25 Cities Where You Don’t Want to Get Sick

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20. Bowling Green, Kentucky
> 30-day hospital readmission rate: 16.3% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.8% (national rate: 12.4%)
> Preventable hospitalizations: 59 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 55 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $51,198 (national median: $65,712)

In Bowling Green, Kentucky, people are more likely than most Americans to be admitted to the hospital for conditions that could have been treated in an outpatient setting. These preventable hospitalizations add undue strain on the local health care system, taking resources from those for whom hospitalization is necessary.

As it is, Bowling Green has relatively few primary care physicians for its population size. There are only 55 doctors for every 100,000 people in Bowling Green, a far lower concentration than the national average of 75 physicians for every 100,000 people.

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19. Springfield, Illinois
> 30-day hospital readmission rate: 16.1% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 14.2% (national rate: 12.4%)
> Preventable hospitalizations: 46 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 115 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $62,205 (national median: $65,712)

In Springfield, Illinois, people who are hospitalized after suffering strokes, heart attacks, pneumonia, and COPD are more likely to die than Americans hospitalized with these conditions nationwide. An estimated 14.2% of metro area Medicare enrollees who are treated in a hospital die within 30 days of admission, compared to 12.4% of Medicare recipients nationwide who do.

Springfield residents are also far more likely to have to be readmitted to the hospital within a month of discharge than Americans in the vast majority of U.S. metro areas. Springfield’s 30-day readmission rate is 16.1%, compared to the national readmission rate of 15.3%.

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18. Mobile, Alabama
> 30-day hospital readmission rate: 15.6% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 13.1% (national rate: 12.4%)
> Preventable hospitalizations: 64 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 67 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $49,561 (national median: $65,712)

There are only about 67 primary care physicians for every 100,000 people in Mobile, Alabama, a lower concentration than the national average of 75 per 100,000. An inadequate number of doctors in a city can make it more difficult to seek necessary preventive and primary care, which can lead to an overreliance on hospitals. In Mobile, a larger than typical share of residents are hospitalized for conditions that could or should have been treated in an outpatient setting. There are about 64 preventable hospitalizations for every 1,000 Medicare enrollees in the metro area, compared to 45 per 1,000 nationwide.

Mobile residents are more likely to earn lower incomes than the typical American. The median annual household income in Mobile is $49,561, well below the national median of $65,712.

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17. Goldsboro, North Carolina
> 30-day hospital readmission rate: 15.7% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 14.3% (national rate: 12.4%)
> Preventable hospitalizations: 53 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 47 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $44,596 (national median: $65,712)

Along with Rocky Mount, Goldsboro is one of two North Carolina metro areas to rank on this list. In Goldsboro, some 14.3% of patents die within 30 days of being admitted to a hospital, a higher share than most metro areas in the country and well above the corresponding 12.4% national rate. Additionally, there are only 47 primary care doctors per 100,000 residents in Goldsboro, well below the national concentration of 75 doctors per 100,000.

Wealthier Americans can better afford regular, preventative health care and a greater range of healthy options related to diet and lifestyle. As a result, income is closely linked to health outcomes. The median annual household income in Goldsboro is among the lowest in the country at just $44,596, or over $20,000 below the national median of $65,712.

Source: Courtesy of the City of Sherman, TX

16. Sherman-Denison, Texas
> 30-day hospital readmission rate: 16.7% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 11.6% (national rate: 12.4%)
> Preventable hospitalizations: 72 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 47 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $57,476 (national median: $65,712)

In the Sherman-Denison, Texas, metro area, people are more likely than most Americans to be admitted to the hospital for conditions that could have been treated in an outpatient setting. These preventable hospitalizations add undue strain on the local health care system, taking resources from those for whom hospitalization is necessary. There are 72 preventable hospitalizations for every 1,000 Medicare enrollees in the metro area, well above the national rate of 45 per 1,000.