America’s Unhealthiest Cities: A State-by-State Breakdown

According to County Health Rankings and Roadmaps, many factors influence how healthy we are, including the resources available in our communities. Things such as affordable housing and well-paying jobs affect an area's access to healthcare, while beneficial activities, such as exercise and healthful eating improve overall well-being. We took a look at the other end of the scale to find out which was the unhealthiest city in each state. (Also see, in this US city, life expectancy is only 72 years.)

24/7 Tempo calculated an index using eight health measures such as potential life lost, smoking rate, and percentage reporting fair or poor health, using data from the 2023 County Health Rankings & Roadmaps program of the University of Wisconsin Population Health Institute to measure and rank the health of the population in cities in every state.

Here is the city that is the unhealthiest in each state:

• Adults in fair or poor health: 19.9% (state: 18.9%)
• Adult smoking rate: 20.5% (state: 19.5%)
• Adult obesity rate: 39.5% (state: 39.3%)
• Median household income: $49,691 (state: $53,913)

• Adults in fair or poor health: 11.5% (state: 12.2%)
• Adult smoking rate: 16.4% (state: 18.0%)
• Adult obesity rate: 30.0% (state: 31.8%)
• Median household income: $84,476 (state: $77,845)

• Adults in fair or poor health: 16.7% (state: 14.5%)
• Adult smoking rate: 21.0% (state: 13.7%)
• Adult obesity rate: 35.7% (state: 31.5%)
• Median household income: $46,616 (state: $69,056)

• Adults in fair or poor health: 22.8% (state: 19.4%)
• Adult smoking rate: 23.1% (state: 21.6%)
• Adult obesity rate: 42.9% (state: 37.2%)
• Median household income: $46,826 (state: $52,528)

• Adults in fair or poor health: 21.2% (state: 14.4%)
• Adult smoking rate: 15.1% (state: 9.0%)
• Adult obesity rate: 35.0% (state: 30.2%)
• Median household income: $58,217 (state: $84,907)

• Adults in fair or poor health: 15.5% (state: 10.2%)
• Adult smoking rate: 17.6% (state: 12.6%)
• Adult obesity rate: 29.6% (state: 24.2%)
• Median household income: $56,689 (state: $82,254)

• Adults in fair or poor health: 11.6% (state: 11.0%)
• Adult smoking rate: 15.4% (state: 12.6%)
• Adult obesity rate: 33.3% (state: 29.5%)
• Median household income: $75,295 (state: $83,771)

• Adults in fair or poor health: 14.6% (state: 12.8%)
• Adult smoking rate: 20.0% (state: 15.8%)
• Adult obesity rate: 39.1% (state: 36.2%)
• Median household income: $64,308 (state: $71,091)

• Adults in fair or poor health: 17.8% (state: 13.3%)
• Adult smoking rate: 20.8% (state: 15.5%)
• Adult obesity rate: 38.2% (state: 28.3%)
• Median household income: $55,161 (state: $63,062)

• Adults in fair or poor health: 20.0% (state: 15.1%)
• Adult smoking rate: 21.1% (state: 16.3%)
• Adult obesity rate: 41.4% (state: 34.3%)
• Median household income: $48,659 (state: $66,559)

• Adults in fair or poor health: 11.0% (state: 10.3%)
• Adult smoking rate: 14.0% (state: 12.2%)
• Adult obesity rate: 23.9% (state: 25.0%)
• Median household income: $76,273 (state: $84,857)

• Adults in fair or poor health: 13.6% (state: 11.8%)
• Adult smoking rate: 18.2% (state: 14.2%)
• Adult obesity rate: 36.3% (state: 31.3%)
• Median household income: $60,475 (state: $66,474)

• Adults in fair or poor health: 16.7% (state: 12.3%)
• Adult smoking rate: 22.1% (state: 12.8%)
• Adult obesity rate: 38.2% (state: 32.5%)
• Median household income: $49,091 (state: $72,205)

• Adults in fair or poor health: 17.3% (state: 15.1%)
• Adult smoking rate: 22.5% (state: 20.2%)
• Adult obesity rate: 40.1% (state: 37.2%)
• Median household income: $50,497 (state: $62,743)

• Adults in fair or poor health: 12.9% (state: 12.0%)
• Adult smoking rate: 16.8% (state: 16.8%)
• Adult obesity rate: 36.3% (state: 37.2%)
• Median household income: $61,166 (state: $65,600)

• Adults in fair or poor health: 13.1% (state: 12.8%)
• Adult smoking rate: 17.7% (state: 17.2%)
• Adult obesity rate: 37.5% (state: 35.8%)
• Median household income: $57,474 (state: $64,124)

• Adults in fair or poor health: 18.9% (state: 19.5%)
• Adult smoking rate: 22.1% (state: 22.2%)
• Adult obesity rate: 37.6% (state: 37.0%)
• Median household income: $57,057 (state: $55,573)

• Adults in fair or poor health: 20.8% (state: 19.0%)
• Adult smoking rate: 21.2% (state: 18.9%)
• Adult obesity rate: 42.5% (state: 38.3%)
• Median household income: $45,001 (state: $52,087)

• Adults in fair or poor health: 12.6% (state: 11.1%)
• Adult smoking rate: 20.2% (state: 18.0%)
• Adult obesity rate: 34.3% (state: 31.3%)
• Median household income: $56,250 (state: $64,767)

• Adults in fair or poor health: 15.1% (state: 10.6%)
• Adult smoking rate: 20.4% (state: 11.1%)
• Adult obesity rate: 37.7% (state: 30.9%)
• Median household income: $67,372 (state: $90,203)

• Adults in fair or poor health: 12.9% (state: 10.8%)
• Adult smoking rate: 15.4% (state: 11.4%)
• Adult obesity rate: 29.2% (state: 24.5%)
• Median household income: $65,520 (state: $89,645)

• Adults in fair or poor health: 16.8% (state: 14.7%)
• Adult smoking rate: 22.2% (state: 19.3%)
• Adult obesity rate: 42.1% (state: 35.3%)
• Median household income: $52,025 (state: $63,498)

• Adults in fair or poor health: 11.7% (state: 10.0%)
• Adult smoking rate: 20.5% (state: 14.3%)
• Adult obesity rate: 33.0% (state: 30.6%)
• Median household income: $64,960 (state: $77,720)

• Adults in fair or poor health: 18.6% (state: 18.7%)
• Adult smoking rate: 19.4% (state: 20.7%)
• Adult obesity rate: 39.1% (state: 39.9%)
• Median household income: $55,444 (state: $48,716)

• Adults in fair or poor health: 16.2% (state: 15.2%)
• Adult smoking rate: 22.2% (state: 18.6%)
• Adult obesity rate: 37.3% (state: 34.2%)
• Median household income: $54,702 (state: $61,847)

• Adults in fair or poor health: 12.9% (state: 12.1%)
• Adult smoking rate: 18.6% (state: 17.5%)
• Adult obesity rate: 35.0% (state: 28.9%)
• Median household income: $57,706 (state: $63,249)

• Adults in fair or poor health: 12.8% (state: 10.2%)
• Adult smoking rate: 17.3% (state: 14.5%)
• Adult obesity rate: 39.1% (state: 34.0%)
• Median household income: $61,749 (state: $66,817)

• Adults in fair or poor health: 16.3% (state: 16.7%)
• Adult smoking rate: 18.4% (state: 14.1%)
• Adult obesity rate: 34.4% (state: 28.1%)
• Median household income: $65,330 (state: $66,274)

• Adults in fair or poor health: 10.9% (state: 10.8%)
• Adult smoking rate: 14.1% (state: 14.7%)
• Adult obesity rate: 29.2% (state: 30.5%)
• Median household income: $91,627 (state: $88,465)

• Adults in fair or poor health: 17.8% (state: 10.8%)
• Adult smoking rate: 19.1% (state: 11.1%)
• Adult obesity rate: 35.7% (state: 27.7%)
• Median household income: $58,389 (state: $89,296)

• Adults in fair or poor health: 17.7% (state: 13.8%)
• Adult smoking rate: 22.6% (state: 16.9%)
• Adult obesity rate: 35.0% (state: 31.7%)
• Median household income: $47,819 (state: $53,992)

• Adults in fair or poor health: 12.5% (state: 11.8%)
• Adult smoking rate: 19.1% (state: 12.3%)
• Adult obesity rate: 33.0% (state: 26.5%)
• Median household income: $60,219 (state: $74,314)

• Adults in fair or poor health: 17.5% (state: 13.5%)
• Adult smoking rate: 20.9% (state: 17.0%)
• Adult obesity rate: 39.0% (state: 33.6%)
• Median household income: $51,769 (state: $61,972)

• Adults in fair or poor health: 11.6% (state: 11.6%)
• Adult smoking rate: 17.8% (state: 17.9%)
• Adult obesity rate: 35.9% (state: 33.6%)
• Median household income: $62,568 (state: $66,519)

• Adults in fair or poor health: 16.3% (state: 14.5%)
• Adult smoking rate: 23.9% (state: 20.2%)
• Adult obesity rate: 36.7% (state: 35.8%)
• Median household income: $59,431 (state: $62,262)

• Adults in fair or poor health: 18.0% (state: 17.3%)
• Adult smoking rate: 20.7% (state: 19.6%)
• Adult obesity rate: 39.4% (state: 37.1%)
• Median household income: $49,422 (state: $55,826)

• Adults in fair or poor health: 15.8% (state: 12.7%)
• Adult smoking rate: 19.1% (state: 13.6%)
• Adult obesity rate: 30.4% (state: 28.3%)
• Median household income: $48,785 (state: $71,562)

• Adults in fair or poor health: 14.4% (state: 13.1%)
• Adult smoking rate: 20.8% (state: 16.7%)
• Adult obesity rate: 33.2% (state: 31.6%)
• Median household income: $52,995 (state: $68,957)

• Adults in fair or poor health: 12.5% (state: 11.8%)
• Adult smoking rate: 15.7% (state: 14.1%)
• Adult obesity rate: 29.6% (state: 30.6%)
• Median household income: $73,788 (state: $74,008)

• Adults in fair or poor health: 18.4% (state: 15.9%)
• Adult smoking rate: 20.8% (state: 19.1%)
• Adult obesity rate: 41.7% (state: 36.7%)
• Median household income: $49,724 (state: $59,318)

• Adults in fair or poor health: 10.8% (state: 10.4%)
• Adult smoking rate: 18.0% (state: 19.0%)
• Adult obesity rate: 32.8% (state: 33.4%)
• Median household income: $63,342 (state: $66,143)

• Adults in fair or poor health: 17.9% (state: 15.7%)
• Adult smoking rate: 19.1% (state: 19.7%)
• Adult obesity rate: 38.8% (state: 35.8%)
• Median household income: $55,840 (state: $59,695)

• Adults in fair or poor health: 19.1% (state: 15.7%)
• Adult smoking rate: 21.1% (state: 13.3%)
• Adult obesity rate: 38.6% (state: 35.8%)
• Median household income: $50,070 (state: $66,963)

• Adults in fair or poor health: 12.0% (state: 10.9%)
• Adult smoking rate: 9.3% (state: 8.3%)
• Adult obesity rate: 30.8% (state: 29.3%)
• Median household income: $61,186 (state: $79,449)

• Adults in fair or poor health: 9.1% (state: 10.6%)
• Adult smoking rate: 13.0% (state: 14.4%)
• Adult obesity rate: 24.5% (state: 26.3%)
• Median household income: $81,852 (state: $72,431)

• Adults in fair or poor health: 14.6% (state: 12.4%)
• Adult smoking rate: 18.6% (state: 13.9%)
• Adult obesity rate: 35.0% (state: 32.4%)
• Median household income: $59,630 (state: $80,963)

• Adults in fair or poor health: 19.2% (state: 11.8%)
• Adult smoking rate: 17.5% (state: 11.6%)
• Adult obesity rate: 37.1% (state: 28.0%)
• Median household income: $61,012 (state: $84,247)

• Adults in fair or poor health: 21.7% (state: 20.0%)
• Adult smoking rate: 25.8% (state: 24.0%)
• Adult obesity rate: 41.8% (state: 39.6%)
• Median household income: $38,737 (state: $51,248)

• Adults in fair or poor health: 12.1% (state: 12.4%)
• Adult smoking rate: 18.4% (state: 16.1%)
• Adult obesity rate: 35.1% (state: 32.7%)
• Median household income: $66,090 (state: $67,125)

• Adults in fair or poor health: 12.2% (state: 11.5%)
• Adult smoking rate: 20.3% (state: 19.4%)
• Adult obesity rate: 34.0% (state: 30.6%)
• Median household income: $63,605 (state: $65,204)