maine residents.
Poorer areas tend to report worse health outcomes, and Lewiston is far less wealthy than Maine as a whole. The typical household in Lewiston earns $49,081 a year, less than the state median household income of $53,079 a year.
20. Cumberland, Maryland
> Premature death rate: 418.0 per 100,000
> Adult obesity rate: 35.2%
> Adult smoking rate: 17.4%
> Median household income: $45,808
Maryland has some of the highest income inequality in the country, which contributes to large health disparities throughout the state. The typical household in the Cumberland metro area earns $45,808 a year, nearly $33,000 less than the median household income in the California-Lexington Park metro area, the wealthiest city in Maryland. Additionally, 16.1% of residents live in poverty, the highest poverty rate in Maryland and far above the 9.7% state rate.
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 Cumberland, 27.1% of adults do not exercise and 35.2% of adults are obese, each the largest such share of any city in Maryland. Every year, 418 in every 100,000 residents die before age 75, far above the state premature death rate of 326 per 100,000 residents and the most of any city in Maryland.