Hawaii: Hawaii County
> Largest place in county: Hilo
> 5-yr. population change: +5.3% (state: +2.1%)
> Poverty rate: 15.6% (state: 9.4%)
> Adults with a bachelor’s degree: 29.4% (state: 33.0%)
> Life expectancy at birth: 80.6 years (state: 82.3 years)
Hawaii is a geographically small state of only five counties, and as a result, variation in socioeconomic outcomes between a given county and the state as a whole are relatively small. Still, based on several key measures, Hawaii County, coterminous with the Island of Hawaii — the largest by landmass in the archipelago — ranks behind the other counties in the state.
The local poverty rate of 15.6% is the highest among the counties in Hawaii and well above the 9.4% state poverty rate. Additionally, even though at 80.6 years, life expectancy at birth is higher than the 79.2 year national average, it is lower than the statewide average life expectancy of 82.3 years.
Idaho: Shoshone County
> Largest place in county: Kellogg
> 5-yr. population change: -0.2% (state: +7.4%)
> Poverty rate: 19.4% (state: 13.1%)
> Adults with a bachelor’s degree: 11.5% (state: 27.6%)
> Life expectancy at birth: 75.5 years (state: 79.4 years)
Idaho is one of the fastest growing states in the country, reporting 7.4% population growth over the last five years. Shoshone County, however, a mining region located in northern Idaho along the Montana border, is bucking the trend, reporting a 0.2% population decline over the same period.
Prevailing economic hardships in the area contribute to its ranking as the worst county to live in in the state and may explain population decline. An estimated 19.4% of the population live below the poverty line, compared to 13.1% of Idaho residents. The greater likelihood of poverty means many county residents are less likely to be able to afford health care or healthy lifestyles, which may result in poorer health outcomes. For example, life expectancy at birth in Shoshone County is 75.5 years, about four years shy of the state average.
Illinois: Saline County
> Largest place in county: Harrisburg
> 5-yr. population change: -3.5% (state: -0.8%)
> Poverty rate: 21.1% (state: 12.5%)
> Adults with a bachelor’s degree: 19.2% (state: 34.7%)
> Life expectancy at birth: 73.4 years (state: 79.4 years)
The southern Illinois county of Saline, named after the Saline River, ranks as the worst of the state’s 102 counties to live in. An estimated 21.1% of local residents live below the poverty line, well above the 12.5% state poverty rate.
Poverty can have a negative impact on health outcomes, including life expectancy, as poorer Americans often struggle to afford health care and healthy lifestyle choices. Partially as a result, at just 73.4 years, life expectancy at birth in the county is six years below the state average.
Indiana: Fayette County
> Largest place in county: Connersville
> 5-yr. population change: -3.2% (state: +1.9%)
> Poverty rate: 19.0% (state: 13.4%)
> Adults with a bachelor’s degree: 13.3% (state: 26.5%)
> Life expectancy at birth: 73.0 years (state: 77.1 years)
Fayette County, Indiana, ranks as the worst county to live in in the state. Adults in the area are about half as likely to have a college degree as the typical Indiana resident 25 and older. Financial security tends to improve with educational attainment, and the poverty rate in the county of 19.0% is well above the statewide rate of 13.4%.
Like many U.S. counties lagging in key socioeconomic indicators, Fayette County’s population is shrinking. Over the last five years, the number of people living there contracted by 3.2%, even as Indiana’s population expanded by 1.9%.
Iowa: Appanoose County
> Largest place in county: Centerville
> 5-yr. population change: -2.4% (state: +2.0%)
> Poverty rate: 17.7% (state: 11.5%)
> Adults with a bachelor’s degree: 16.3% (state: 28.6%)
> Life expectancy at birth: 77.1 years (state: 79.4 years)
Appanoose County, Iowa, located along the Missouri state border, ranks as the worst county to live in in the state. Life expectancy at birth in the county, at 77.1 years, is over two years below the state average. The area’s poor health outcomes are likely attributable in part to unhealthy behaviors. For example, adults in Appanoose County are less likely to exercise than adults in any of the state’s 98 other counties.
The area’s poor health outcomes are also likely attributable in part to high poverty. Americans living below the poverty line are more likely to struggle to afford health care and healthy lifestyles, and in Appanoose County, 17.7% of the population live below the poverty line, compared to 11.5% of Iowa’s population.
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