Special Report

The Least Healthy County in Every State

Source: Omnedon / Wikimedia Commons

36. Oklahoma: Adair County
> Uninsured rate: 26.9% (county) 14.2% (state)
> Adults in fair or poor health: 27.9% (county) 19.6% (state)
> Obesity rate: 41.9% (county) 33.2% (state)
> Smoking rate: 26.5% (county) 19.6% (state)

Of all 77 counties in Oklahoma, Adair’s near 27% share of uninsured residents is the highest and is nearly double the state’s rate. Nationwide, the county ranks among the least healthy for the average number of mentally and physically unhealthy days every month, at fourth worst and 11th worst, respectively.

Adair County residents have some of the worst health behaviors and health outcomes in the country, too. Almost 27% of adult residents regularly smoke, compared with a nationwide smoking rate of 17%. In addition, almost 42% of adults are obese, far more than the corresponding state and national rates of 28% and 33%.

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Source: icetsarina / Flickr

37. Oregon: Jefferson County
> Uninsured rate: 13.1% (county) 6.8% (state)
> Adults in fair or poor health: 19.1% (county) 15.8% (state)
> Obesity rate: 35.2% (county) 27.2% (state)
> Smoking rate: 18.6% (county) 16.2% (state)

An estimated 35.2% of adults in Jefferson County, Oregon, are obese, well above the 27.2% statewide obesity rate. Low-income Americans tend to have less access to health care and cannot afford a wide range of healthy food options. The high obesity rate in Jefferson County may be attributable to poor diets among financially insecure county residents. Nearly 21% of Jefferson County residents live below the poverty line, the second highest poverty rate of any county in the state.

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Source: JERRYE & ROY KLOTZ, M.D. / Wikimedia Commons

38. Pennsylvania: Philadelphia County
> Uninsured rate: 10.6% (county) 5.5% (state)
> Adults in fair or poor health: 20.2% (county) 15.1% (state)
> Obesity rate: 29.4% (county) 29.6% (state)
> Smoking rate: 19.7% (county) 18.0% (state)

Philadelphia County, which contains the entire city of Philadelphia, has the highest poverty rate of all 67 counties in Pennsylvania. Nearly 26% of residents live below the poverty line, compared with the state’s poverty rate of 12.5%. (For reference, the second highest poverty rate is 19%, in Fayette.)

Although nearly all residents have access to places for physical activity (one of the highest rates in the country as a whole), 26% of local adults do not exercise, a larger share than the state inactivity rate of 24%.

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39. Rhode Island: Providence County
> Uninsured rate: 8.1% (county) 4.6% (state)
> Adults in fair or poor health: 16.5% (county) 14.8% (state)
> Obesity rate: 28.1% (county) 27.2% (state)
> Smoking rate: 15.4% (county) 14.4% (state)

Rhode Island’s population is relatively healthy compared to the nation as a whole. Even in Providence, the least healthy county in the state, the population is healthier than the broader U.S. population by several measures. For example, while Providence County’s 17.8% excessive drinking rate is higher than the 17.4% state rate, it is slightly below the 18.0% national rate. Similarly, the county’s 15.4% smoking rate is above the 14.4% state rate but below the 17.0% national rate.

Greater educational attainment is linked with healthier lifestyles, and though Providence County’s 27.8% bachelor’s degree attainment rate is by far the lowest of any county in the state, it is only slightly below the 30.9% national rate.

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Source: gerrydincher / Flickr

40. South Carolina: Marlboro County
> Uninsured rate: 12.3% (county) 11.0% (state)
> Adults in fair or poor health: 24.7% (county) 19.1% (state)
> Obesity rate: 36.6% (county) 32.0% (state)
> Smoking rate: 22.0% (county) 20.0% (state)

Prevalent unhealthy behavior may be partially responsible for poor health outcomes in Marlboro County. County adults are far more likely to not exercise and slightly more likely to smoke than adults in South Carolina as a whole. Such unhealthy habits can have harmful health consequences. The county’s annual premature mortality rate of 658 deaths before age 75 per 100,000 people is the highest of any county in the state and among the highest nationwide.

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