The Least Healthy County in Every State
31. New Mexico: McKinley County
> Uninsured rate: 24.0% (county) 9.1% (state)
> Adults in fair or poor health: 26.2% (county) 20.8% (state)
> Obesity rate: 35.1% (county) 24.4% (state)
> Smoking rate: 21.8% (county) 16.6% (state)
Personal health is often closely tied to income, and McKinley County is both the poorest and least healthy county in New Mexico. More than one in every three county residents live below the poverty line, compared with less than one in every five people across the state as a whole.
Stress associated with poverty can take a toll on personal health, and lower-income Americans can afford less health care and fewer healthy options related to diet and lifestyle. Partially as a result, more than a third of county adults are obese compared with less than a quarter of adults in the state. Additionally, 26.2% of adults in the county report being not in good health compared with 20.8% of adults across the state.
32. New York: Bronx County
> Uninsured rate: 11.1% (county) 5.7% (state)
> Adults in fair or poor health: 26.8% (county) 16.1% (state)
> Obesity rate: 30.0% (county) 25.0% (state)
> Smoking rate: 16.2% (county) 14.2% (state)
Bronx County has the highest share of adults who report being in poor or fair health, at almost 27%. The second highest share, in Sullivan County, is a much lower 19%, and the national and state shares are 16%.
Of all 62 counties in New York state, Bronx is also the county with adults reporting the highest average number of physically unhealthy days. One in three adults do not exercise, significantly higher than the state’s inactivity rate of one in four.
33. North Carolina: Robeson County
> Uninsured rate: 16.0% (county) 10.7% (state)
> Adults in fair or poor health: 29.5% (county) 17.6% (state)
> Obesity rate: 38.6% (county) 29.6% (state)
> Smoking rate: 27.2% (county) 17.9% (state)
About one in every three adults in Robeson County, North Carolina get no exercise beyond getting up and going to work, the highest physical inactivity rate of any county in the state. Regular exercise can help maintain a healthy body weight, and the prevalence of sedentary lifestyles may explain Robeson County’s 38.6% obesity rate — nearly the highest in North Carolina.
34. North Dakota: Sioux County
> Uninsured rate: 30.3% (county) 7.5% (state)
> Adults in fair or poor health: 32.1% (county) 14.3% (state)
> Obesity rate: 34.9% (county) 31.8% (state)
> Smoking rate: 38.3% (county) 19.8% (state)
Sioux County is located in the northernmost portion of the Standing Rock Reservation. The county’s population idenitifies primarily as Native American. Sioux County is not only the least healthy county in North Dakota, but also one of the least healthy nationwide. The county’s 38% adult smoking rate is the fourth highest in the United States, more than double the national smoking rate. Sioux’s annual premature mortality rate of 1,142 deaths before age 75 per 100,000 people is the worst in the country.
One in three county residents do not have health insurance, the highest uninsured rate of any county in North Dakota. The state’s uninsured rate is about 8%.
35. Ohio: Adams County
> Uninsured rate: 10.1% (county) 6.0% (state)
> Adults in fair or poor health: 22.8% (county) 17.0% (state)
> Obesity rate: 31.5% (county) 31.6% (state)
> Smoking rate: 25.3% (county) 22.5% (state)
Adams is the only county in Ohio where more than one in every four adults smoke. The life expectancy of smokers is about 10 years below that of non-smokers, and of the 88 counties in Ohio, Adams County has the fifth highest premature mortality rate.
The increased likelihood of death before age 75 in Adams County is also likely attributable to the high uninsured rate. Americans with health insurance are more likely to receive preventative medical care, but 10.1% of county residents are uninsured, well above the 6.0% state uninsured rate.