Special Report

The Least Healthy County In Every State

Source: sorincolac / iStock via Getty Images

Hawaii: Hawaii County
> Adults in fair or poor health: 13.9% (county) 14.2% (state)
> Adult obesity rate: 25.5% (county) 23.7% (state)
> Adult smoking rate: 14.3% (county) 12.8% (state)
> Adults with no health insurance: 4.9% (county) 3.9% (state)
> County population: 199,459
> Largest city: Hilo CDP

There are only five counties in Hawaii. Though Hawaii County ranks as the least healthy of the five, unhealthy behaviors in the county are not much more common than they are across the state as a whole. For example, the county’s inactivity rate — 21.0% of county adults do not exercise on a regular basis — is the highest in the state by a slim margin and is better than the national inactivity rate of 23.3%.

Health outcomes are also not especially poor in Hawaii County. Just 13.9% of adult residents report being in fair or poor health, only slightly higher than the 14.2% share of adults across the state as a whole. For reference, 17.0% of adults nationwide report being in suboptimal health.

Idaho: Owyhee
> Adults in fair or poor health: 20.1% (county) 14.6% (state)
> Adult obesity rate: 39.3% (county) 29.3% (state)
> Adult smoking rate: 15.5% (county) 14.3% (state)
> Adults with no health insurance: 21.6% (county) 10.6% (state)
> County population: 11,552
> Largest city: Homedale

While several unhealthy behaviors are more common among residents of Owyhee County, Idaho, than the state averages, they are not significantly more common. In some cases, such as drinking excessively, the rate is lower than both the state and national average.

Still, one in five adult residents do not have health coverage, higher than the state uninsured rate of 10.6%. People with no health insurance see doctors less frequently, even when feeling unwell, often due to concern over cost.

Source: Daniel Schwen / Wikimedia Commons

Illinois: Vermilion
> Adults in fair or poor health: 17.9% (county) 17.2% (state)
> Adult obesity rate: 40.9% (county) 29.7% (state)
> Adult smoking rate: 17.7% (county) 15.5% (state)
> Adults with no health insurance: 5.7% (county) 6.8% (state)
> County population: 77,563
> Largest city: Danville

Of the 102 counties in Illinois, Vermilion County is one of two where more than 40.0% of adults are obese. The state obesity rate is 29.7%. Unhealthy behaviors such as not exercising may contribute to the high obesity rate in the county. Nearly one in three adults in the county lead a sedentary lifestyle, compared to 22.3% of adults across the state as a whole.

The county also has one of the highest smoking rates in the state. The average life expectancy of smokers is about 10 years shorter than nonsmokers, and Vermilion County residents are more likely to die before age 75 than residents of all but seven counties in Illinois.

Indiana: Switzerland
> Adults in fair or poor health: 21.6% (county) 19.8% (state)
> Adult obesity rate: 34.4% (county) 33.4% (state)
> Adult smoking rate: 24.0% (county) 21.8% (state)
> Adults with no health insurance: 10.9% (county) 8.4% (state)
> County population: 10,685
> Largest city: Vevay

Switzerland County ranks only marginally worse than other counties in Indiana. For example, 24.0% of county adults smoke, compared with the state smoking rate of 21.8%.

Still, more than a third of the adult population in Switzerland County is obese and the adult inactivity rate is similar. This may help explain why people report, on average, more than four physically unhealthy days in a month, the second highest number out of all 92 counties in the state.

Source: Scott Romine / Wikimedia Commons

Iowa: Wayne
> Adults in fair or poor health: 15.0% (county) 14.5% (state)
> Adult obesity rate: 39.1% (county) 33.2% (state)
> Adult smoking rate: 16.9% (county) 17.1% (state)
> Adults with no health insurance: 11.2% (county) 4.7% (state)
> County population: 6,429
> Largest city: Corydon

About 31.3% of adults in Wayne County, Iowa, get no exercise beyond getting up and going to work, the sixth highest share of the state’s 99 counties. The prevalence of sedentary lifestyles may be partially attributable to lack of opportunities. Only 54.5% of area residents have access to areas for physical activity like parks and recreation centers, well below the 82.9% share of Iowa residents.

Americans with health insurance are far more likely to make regular doctor visits and receive treatments and preventative medical care. In Wayne County, 11.2% of adult residents are uninsured, compared with 4.7% of Iowa residents.

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