Special Report

The Least Healthy County In Every State

Source: afiler from Seattle (ex-Minneapolis) / Wikimedia Commons

New Mexico: McKinley
> Adults in fair or poor health: 26.5% (county) 20.6% (state)
> Adult obesity rate: 38.8% (county) 26.6% (state)
> Adult smoking rate: 21.6% (county) 17.5% (state)
> Adults with no health insurance: 19.9% (county) 9.6% (state)
> County population: 72,438
> Largest city: Gallup

Personal health is often closely tied to income, and McKinley County is the least healthy county and has the highest poverty rate in New Mexico. More than one in every three county residents live below the poverty line, compared with less than one in every five people across the state as a whole.

Stress associated with poverty can take a toll on personal health, and lower-income Americans can afford less health care and fewer healthy options related to diet and lifestyle. Partially as a result, 38.8% of county adults are obese compared with 26.6% adults in the state. Additionally, 26.5% of adults in the county report being not in good health compared with 20.6% of adults across the state.

New York: Orleans
> Adults in fair or poor health: 15.7% (county) 16.6% (state)
> Adult obesity rate: 38.1% (county) 25.5% (state)
> Adult smoking rate: 17.0% (county) 14.1% (state)
> Adults with no health insurance: 5.1% (county) 5.8% (state)
> County population: 40,904
> Largest city: Medina

Orleans County, New York, has the highest share of adults who have diabetes, at 15.5%. The county is one of four in the state where the obesity rate is more than 38.0%, compared to a state adult obesity rate of 25.5%.

Adults in Orleans report the eighth highest average number of physically unhealthy days of adults in all 62 counties in the state. One in three adults do not exercise, more than any other county and significantly higher than the state inactivity rate of one in four.

Source: Indy beetle / Wikimedia Commons

North Carolina: Hertford
> Adults in fair or poor health: 23.5% (county) 18.5% (state)
> Adult obesity rate: 46.5% (county) 31.4% (state)
> Adult smoking rate: 19.3% (county) 17.2% (state)
> Adults with no health insurance: 11.4% (county) 10.7% (state)
> County population: 24,012
> Largest city: Ahoskie

About 42.5% of adults in Hertford County, North Carolina, get no exercise beyond getting up and going to work, the highest physical inactivity rate of any county in the state and the 18th highest among all 3,142 U.S. counties. Regular exercise can help maintain a healthy body weight, and the prevalence of sedentary lifestyles may help explain Hertford County’s 46.5% obesity rate — the highest in North Carolina and the 25th highest in the U.S.

Certain unhealthy behaviors are more common in Hertford than in North Carolina as a whole. About 19.3% of adult residents smoke, compared to a state smoking rate of 17.2%.

Source: Andrew Filer / Wikimedia Commons

North Dakota: Sioux
> Adults in fair or poor health: 33.7% (county) 15.1% (state)
> Adult obesity rate: 39.0% (county) 32.7% (state)
> Adult smoking rate: 38.7% (county) 18.3% (state)
> Adults with no health insurance: 31.6% (county) 7.4% (state)
> County population: 4,373
> Largest city: Cannon Ball CDP

Sioux County, North Dakota, is located in the northernmost portion of the Standing Rock Reservation. The county’s population identifies primarily as Native American. The county is not only the least healthy among North Dakota’s 53 counties, but also the third least healthy nationwide. The county’s 38.7% adult smoking rate is the third highest in the U.S. and more than double the national smoking rate of 17.1%. Sioux’s annual premature mortality rate of 969 deaths before age 75 per 100,000 people is the fourth worst in the country and the worst in North Dakota. For reference, the second worst premature death rate in the state is 626 death per 100,000 residents.

Nearly one in three county residents do not have health insurance, the highest uninsured rate of any county in North Dakota. The state uninsured rate is 8.8%.

Ohio: Lawrence
> Adults in fair or poor health: 24.0% (county) 18.0% (state)
> Adult obesity rate: 39.9% (county) 32.3% (state)
> Adult smoking rate: 21.2% (county) 21.1% (state)
> Adults with no health insurance: 5.6% (county) 6.1% (state)
> County population: 60,184
> Largest city: Ironton

Lawrence is one of only two Ohio counties where more than 37.0% of adults do not exercise. A sedentary lifestyle may be a factor in the county’s high adult obesity rate. At 39.9%, it is significantly higher than the state adult obesity rate of 32.3%.

Of the 88 counties in Ohio, Adams County has the fifth highest premature mortality rate. The increased likelihood of death before age 75 in Adams County may be attributable to the high diabetes rate. Diabetes is associated with premature death from cardiovascular diseases. About 18.9% of adults living in Lawrence have diabetes, the highest rate in the state.

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