25 Cities Where You Don’t Want to Get Sick

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Nearly 8% of the U.S. population needed an overnight stay in a hospital in 2018. While a full and speedy recovery following treatment depends on several factors, including the nature of the illness, the quality of medical care at the hospital can play a significant role.

There are more than 6,100 hospitals in the United States, and not all of them provide the same quality of care. While it is difficult to precisely determine the quality of a health care system, there are certain measures that can be indicative of overall quality of care. 

24/7 Tempo created an index of three such measures — hospital readmission rate, hospital mortality rate, and the rate of preventable hospitalizations — reviewed at the metro area level to identify the cities with the worst health care system outcomes.

The quality of hospital care and appropriate follow-up after discharge can influence the measures that make up the index, but factors such as the type of patients that need medical treatment appear to play a role as well.

Socioeconomic characteristics of residents of a metro area appear to have an impact on the measures used to rate health care system performance, including those related to personal health. For example, unhealthy patient behaviors such as smoking, sedentary lifestyles, and poor diets can contribute to higher readmission rates and negative health outcomes. In fact, many of the cities on this list have relatively unhealthy populations and high premature mortality rates — these are the least healthy cities in every state.

Additionally, the majority of metro areas on this list, have far lower household incomes than the typical American household. Economically disadvantaged areas may have less effective health care systems because of fewer resources and an insufficient number of doctors in an area — these are the states with the fewest and most doctors per person.