Special Report

The Least Healthy City in Every State

Source: AllenS / Wikimedia Commons

New Mexico: Farmington
> Adult obesity rate: 33.2% (state: 26.6%)
> Adult smoking rate: 21.6% (state: 17.5%)
> Pct. of adults who don’t exercise: 23.9% (state: 19.7%)
> Residents with no health insurance: 14.0% (state: 11.0%)
> Median household income: $44,321 (state: $51,945)

Residents of Farmington report among the most mentally and physically unhealthy days not just in New Mexico but the entire country. City adults report an average of 5.2 physically unhealthy days a month, the highest in the state and second highest of all 381 metro areas. Adults report an average of 4.9 mentally unhealthy days per month, the highest in the state and 19th highest in the U.S. With an obesity rate of 33.2%, the metro area also has far and away the largest share of adults who are dangerously overweight.

Unhealthy lifestyles may contribute to such unhealthy outcomes. Regular exercise can be good for mental health and help in maintaining a healthy weight. In Farmington, 23.9% of adults don’t exercise regularly, by far the largest share of any metro area in the state and well above the 19.7% of adults across the state who lead sedentary lives.

Source: Jacek_Sopotnicki / iStock

New York: Buffalo-Cheektowaga-Niagara Falls
> Adult obesity rate: 30.8% (state: 25.5%)
> Adult smoking rate: 17.2% (state: 14.1%)
> Pct. of adults who don’t exercise: 26.3% (state: 24.7%)
> Residents with no health insurance: 4.6% (state: 6.6%)
> Median household income: $60,105 (state: $72,108)

Smoking is a leading cause of preventable death in the United States, and the adult smoking rate of Buffalo-Cheektowaga-Niagara Falls is 17.2%, the highest of New York’s 12 metro areas. Regular and excessive consumption of alcohol can result in chronic conditions and other long-term health problems, such as high blood pressure, heart disease, stroke, liver disease, and certain cancers. About 22.2% of adults in the metro area report excessive drinking, more than any other metro area in the state and higher than the national rate of 19.0%.

Low-income Americans have less access to quality health care options than those with higher incomes, and they are less able to afford living a healthy lifestyle. In the Buffalo metro area, the typical household earns $60,105 a year, compared to the state median of $72,108.

Source: Leonard J. DeFrancisci / Wikimedia Commons

North Carolina: Rocky Mount
> Adult obesity rate: 40.6% (state: 31.4%)
> Adult smoking rate: 19.2% (state: 17.2%)
> Pct. of adults who don’t exercise: 29.8% (state: 24.3%)
> Residents with no health insurance: 12.2% (state: 12.6%)
> Median household income: $46,466 (state: $57,341)

Rocky Mount is the least healthy metro area in North Carolina and also among the least healthy in the nation. Rocky Mount’s premature death rate of 505 deaths before age 75 for every 100,000 people is by far the highest of the 15 metro areas in North Carolina and the 16th highest in the nation. It is also far higher than the state premature death rate of 372 per 100,000 or the national rate of 340 premature deaths per 100,000.

The higher premature death rate in the metro area is likely due in part to the prevalence of some unhealthy behaviors and outcomes. For example, 40.6% of metro area adults are obese, the largest share of any metro area in the state and the seventh highest obesity rate of all 381 metro areas. Obesity is a risk factor for a number of potentially deadly diseases and conditions, including diabetes, heart disease, and certain cancers.

Source: Randy Stern / Flickr

North Dakota: Grand Forks
> Adult obesity rate: 34.0% (state: 32.7%)
> Adult smoking rate: 15.9% (state: 18.3%)
> Pct. of adults who don’t exercise: 24.2% (state: 23.9%)
> Residents with no health insurance: 7.3% (state: 8.6%)
> Median household income: $57,301 (state: $64,577)

People living in urban areas tend to have healthier behaviors and better health outcomes than residents of rural areas. While Grand Forks ranks as the least healthy metro area in North Dakota, it performs better than the largely rural state as a whole in several measures.

For example, 15.9% of adults in Grand Forks smoke, less than the 18.3% state smoking rate. Adults who do not smoke and are normal weight are less likely to self-report being in poor health, and in Grand Forks, 14.5% of adults report being in fair or poor health, less than the 15.1% of adults who do statewide and the 17.0% who do nationwide.

Source: Public Domain / Wikimedia Commons

Ohio: Springfield
> Adult obesity rate: 33.7% (state: 32.3%)
> Adult smoking rate: 21.4% (state: 21.1%)
> Pct. of adults who don’t exercise: 30.5% (state: 26.4%)
> Residents with no health insurance: 7.2% (state: 7.1%)
> Median household income: $50,128 (state: $58,642)

Springfield is the only metro area in Ohio where adults report an average of 4.5 physically unhealthy days per month, the most of all 11 metro areas in the state. Springfield residents are also more likely than those in any other Ohio metro areas to die prematurely. There are 551 deaths before age 75 for every 100,000 metro area residents annually, compared to the statewide premature death rate of 408 per 100,000.

Poor health outcomes are partially attributable to unhealthy lifestyles. For example, adults in Springfield are more likely to smoke than adults across the state. Springfield’s 21.4% adult smoking rate is the highest of all metro areas in Ohio and the 14th highest of all 381 U.S. metro areas.

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