The Least Healthy City in Every State

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46. Virginia: Roanoke
> Premature death rate (per 100,000): 415.7 (state: 318.9)
> Adult obesity rate: 29.9% (state: 28.8%)
> Adult smoking rate: 16.5% (state: 15.3%)
> Median household income: $54,233 (state: $71,535)

Premature death — before age 75 — is more prevalent in Roanoke than in any other metro area in Virginia. There are 412 premature deaths for every 100,000 people annually in the metro area, compared to the state rate of 319 premature deaths per 100,000 Virginia residents.

Smoking is the leading cause of preventable death in the United States, and in Roanoke, 16.5% of adults are smokers, compared to 15.3% of adults across the state. Additionally, obesity is a risk factor for a number of potentially deadly diseases and conditions, including diabetes, heart disease, and certain cancers. In Roanoke, 29.9% of adults are obese, slightly higher than the 28.8% state obesity rate.

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47. Washington: Yakima
> Premature death rate (per 100,000): 362.4 (state: 288.7)
> Adult obesity rate: 32.1% (state: 27.6%)
> Adult smoking rate: 15.2% (state: 13.9%)
> Median household income: $47,402 (state: $70,979)

In Yakima, Washington, 21.2% of adults report being in fair or poor health, by far the largest share of any metro area in the state and more than the 13.9% of adults across Washington who report similar health outcomes.

Living with serious financial hardship can reduce access to health care options as well as reduce the ability to make healthier lifestyle choices, and as a result, poorer Americans often report worse health outcomes. In Yakima, 18.1% of residents live below the poverty line, compared to the state poverty rate of 11.0%.

Source: Tim Kiser (w:User:Malepheasant) / Wikimedia Commons

48. West Virginia: Beckley
> Premature death rate (per 100,000): 592.2 (state: 492.7)
> Adult obesity rate: 39.3% (state: 36.3%)
> Adult smoking rate: 24.3% (state: 24.8%)
> Median household income: $42,493 (state: $43,469)

Beckley, West Virginia, has the highest premature death rate in the United States. There are 592 deaths before age 75 annually for every 100,000 people, more than the state rate of 493 per 100,000 and the national rate of 340 per 100,000. Smoking is the leading cause of preventable death in the United States, and in Beckley, 24.3% of adults smoke, the largest share of any metro area in the state and well above the 17.0% national smoking rate.

Those who are unemployed are more likely to have unhealthy behaviors and to report worse health outcomes than those who are employed. In Beckley, the unemployment rate stands at 5.7%, higher than the 5.3% rate across the state.

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49. Wisconsin: Milwaukee-Waukesha-West Allis
> Premature death rate (per 100,000): 355.4 (state: 308.5)
> Adult obesity rate: 31.1% (state: 31.1%)
> Adult smoking rate: 16.2% (state: 17.1%)
> Median household income: $59,448 (state: $59,305)

Education and income are two of the primary determinants of health. While some 35.8% of adults in Milwaukee have a bachelor’s degree and 5.7% of households in the metro area earn at least $200,000 a year — each the second largest share in Wisconsin — it still ranks as the least healthy city in the state.

Some 8.7% of births in Milwaukee are considered low birthweight, by far the largest share in Wisconsin and more than the 7.3% rate statewide. Low birthweight is often an indication of poor maternal health. Similarly, 355 in every 100,000 Milwaukee residents die before the age of 75, more than the state premature death rate of 309 per 100,000 and the highest rate of any city in the state.

Source: Andrew Farkas / Wikimedia Commons

50. Wyoming: Casper
> Premature death rate (per 100,000): 386.8 (state: 348.5)
> Adult obesity rate: 31.5% (state: 28.5%)
> Adult smoking rate: 16.9% (state: 18.9%)
> Median household income: $60,546 (state: $60,434)

In Casper, Wyoming, there are 387 deaths before age 75 for every 100,000 people annually, a higher premature death rate than in Cheyenne — the only other metro area in the state — and across Wyoming as a whole.

Obesity is a risk factor for a number of potentially deadly diseases and conditions, including diabetes, heart disease, and certain cancers. In Casper, 31.5% of adults are obese, higher than the 28.5% state obesity rate and the 30.5% obesity rate in Cheyenne.