Special Report

The Least Healthy County in Every State

Source: Jimmy Emerson, DVM / Flickr

41. South Dakota: Oglala Lakota County
> Uninsured rate: 34.4% (county) 9.1% (state)
> Adults in fair or poor health: 33.4% (county) 11.8% (state)
> Obesity rate: 41.2% (county) 30.6% (state)
> Smoking rate: 41.2% (county) 18.1% (state)

Oglala Lakota is one of only two counties nationwide where the majority of residents live below the poverty line. Stress associated with poverty can take a toll on personal health, and about one in every three adults in Oglala Lakota County report being in suboptimal health, nearly triple the 11.8% share of adults across the state reporting suboptimal health.

Low-income Americans tend to have less access to health care and often cannot afford a wide range of healthy food options, and this appears to be taking a toll in Oglala Lakota County. An estimated 41.2% of adults in the county are obese, well above the obesity rates of 30.6% statewide and 28.0% nationwide.

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Source: Thomas R Machnitzki (thomasmachnitzki.com) / Wikimedia Commons

42. Tennessee: Lake County
> Uninsured rate: 11.4% (county) 9.5% (state)
> Adults in fair or poor health: 26.1% (county) 19.1% (state)
> Obesity rate: 34.9% (county) 32.4% (state)
> Smoking rate: 26.6% (county) 22.1% (state)

About 30% of Lake County residents live below the poverty line, double the state’s poverty rate, and more than in any of the 95 Tennessee counties. Having limited means can tie people into a cycle not being able to afford health care, nutritious foods, and healthy lifestyles in general. This can, over time, undermine overall health. More than one in four adults in the county report being in poor or fair health, the second largest share in the state. Nationwide, 16.0% of adults report being in suboptimal health, and statewide 19.1% of adults do.

In addition, about 35% of adults in Lake County are obese, slightly more than the comparable shares statewide.

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Source: 25or6to4 / Wikimedia Commons

43. Texas: Brooks County
> Uninsured rate: 20.1% (county) 17.3% (state)
> Adults in fair or poor health: 37.8% (county) 18.2% (state)
> Obesity rate: 28.1% (county) 28.4% (state)
> Smoking rate: 18.8% (county) 14.3% (state)

As is often the case among counties on this list, Brooks County, Texas, is poor. Nearly 42% of the population of the southern Texas county lives below the poverty line, by far the highest poverty rate in the state. Stress associated with poverty can be detrimental to overall health, and in Brooks County, 37.8% of adults report being not in good health, more than double the 18.2% share of adults statewide who report being in suboptimal health. Brooks County adults are also more likely to smoke and less likely to exercise than the typical adult in Texas.

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Source: Alexander Svendsen / Flickr

44. Utah: San Juan County
> Uninsured rate: 22.4% (county) 9.2% (state)
> Adults in fair or poor health: 20.9% (county) 12.1% (state)
> Obesity rate: 30.6% (county) 25.3% (state)
> Smoking rate: 15.1% (county) 8.8% (state)

Located in southeastern Utah, San Juan County is the least healthy county in the state. Only about half of county residents have access to recreation centers, parks, and other venues for physical exercise, significantly less than the 87.7% of Utah residents. Also, nearly 31% of adults in the county are obese, the fourth highest share of all 29 counties in the state.

In addition, the San Juan’s adult residents report the highest average number of both mentally and physically unhealthy days in a month, both significantly higher than the state’s average and the county with the second highest number.

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Source: mar_ibert / Flickr

45. Vermont: Essex County
> Uninsured rate: 6.9% (county) 4.6% (state)
> Adults in fair or poor health: 16.3% (county) 12.5% (state)
> Obesity rate: 28.8% (county) 24.7% (state)
> Smoking rate: 16.6% (county) 17.0% (state)

Vermont is a relatively healthy state compared to the U.S. as a whole. Even in Essex County, the least healthy county in the state, residents are only slightly more likely to be unhealthy than the typical American. For example, 25.2% of county adults lead completely sedentary lives — well above the 19.5% state physical inactivity rate but only slightly higher than the 23.0% national rate. Similarly, 16.3% of county adults report being in fair or poor health, a far larger share than the 12.5% of adults across Vermont but closely aligned with the 16.0% national share.

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