Special Report

The Least Healthy City in Every State

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Montana: Great Falls
> Adult obesity rate: 27.3% (state: 25.8%)
> Adult smoking rate: 16.8% (state: 17.2%)
> Pct. of adults who don’t exercise: 24.5% (state: 21.6%)
> Residents with no health insurance: 10.1% (state: 10.4%)
> Median household income: $51,227 (state: $57,153)

Of the three metro areas in Montana, Great Falls is the least healthy. Adults in Great Falls are the least likely to exercise and are most likely to be obese than residents of any other metro area in the state. Adults in Great Falls also have more mentally and physically unhealthy days a month than adults in the other two metro areas in Montana.

Uninsured adults are less likely to receive preventative medical care than adults with health insurance, and they are more likely to suffer negative health consequences such as preventable hospitalization as a result. In Great Falls, 10.1% of adults under age 65 lack health insurance, the largest uninsured rate in Montana. Additionally, there are 3,455 preventable hospitalizations per 100,000 Medicare enrollees in Great Falls, the highest rate of any metro area in the state.

Source: library_of_congress / Flickr

Nebraska: Grand Island
> Adult obesity rate: 35.0% (state: 32.2%)
> Adult smoking rate: 15.3% (state: 15.4%)
> Pct. of adults who don’t exercise: 27.9% (state: 23.3%)
> Residents with no health insurance: 12.1% (state: 9.6%)
> Median household income: $55,907 (state: $63,229)

Obesity is a risk factor for a number of potentially fatal diseases and conditions, including heart disease, diabetes, and certain cancers. The adult obesity rate of 35.0% in Grand Island is higher than the state obesity rate of 32.2% and higher than the obesity rate in the two other metro areas in Nebraska — Omaha-Council Bluffs and Lincoln. The premature death rate in Grand Island of 326 deaths before age 75 for every 100,000 people is also higher than the statewide rate of 310 premature deaths per 100,000 Nebraska residents.

Lower-income households cannot afford as many healthy options related to health care, diet, and lifestyle as wealthy households, and as a result they often report worse health outcomes. In Grand Island, 7.7% of households live on less than $10,000 a year, the largest share of any Nebraska metro area and higher than the statewide share of 4.8%.

Nevada: Carson City
> Adult obesity rate: 28.3% (state: 25.7%)
> Adult smoking rate: 19.0% (state: 17.6%)
> Pct. of adults who don’t exercise: 22.3% (state: 23.1%)
> Residents with no health insurance: 12.6% (state: 13.1%)
> Median household income: $57,270 (state: $63,276)

Carson City has far and away the highest premature death rate of any metro area in Nevada. There are 499 deaths before age 75 for every 100,000 people in the metro area annually, significantly higher than the state premature death rate of 364 per 100,000.

Smoking is the leading cause of preventable death in the United States. In Carson City, 19.0% of adults smoke, higher than the 17.6% state smoking rate. Obesity is also a risk factor for a number of potentially deadly diseases and conditions, including stroke, diabetes, and certain cancers, and Carson City’s 28.3% obesity rate is the highest of the three metro areas in Nevada.

Source: DenisTangneyJr / Getty Images

New Hampshire: Manchester-Nashua
> Adult obesity rate: 28.0% (state: 27.9%)
> Adult smoking rate: 13.5% (state: 15.7%)
> Pct. of adults who don’t exercise: 22.5% (state: 21.3%)
> Residents with no health insurance: 7.2% (state: 7.0%)
> Median household income: $83,626 (state: $77,933)

Manchester is the only metro area in New Hampshire and therefore ranks as the least healthy by default. Still, Manchester is slightly worse off than the state as a whole in a number of health outcomes. For example, Manchester’s premature death rate of 313 deaths before age 75 per 100,000 people is slightly higher than the state rate of 308 per 100,000.

Despite the poorer health outcomes, Manchester residents are more likely to exhibit certain healthy habits than the typical New Hampshire resident. Just 13.5% of metro area adults smoke, and 20.2% drink excessively, compared to 15.7% and 20.7% of adults statewide, respectively.

Source: Public Domain / Wikimedia Commons

New Jersey: Vineland-Bridgeton
> Adult obesity rate: 35.9% (state: 26.4%)
> Adult smoking rate: 18.3% (state: 13.7%)
> Pct. of adults who don’t exercise: 31.2% (state: 26.0%)
> Residents with no health insurance: 12.1% (state: 9.0%)
> Median household income: $54,587 (state: $85,751)

In Vineland-Bridgeton, 22.6% of adults report being in fair or poor health, by far the largest share of any of the state’s four metro areas and well above the 17.7% share of adults who report similar health outcomes across New Jersey as a whole.

Poor health status among area adults may be partially attributable to unhealthy lifestyles. Just 68.8% of adults in the Vineland metro exercise regularly, the smallest share in New Jersey. Adults in Vineland are also more likely to smoke and be obese than than the average adult in the state.

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