Special Report

States With the Most Heart Disease

Detailed Findings

States with higher rates of cardiovascular disease also generally have the highest rates of premature mortality. Nine of the 10 states where heart disease is most common among adults are also among the 10 states with the highest overall premature mortality rates.

Cardiovascular disease can be caused by genetic disposition and other factors outside of the control of the individual, but a number of factors increase the risk of developing a related disease, and the behaviors that lead to obesity, which include poor diet and a lack of exercise, are among the greatest of these. Nationwide, 30% of adults are obese, but in the majority of the 10 states with the highest heart disease rates, obesity rates exceed 35%. In West Virginia, which has the highest cardiovascular disease rate, 37.7% of adults are obese, the highest share of any state.

Smoking is also known to be a major cause of heart disease, and like obesity rates, smoking rates are similarly high in states with high rates of cardiovascular illness. Only one of the 10 states with the highest rates of heart disease is not among the 10 states with the highest adult smoking rate. Almost 25% of West Virginia’s adult population smokes, the highest share in the country and well above the 17% national smoking rate.

Many of the conditions associated with heart disease, Including smoking and obesity, have been shown to be correlated to living in or near poverty. These include high stress, a lack of access to medical care, a lack of access to places for physical activity, and more. In the 10 states with the highest rates of heart disease, the median household income is between $6,000 and $16,000 below the median household income of $60,336 a year.


To determine the states with the most heart disease, 24/7 Wall St. reviewed the share of residents 18 or older who had a major cardiovascular disease as of 2015 from the U.S. Centers for Disease Control’s Behavioral Risk Factor Surveillance System. Also from the CDC BRFSS, we reviewed the share of adults who reported healthy weight, meaning a BMI of less than 25, and the share of adults who reported being in fair or poor health, both for 2015. The state median household income came from the U.S. Census Bureau’s 2017 1-year American Community Survey.

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