Special Report

The Least Healthy County in Every State

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16. Kansas: Labette County
> Uninsured rate: 10.3% (county) 8.7% (state)
> Adults in fair or poor health: 17.2% (county) 15.0% (state)
> Obesity rate: 36.1% (county) 32.4% (state)
> Smoking rate: 20.9% (county) 17.2% (state)

While a slightly smaller share of adults in Labette Country drinks excessively compared with the excessive drinking rate statewide, a significantly higher percentage does not engage in leisure-time physical activity. More than a third of adults do not exercise, compared with a state inactivity rate of 25%.

Adult residents of the county are also more likely to smoke on a regular basis, be obese, and

report being in poor or fair health compared with Kansas as a whole.

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17. Kentucky: Leslie County
> Uninsured rate: 9.3% (county) 5.4% (state)
> Adults in fair or poor health: 26.3% (county) 21.3% (state)
> Obesity rate: 43.3% (county) 33.7% (state)
> Smoking rate: 26.3% (county) 24.5% (state)

Leslie County, Kentucky, is the least healthy county in the state and one of the least healthy in the country. The county’s adult obesity rate of 43.3% is the highest of the 120 counties in the state and the 15th highest of the more than 3,000 counties nationwide.

Engaging in regular physical activity can help maintain a healthy weight, but in Leslie County, sedentary lifestyles are relatively common. An estimated 37.4% of adults in the county get no exercise beyond getting up and going to work, well above the 28.1% of inactive adults statewide and 23.0% nationwide.

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18. Louisiana: East Carroll Parish
> Uninsured rate: 14.3% (parish) 8.4% (state)
> Adults in fair or poor health: 38.2% (parish) 21.1% (state)
> Obesity rate: 38.4% (parish) 34.7% (state)
> Smoking rate: 32.0% (parish) 22.8% (state)

East Carroll is not only the least healthy county in Louisiana, but also among the least healthy nationwide. Behaviors that may lead to unhealthy outcomes are very common among county residents. For example, one in three adult residents smoke regularly, the 13th highest smoking rate in the United States. Also, nearly 40% of adults are obese, compared with a 35% obesity rate statewide and 28% nationwide.

The average number of both mentally and physically unhealthy days a month people in East Carroll report having is among the highest in the country. More than 38% say they are in poor or fair health, the third highest share in the United States.

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19. Maine: Washington County
> Uninsured rate: 12.6% (county) 8.1% (state)
> Adults in fair or poor health: 14.7% (county) 15.4% (state)
> Obesity rate: 29.7% (county) 29.0% (state)
> Smoking rate: 18.4% (county) 19.8% (state)

Washington County is a coastal county in the easternmost corner of Maine. Nearly 28% of adult county residents get no exercise beyond getting up and going to work, well above Maine’s 21.4% physical inactivity rate. Sedentary lifestyles may be attributable to limited opportunities. Just 46.7% of county residents have access to places for physical activity, such as parks and recreation centers, compared with 72.8% of state residents.

Regular exercise can promote better physical and mental health, and adults in Washington County report being in poor mental health more frequently than adults across Maine as a whole, and they are also slightly more likely to be obese.

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20. Maryland: Baltimore City
> Uninsured rate: 8.0% (city) 6.1% (state)
> Adults in fair or poor health: 18.9% (city) 13.9% (state)
> Obesity rate: 33.6% (city) 29.2% (state)
> Smoking rate: 20.2% (city) 13.7% (state)

Baltimore City is an independent city that is considered a county equivalent. Baltimore ranks slightly worse that the 24 counties in Maryland. Almost 34% of adults are obese compared with 29% statewide, and 18% drink excessively compared with 17% in the state as a whole. The differences are more significant in other measures such as not exercising and smoking. About 26% of adults do not exercise, and 20% smoke, compared with 22% and 14% statewide, respectively.

What sets Baltimore apart from most other counties is the poverty rate. At 22.4%, it is the second highest poverty rate in the state after Somerset’s rate of 22.5%. In comparison, the third highest poverty rate is 16.8%. Poverty and chronic diseases are interconnected. The premature mortality rate in Baltimore is 610 deaths before age 75 per 100,000 residents annually, nearly twice the rate for Maryland as a whole.

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