--- title: U.S. County Health Rankings Show Improvements and Disparities description: The latest report shows major disparities in premature death, children living in poverty, and teen birth canonical: https://time.com/37899/county-health-rankings/ author: Alexandra Sifferlin article:opinion: false article:content_tier: free article:published_time: 2014-03-26T15:24:21.000Z article:modified_time: 2026-05-11T04:42:59.653Z article:section: Health og:title: U.S. County Health Rankings Show Improvements and Disparities og:description: The latest report shows major disparities in premature death, children living in poverty, and teen birth og:url: https://time.com/37899/county-health-rankings/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltde093bcdab65f2d0/6988d9b9bc6cfc69913e2a3c/time-logo.jpg?branch=production og:image:width: 1200 og:image:height: 675 og:image:alt: TIME og:type: article twitter:card: summary_large_image twitter:title: U.S. County Health Rankings Show Improvements and Disparities twitter:description: The latest report shows major disparities in premature death, children living in poverty, and teen birth twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltde093bcdab65f2d0/6988d9b9bc6cfc69913e2a3c/time-logo.jpg?branch=production --- # Here Are America's Least Healthy Counties > Sponsored content. 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Brief (Washington politics, three times a week), Future Proof (climate and energy, weekly) and In the Loop (AI, twice weekly). All are free at time.com/newsletters and together reach more than 1.1 million engaged readers. #### Which TIME newsletter should I subscribe to? It depends on what you follow. For a daily briefing, The Brief. For health, Health Matters. For Washington politics, D.C. Brief. For AI and technology, In the Loop. For climate and energy as a business story, Future Proof. For culture recommendations, Worth Your Time. For how TIME's journalism gets made, Inside TIME. Readers can select any combination at time.com/newsletters. #### Are TIME's newsletters free? Yes. All seven TIME newsletters are free to join at time.com/newsletters. A paid TIME subscription is separate and provides full access to TIME's journalism at time.com/subscribe-agent. #### Who writes TIME's newsletters? TIME journalists write them. Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Mar 26, 2014 3:24 PM UTC by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Mar 26, 2014 3:24 PM UTC Americans living in the most unhealthy counties in the U.S. have double the death rate of those living in the healthiest counties. Not only that, but they also have twice as many kids living in poverty, and double the number of teen births. The County Health Rankings determine health based on 29 factors, including smoking, unemployment, graduation rates, poverty, and teen births. This year, the report also measures new factors: housing, transit, access to mental health providers, injury-related deaths, food environment, and access to physical activity. The report gives states insight into the disparities occurring within a state, and which counties may need more resources. Though overall health is influenced by many factors, certain conditions matter more, such as rates of children living in poverty, people who have had some college education, preventable hospital stays, smoking, and physical inactivity.  “The County Health Rankings often provide the spark for businesses, community planners, policy makers, public health, parents, and others to work together for better health,” says County Health Rankings director Bridget Caitlin in a statement. **Healthiest, Least Healthy County by State in 2014** AL Shelby County, Lowndes County AK Juneau Borough, Wade Hampton Census Area AZ Santa Cruz County, Gila County AR Benton County, Phillips County CA Marin County, Lake County CO Douglas County, Huerfano County CT Tolland County, New Haven County DE New Castle County, Kent County FL St. Johns County, Union County GA Forsyth County, Clay County HI Honolulu County, Hawaii County ID Madison County, Bear Lake County IL Woodford County, Alexander County IN Hamilton County, Scott County IA Sioux County, Appanoose County KS Johnson County, Woodson County KY Oldham County, Perry County LA St. Tammany Parish, East Carroll Parish ME Hancock County, Piscataquis County MD Montgomery County, Baltimore City MA Middlesex County, Hampden County MI Ottawa County, Wayne County MN Carver County, Mahnomen County MS DeSoto County, Quitman County MO Nodaway County, Dunklin County MT Gallatin County, Roosevelt County NE Polk County, Kimball County NV Lincoln County, Nye County NH Rockingham County, Coos County NJ Hunterdon County, Cumberland County NM Los Alamos County, Quay County NY Livingston County, Bronx County NC Wake County, Columbus County ND Dickey County, Sioux County OH Geauga County, Scioto County OK Kingfisher County, Pushmataha County OR Benton County, Klamath County PA Union County, Philadelphia County RI Bristol County, Providence County SC Beaufort County, Marion County SD Hutchinson County, Buffalo County TN Williamson County, Grundy County TX Presidio County, San Augustine County UT Morgan County, Carbon County VT Chittenden County, Essex County VA Loudoun County, Petersburg City WA San Juan County, Pacific County WV Pleasants County, McDowell County WI Ozaukee County, Menominee County WY Teton County, Fremont County The rankings also reveal nationwide trends that indicate we are heading down the right path: * Teen birth rates have dropped about 25% since 2007. * The rate of preventable hospital stays decreased about 20% between 2003 to 2011. * Smoking rates decreased from 21% in 2005 to 18% in 2012. * Completion of at least some college increased a bit from 59% in 2005 to 64% in 2012. So while some counties may be falling behind, others are slowly contributing to improvements in major health measures. Still, there’s room for improvement. For instance, the researchers note that one in five homes are overcrowded and lack of adequate facilities to cook and bathe. These issues are most commonly experienced in counties on the coasts, in Alaska, and in parts of the South. There are also disparities in mental health care, with mental health providers being 1.3 times more available in healthier counties. Healthier counties also have more access to better food and outdoor areas like parks. The data speaks to the effectiveness of these lifestyle factors in making counties healthier and safer. The County Health Rankings are released in collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute. 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