• Health

Here Are America’s Least Healthy Counties

4 minute read

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. You can see the full report here.

    More Must-Reads from TIME

    Contact us at letters@time.com