Special Report

The Least Healthy County In Every State

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Kansas: Wyandotte
> Adults in fair or poor health: 23.0% (county) 16.1% (state)
> Adult obesity rate: 39.5% (county) 33.2% (state)
> Adult smoking rate: 21.0% (county) 17.4% (state)
> Adults with no health insurance: 18.0% (county) 8.8% (state)
> County population: 164,861
> Largest city: Kansas City

While a slightly smaller share of adults in Wyandotte Country, Kansas, drinks excessively compared with the excessive drinking rate statewide, a significantly higher percentage than the average statewide does not engage in leisure-time physical activity. A third of adults do not exercise, compared with a state inactivity rate of 24.8%.

Adult county residents are also more likely to smoke on a regular basis, be obese, and report being in poor or fair health compared with Kansas as a whole.

Source: I, W.marsh/ Wikimedia Commons

Kentucky: McCreary
> Adults in fair or poor health: 34.3% (county) 23.9% (state)
> Adult obesity rate: 39.8% (county) 33.8% (state)
> Adult smoking rate: 31.9% (county) 24.6% (state)
> Adults with no health insurance: 4.6% (county) 5.7% (state)
> County population: 17,465
> Largest city: Pine Knot CDP

McCreary County, Kentucky, is the least healthy county in the state and one of the least healthy in the country. One in three county adults are in poor or fair health, the highest share of the 120 counties in the state and the 24th highest of the more than 3,000 counties nationwide.

Two unhealthy behaviors that are significantly more common among McCreary County residents than in other counties in the state are sedentary lifestyles and smoking. An estimated 39.3% of adults in the county get no exercise beyond getting up and going to work, well above the 28.6% of inactive adults statewide and 23.0% nationwide. Also, 31.9% of county adults smoke, the 10th highest smoking rate of U.S. counties and significantly higher than the state smoking rate of 24.6%

Louisiana: Madison
> Adults in fair or poor health: 31.1% (county) 22.0% (state)
> Adult obesity rate: 41.2% (county) 35.4% (state)
> Adult smoking rate: 27.6% (county) 23.1% (state)
> Adults with no health insurance: 11.0% (county) 9.5% (state)
> County population: 11,306
> Largest city: Tallulah

Madison, Louisiana, is not only the least healthy county in Louisiana, but also among the least healthy nationwide. Behaviors that may lead to unhealthy outcomes are very common among county residents. For example, more than one in four adult residents smoke regularly, the 33rd highest smoking rate in the U.S. Also, 41.2% of adults are obese, compared with a 35.4% state obesity rate and 29.0% national rate.

The average number of both mentally and physically unhealthy days people in Madison report having — at nearly six a month — is among the highest in the country. About 31.1% say they are in poor or fair health, the third highest share among Louisiana’s 64 counties and the 41st highest among the 3,142 U.S. counties.

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Maine: Aroostook
> Adults in fair or poor health: 17.5% (county) 15.0% (state)
> Adult obesity rate: 35.9% (county) 29.9% (state)
> Adult smoking rate: 18.6% (county) 17.3% (state)
> Adults with no health insurance: 8.4% (county) 7.9% (state)
> County population: 67,809
> Largest city: Presque Isle

Aroostook County borders Canada in northern Maine. About 31.2% of adult residents get no exercise beyond getting up and going to work, the highest share in the state and well above Maine’s 21.6% physical inactivity rate. Sedentary lifestyles may be due to limited opportunities. Just 55.6% of county residents have access to places for physical activity, such as parks and recreation centers, compared with 70.0% of state residents.

Regular exercise can promote better physical and mental health, and adults in Aroostook County report being in poor mental health more frequently than adults across Maine as a whole. They are also more likely to be obese.

Maryland: Somerset
> Adults in fair or poor health: 19.1% (county) 14.9% (state)
> Adult obesity rate: 44.4% (county) 31.0% (state)
> Adult smoking rate: 19.8% (county) 13.8% (state)
> Adults with no health insurance: 5.8% (county) 6.1% (state)
> County population: 25,729
> Largest city: Princess Anne

Somerset ranks slightly worse than the 24 counties in Maryland, except for a few health measures. About 44.4% of county adults are obese compared with 31.0% statewide. The differences are similarly relatively big in other measures such as inactivity and smoking. About 34.5% of adults do not exercise, and 19.8% smoke, compared with 22.4% and 13.8% statewide, respectively.

What sets Somerset apart from most other counties is the poverty rate. At 21.7%, it is the highest poverty rate in the state, one of just two places in the state in which more than one in five people live below the poverty line. For different reasons, there is a link between poverty and chronic diseases. The premature mortality rate in Somerset is 475 deaths before age 75 per 100,000 residents annually, compared to 339 deaths per 100,000 residents in Maryland as a whole.

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