Special Report

The Least Healthy City in Every State

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South Dakota: Rapid City
> Adult obesity rate: 28.8% (state: 31.8%)
> Adult smoking rate: 16.0% (state: 19.3%)
> Pct. of adults who don’t exercise: 19.9% (state: 21.3%)
> Residents with no health insurance: 11.4% (state: 10.8%)
> Median household income: $58,361 (state: $59,533)

Of the two metro areas in South Dakota — Sioux Falls and Rapid City — Rapid City is the least healthy. Unlike in Sioux Falls, adults in Rapid City report more than three physically unhealthy days and more than three mentally unhealthy days per month on average.

Some 13.4% of adults in Rapid City report being in fair or poor health, more than the 11.1% of adults who report similar health outcomes in Sioux Falls and in line with the share of adults in fair or poor health statewide. For every 100,000 Rapid City residents, 323 die before the age of 75 — more than the Sioux Falls premature death rate of 290 per 100,000, yet less than the state rate of 333 per 100,000.

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Tennessee: Memphis
> Adult obesity rate: 35.9% (state: 33.2%)
> Adult smoking rate: 19.5% (state: 22.6%)
> Pct. of adults who don’t exercise: 27.0% (state: 27.2%)
> Residents with no health insurance: 11.5% (state: 11.3%)
> Median household income: $54,859 (state: $56,071)

Low birthweight can be indicative of unhealthy maternal lifestyles, limited access to health care, and other negative environmental factors. In Memphis, 11.3% of newborns weigh less than what is considered a healthy weight, compared to 9.2% of newborns across the state as a whole.

Living below the poverty line can greatly reduce an individual’s ability to access health care and make healthy lifestyle choices, and as a result, poorer Americans often report worse health outcomes. In Memphis, 15.4% of residents live below the poverty line, compared to 13.9% of the Tennessee population.

Source: Jimmy Emerson / Wikimedia Commons

Texas: Texarkana
> Adult obesity rate: 43.6% (state: 30.1%)
> Adult smoking rate: 18.7% (state: 15.7%)
> Pct. of adults who don’t exercise: 39.2% (state: 24.4%)
> Residents with no health insurance: 13.3% (state: 19.4%)
> Median household income: $51,544 (state: $64,034)

In Texarkana, Texas, 43.6% of adults are obese, well above the state obesity rate of 30.1% and the highest obesity rate of all metro areas not only in Texas but the entire country. Obesity is a risk factor for a number of potentially deadly diseases and conditions, including diabetes, heart disease, and certain cancers, and premature death is far more common in Texarkana than it is across the state as a whole. For every 100,000 people in the metro area, there are 507 deaths before age 75 annually, the highest premature death rate of all 25 metro areas in the state and the 12th highest in the U.S.

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Utah: Salt Lake City
> Adult obesity rate: 25.2% (state: 25.9%)
> Adult smoking rate: 9.6% (state: 8.9%)
> Pct. of adults who don’t exercise: 18.2% (state: 18.1%)
> Residents with no health insurance: 10.8% (state: 10.0%)
> Median household income: $80,196 (state: $75,780)

Of Utah’s five metro areas, Salt Lake City is the least healthy. Part of the reason may be environmental. The air in Salt Lake City has the highest concentration of harmful particulate matter of any metro area in the state. Still, Salt Lake City’s air is slightly cleaner than average on a national scale.

Adults in Salt Lake City are also more likely than those in every other metro area in the state to have certain unhealthy habits. For example, 15.6% of adults in the city drink excessively, higher than the excessive drinking rate of 12.2% statewide.

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Vermont: Burlington-South Burlington
> Adult obesity rate: 25.6% (state: 26.3%)
> Adult smoking rate: 12.8% (state: 15.8%)
> Pct. of adults who don’t exercise: 17.2% (state: 19.1%)
> Residents with no health insurance: 5.0% (state: 5.5%)
> Median household income: $74,909 (state: $63,001)

Burlington is the only metro area in Vermont, and as a result it ranks as the least healthy city in the state by default only. In fact, by several measures, city residents are more likely to have healthier lifestyles and report better health outcomes than those living across the state as a whole. For example, just 12.8% of adults in Burlington smoke, compared to 15.8% of the adult population in Vermont as a whole. Adults in Burlington are also more likely to regularly exercise and are less likely to be obese than the typical adult in the state.

Healthy behaviors can lead to healthy outcomes, and in Burlington, adult residents report an average of 3.2 physically unhealthy days per month, compared to an average of about 3.6 days per month across the state.

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