Special Report

The Least Healthy County In Every State

Source: Jimmy Emerson, DVM / Flickr

Alabama: Conecuh
> Adults in fair or poor health: 28.6% (county) 22.0% (state)
> Adult obesity rate: 43.0% (county) 35.5% (state)
> Adult smoking rate: 21.1% (county) 20.9% (state)
> Adults with no health insurance: 12.7% (county) 9.5% (state)
> County population: 12,394
> Largest city: Evergreen

Of the 67 counties in Alabama, Conecuh ranks as the least healthy. About 43.0% of adults in the county are obese, well above the 35.5% share of adults statewide and one of the highest obesity rates of any county in the U.S.

Low-income Americans tend to have less access to quality health care. Economic conditions partially explain the poor health outcomes in the southern Alabama county, where the median annual household income is $37,834, about $12,000 less than the state median of $50,536.

Source: Vipersniper / iStock via Getty Images

Alaska: Aleutians East
> Adults in fair or poor health: 16.8% (county) 18.1% (state)
> Adult obesity rate: 50.5% (county) 32.5% (state)
> Adult smoking rate: 16.6% (county) 21.0% (state)
> Adults with no health insurance: 46.3% (county) 13.6% (state)
> County population: 3,385
> Largest city: Sand Point

Unhealthy behaviors, particularly not exercising, likely contribute to Aleutians East’s ranking as Alaska’s least healthy borough. About 30.0% of adults report not exercising on a regular basis, 10 percentage points more than the 20.0% of adults statewide reporting not exercising. One in every two county adults is obese, the seventh-largest share in the country and significantly larger than the state obesity rate of over 32.5%.

Nearly half of adult residents in Aleutians East do not have health insurance, the largest uninsured rate of any U.S. county.

Source: Rawf8 / iStock Editorial via Getty Images

Arizona: Apache
> Adults in fair or poor health: 26.0% (county) 18.6% (state)
> Adult obesity rate: 33.5% (county) 27.5% (state)
> Adult smoking rate: 21.5% (county) 15.6% (state)
> Adults with no health insurance: 25.1% (county) 10.4% (state)
> County population: 71,511
> Largest city: Chinle CDP

A quarter of adult residents in Apache County, Arizona, do not have health insurance, the largest uninsured rate of any county in the state and one of the largest in the entire country. People with health insurance are more likely to make regular doctor visits and receive diagnosis and treatment when needed, be it bacterial infections, chronic conditions, or serious diseases. The lower likelihood of regular doctor visits in Apache County may partially explain why the county’s premature death rate is the second highest in the state.

Unhealthy habits also are relatively common in Apache County. Adult county residents are more likely to smoke and less likely to lead physically active lifestyles than the typical Arizona resident.

Arkansas: Lafayette
> Adults in fair or poor health: 25.3% (county) 23.2% (state)
> Adult obesity rate: 46.2% (county) 34.2% (state)
> Adult smoking rate: 20.1% (county) 22.3% (state)
> Adults with no health insurance: 8.2% (county) 8.5% (state)
> County population: 6,800
> Largest city: Stamps

Lafayette County, Arkansas, is located along the state border with Louisiana in southwest Arkansas. A relatively high share of adult county residents lead sedentary lifestyles, a leading cause of disease and disability. In addition, 46.2% of the county’s adult population is obese, the 32nd largest obesity rate of any U.S. county and the second largest in the state.

For several reasons, poverty is associated with unhealthy behaviors, which can result in an increased risk of disease or mortality. In Lafayette, one in four residents live below the poverty line. About 25.3% of county adults say they are in fair or poor health, far more than the national 17.2% and state 23.2% shares.

California: Lassen
> Adults in fair or poor health: 15.2% (county) 17.2% (state)
> Adult obesity rate: 40.9% (county) 23.6% (state)
> Adult smoking rate: 13.7% (county) 11.3% (state)
> Adults with no health insurance: 4.4% (county) 7.5% (state)
> County population: 30,818
> Largest city: Susanville

Unhealthy behaviors are relatively common in Lassen County, California. Of adults in the county, 36.9% report getting no exercise beyond getting up and going to work – more than double the 17.6% share of adults across the state who lead sedentary lifestyles.

Adults in the county are also more likely to drink to excess and be obese than adults across the state as a whole. About 40.9% of Lassen County residents are obese, a much larger share of the population compared to the state as a whole. California’s adult obesity rate is 23.6%.

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