Special Report

The Least Healthy County In Every State

Colorado: Costilla
> Adults in fair or poor health: 28.0% (county) 14.5% (state)
> Adult obesity rate: 27.9% (county) 21.8% (state)
> Adult smoking rate: 17.1% (county) 14.6% (state)
> Adults with no health insurance: 11.5% (county) 7.6% (state)
> County population: 3,745
> Largest city: San Luis

Costilla County is located on Colorado’s border with New Mexico. As the least healthy county in one of the healthiest states in the U.S., Costilla ranks better in several measures of health than the nation as a whole, particularly the adult obesity rate. Relative to the state rates, however, Costilla ranks worse.

Another factor contributing to Costilla County’s rank as least healthy in Colorado is the high share of uninsured residents. Of county adult residents, 11.5% have no health insurance, compared with 8.8% nationwide and 7.6% statewide. Research has shown that uninsured adults have worse access to care, receive poorer quality of care, and experience worse health outcomes than insured adults.

Source: DenisTangneyJr / iStock via Getty Images

Connecticut: Windham
> Adults in fair or poor health: 13.4% (county) 13.8% (state)
> Adult obesity rate: 30.3% (county) 25.8% (state)
> Adult smoking rate: 14.4% (county) 12.7% (state)
> Adults with no health insurance: 4.1% (county) 5.3% (state)
> County population: 116,566
> Largest city: Willimantic CDP

Due in large part to the prevalence of some unhealthy behaviors, Windham, a county situated in the northeast corner of Connecticut, ranks as the least healthy of the eight counties in the state. An estimated 14.4% of county adults smoke, the largest share of any county in the state and above the 12.7% state smoking rate. Adults in Windham are also less likely to exercise than adults in other counties in the state.

Unhealthy habits often lead to unhealthy outcomes, and 30.3% of adults in Windham County are obese, the largest share in the state.

Source: Ataraxy22 / Wikimedia Commons

Delaware: Kent
> Adults in fair or poor health: 19.0% (county) 18.0% (state)
> Adult obesity rate: 35.4% (county) 30.9% (state)
> Adult smoking rate: 16.8% (county) 17.0% (state)
> Adults with no health insurance: 7.1% (county) 5.7% (state)
> County population: 176,699
> Largest city: Dover

Delaware only has three counties, but Kent has the highest share of adults reporting unhealthy habits. About one in three adult residents do not exercise. Kent is also the county with the highest adult smoking rate.

These unhealthy behaviors are likely contributing to poor health outcomes in the county. People report on average more than four physically unhealthy days a month, more than in the other two counties. In addition, nearly one in five adult residents report being in poor or fair health, also the highest share among the three counties.

Source: 35875480@N05 / Flickr

Florida: Gadsden
> Adults in fair or poor health: 25.8% (county) 17.5% (state)
> Adult obesity rate: 42.8% (county) 26.6% (state)
> Adult smoking rate: 20.4% (county) 16.1% (state)
> Adults with no health insurance: 14.1% (county) 12.8% (state)
> County population: 45,945
> Largest city: Quincy

In Gadsden County, Florida, adults report an average of about five physically unhealthy days and five mentally unhealthy days per month. The statewide average is less than four unhealthy days for each. The county’s adult obesity rate of 42.8% is also well above the obesity rate across Florida of 26.6%.

Outcomes like these are likely attributable to some relatively common unhealthy habits in the county. For example, about one in every five adults in the county smoke, higher than the 16.1% smoking rate of Florida as a whole.

Source: BOB WESTON / iStock via Getty Images

Georgia: Clinch
> Adults in fair or poor health: 26.9% (county) 18.0% (state)
> Adult obesity rate: 51.9% (county) 32.0% (state)
> Adult smoking rate: 23.7% (county) 17.5% (state)
> Adults with no health insurance: 19.4% (county) 13.2% (state)
> County population: 6,686
> Largest city: Homerville

Clinch County’s rank as the least healthy of the 159 counties in Georgia is because of the high smoking, diabetes, and obesity rates. Almost 23.7% of adults light a cigarette on a regular basis, compared with the 17.1% national smoking rate and 17.5% state rate. The adult obesity rate is 51.9%, the fourth highest in the U.S. and second highest in Georgia. The county has 15 primary care doctors per 100,000 residents, about four times less than the average concentration across the state of 65 per 100,000 residents. Lack of doctors can restrict or severely hamper access to regular health care.

Clinch County has a population of just over 6,600 people, and one in four adults report being in poor or fair health, the sixth highest share in the state.

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