11. Hawaii: Kahului-Wailuku-Lahaina
> Premature death rate (per 100,000): 266.7 (state: 278.6)
> Adult obesity rate: 23.2% (state: 23.1%)
> Adult smoking rate: 13.3% (state: 13.1%)
> Median household income: $80,183 (state: $77,765)
Of the two metro areas in Hawaii — Kahului-Wailuku-Lahaina and Honolulu — Kahului-Wailuku-Lahaina ranks as the least healthy. Residents of the Kahului metro area are slightly more likely to smoke and be obese than the average Hawaiian.
Still, the city is relatively healthy by some measures of self-reported health status. For example, adults in the area report an average of 3.1 physically unhealthy days per month, lower than the average of 3.4 days across Hawaii. Similarly, only 12.8% of adults in the metro area report to be in fair or poor health, below the 14.0% share across the state.
12. Idaho: Pocatello
> Premature death rate (per 100,000): 386.3 (state: 307.4)
> Adult obesity rate: 30.8% (state: 28.3%)
> Adult smoking rate: 15.9% (state: 14.5%)
> Median household income: $51,612 (state: $52,225)
Adults in Pocatello are more likely to smoke and more likely to be obese than those across Idaho as a whole. Both smoking and obesity are risk factors for a number of potentially deadly diseases and conditions, and in Pocatello, the premature death rate of 386 deaths before age 75 is well above the state rate of 307 deaths per 100,000 people.
Self-reported health outcomes are also poor in Pocatello. Of the five metro areas in the state, Pocatello is the only one where adults report an average more than four physically unhealthy days per month.
13. Illinois: Danville
> Premature death rate (per 100,000): 496.7 (state: 326.4)
> Adult obesity rate: 35.3% (state: 28.7%)
> Adult smoking rate: 18.0% (state: 15.8%)
> Median household income: $42,345 (state: $62,992)
Danville is the least healthy metro area in Illinois and among the least healthy in the entire country. Some 18.0% of metro area adults smoke, compared to 15.8% of adults across the state and 17.0% of adults nationwide. Smoking is the leading cause of preventable death in the United States, and in Danville, the premature death rate of 497 deaths before age 75 annually for every 100,000 people is nearly double the state rate of 326 per 100,000.
Living in poverty can greatly reduce a person’s ability to make healthy lifestyle choices, and as a result, poorer Americans often report worse health outcomes. In Danville, 19.9% of residents live below the poverty line, compared to 12.6% of the Illinois population.
14. Indiana: Kokomo
> Premature death rate (per 100,000): 507.8 (state: 398.3)
> Adult obesity rate: 32.9% (state: 32.8%)
> Adult smoking rate: 24.0% (state: 21.1%)
> Median household income: $49,346 (state: $54,181)
Kokomo has the highest premature death rate of any of the 12 metro areas in Indiana. For every 100,000 Kokomo residents, there are 508 deaths before age 75 annually, compared to the statewide premature death rate of 399 per 100,000. Smoking is the leading cause of premature death in the United States, and in Kokomo 24.0% of adults are smokers, compared to the statewide smoking rate of 21.1%.
15. Iowa: Davenport-Moline-Rock Island
> Premature death rate (per 100,000): 342.9 (state: 315.5)
> Adult obesity rate: 31.1% (state: 32.2%)
> Adult smoking rate: 16.3% (state: 16.7%)
> Median household income: $54,173 (state: $58,570)
Though Davenport ranks as the least healthy metro area in Iowa, area adults still tend to he healthier than the typical American by several health measures. For example, 14.1% of adults in the metro area report being in fair or poor health. While this is a larger share than the 13.1% of adults across the state reporting similarly low health status, it is lower than the nationwide figure of 16.0% of adults. Additionally, Davenport’s 16.3% smoking rate and 31.1% obesity rate are closely in line with the comparable state and national rates.