Least Healthy City in Every State

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31. Farmington, New Mexico
> Premature death rate: 444.3 per 100,000
> Adult obesity rate: 31.6%
> Adult smoking rate: 18.5%
> Median household income: $52,003

Farmington is by far the least healthy city in New Mexico. Some 18.5% of adults smoke, 23.7% do not exercise, and 31.6% are obese, each the largest share in New Mexico and higher than the statewide smoking rate of 16.6%, inactivity rate of 19.4%, and obesity rate of 24.4%. Smokers are more than 25 times as likely to get lung cancer than non-smokers, and are at a greater risk of dying prematurely. Additionally, adults who exercise seven hours a week are 40% less likely to die prematurely than those engaging in less than 30 minutes of exercise per week.

Farmington adults report an average of 4.5 mentally unhealthy days and 4.6 physically unhealthy days per month, each the most of any city in the state and among the most of any metro area nationwide. Every year, 444 in every 100,000 residents die before age 75, far greater than the state premature mortality rate of 385 deaths per 100,000 New Mexico residents and the highest of cities in the state.

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32. Elmira, New York
> Premature death rate: 368.2 per 100,000
> Adult obesity rate: 33.3%
> Adult smoking rate: 20.6%
> Median household income: $51,269

Elmira is the least healthy city in New York by a number of health metrics. Adults in Elmira report the greatest average number of physically and mentally unhealthy days per month in the state, at 4.1 and 4.2. Also, 20.6% of adults in Elmira smoke, the highest smoking rate of cities in the state. One-third of adults in this city are obese, more than any other New York metro area. All of these factors likely contribute to a higher premature death rate. For every 100,000 residents in Elmira, some 368 die before age 75, the highest premature death rate of cities in the state, and well above the statewide rate of 278 premature deaths per 100,000 residents.

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33. Rocky Mount, North Carolina
> Premature death rate: 473.6 per 100,000
> Adult obesity rate: 35.5%
> Adult smoking rate: 19.6%
> Median household income: $38,972

The typical Rocky Mount household earns just $38,972 a year, far less than the statewide median household income of $50,584 a year and the least of any metro area in the state. Some 17.8% of city residents live in poverty, far more than the 15.4% state poverty rate.

While the relationship is complicated, poorer areas tend to report worse behaviors and, ultimately, worse health outcomes. Some 28.3% of Rocky Mount adults do not exercise, and 35.5% are obese — each the second largest share of cities in the state. Every year, 474 in every 100,000 residents die before age 75, by far the highest premature mortality rate in North Carolina.

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34. Grand Forks, North Dakota
> Premature death rate: 301.8 per 100,000
> Adult obesity rate: 32.9%
> Adult smoking rate: 17.2%
> Median household income: $48,671

While Grand Forks may be regarded as the the least healthy city in North Dakota, it is healthier than a handful of U.S. cities by a considerable number of health metrics. Adults in Grand Forks report an average of 3.3 physically unhealthy days per month, the highest figure of cities in the state, but less than the national average of 3.7 days per month. Similarly, adults in Grand Forks report 3.1 mentally unhealthy days per month, more than in any other metro area in North Dakota but well below the national figure of 3.8 days per month.

Grand Forks also has one of the lower premature death rates in the nation. Some 301 residents out of every 100,000 die before age 75 in Grand Forks, compared to 336 premature deaths per 100,000 Americans nationwide.

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35. Springfield, Ohio
> Premature death rate: 507.2 per 100,000
> Adult obesity rate: 32.6%
> Adult smoking rate: 22.0%
> Median household income: $46,811

Springfield is the least healthy metro area in Ohio, and one of the least healthy cities nationwide. Every year, 507 in every 100,000 residents die before age 75, the highest premature mortality rate in the state and the eighth highest nationwide. Adults in the city report an average of 4.1 physically unhealthy days per year, the most of any city in Ohio and among the most of any U.S. metro area.

The presence of negative health behaviors in Springfield likely contributes to the city’s poor health outcomes. Some 22.0% of adults in Springfield smoke, the highest smoking rate in Ohio and the 10th highest in the nation. Smokers are more than 25 times as likely to get lung cancer than non-smokers, and are at a greater risk of dying prematurely. Additionally, 27.2% of adults report no leisure-time physical activity, far more than the 22.5% state inactivity rate. Adults who exercise seven hours a week are 40% less likely to die prematurely than those engaging in less than 30 minutes of exercise per week.