1. Alabama: Gadsden
> Premature death rate (per 100,000): 563.3 (state: 471.6)
> Adult obesity rate: 36.1% (state: 35.1%)
> Adult smoking rate: 23.1% (state: 21.5%)
> Median household income: $41,576 (state: $48,123)
Unhealthy lifestyles are relatively common in Gadsden, Alabama. Adults in the metro area are more likely to smoke and more likely to be obese than adults across the state as a whole. They are also less likely to exercise. More than one in every three adults in the metro area have sedentary lifestyles, compared to 28.2% of adults across the state and 22.0% of American adults nationwide.
Unhealthy habits may be taking a toll. The age-adjusted premature death rate of 563.3 deaths before age 75 for every 100,000 people annually is well above the premature death rate statewide of 472 per 100,000, and is the third highest rate of any metro area.
2. Alaska: Anchorage
> Premature death rate (per 100,000): 354.3 (state: 361.4)
> Adult obesity rate: 29.7% (state: 30.4%)
> Adult smoking rate: 15.9% (state: 19.0%)
> Median household income: $76,871 (state: $73,181)
Of the two metro areas in Alaska — Anchorage and Fairbanks — Anchorage ranks as the least healthy. Adults in Anchorage are less likely to exercise regularly and slightly more likely to be obese than those living in Fairbanks. Also, unlike in Fairbanks, adults in Anchorage report an average of over three mentally unhealthy days per month.
Those who are unemployed are more likely to have unhealthy behaviors such as high alcohol and tobacco consumption and poor diet, and report worse health outcomes than those who are employed. In Anchorage, the unemployment rate stands at 6.0%, higher than the 5.8% rate in Fairbanks.
3. Arizona: Lake Havasu City-Kingman
> Premature death rate (per 100,000): 508.8 (state: 331.2)
> Adult obesity rate: 31.9% (state: 27.2%)
> Adult smoking rate: 20.0% (state: 14.7%)
> Median household income: $42,311 (state: $56,581)
Lake Havasu City has the highest premature death rate of any of the seven metro areas in Arizona. There are 509 deaths before age 75 annually for every 100,000 people in the metro area, more than double the statewide rate of 331 per 100,000.
Such severe negative health outcomes are likely partially attributable to unhealthy lifestyles in the metro area. For example, 20.0% of adults in Lake Havasu City smoke, compared to just 14.7% of adults statewide. Additionally, 31.9% of area adults are obese, compared to 27.2% of adults across the state. Obesity is a risk factor for a number of potentially fatal diseases and conditions, including heart disease, diabetes, and certain cancers.
4. Arkansas: Pine Bluff
> Premature death rate (per 100,000): 561.3 (state: 462.1)
> Adult obesity rate: 40.1% (state: 35.2%)
> Adult smoking rate: 22.1% (state: 23.6%)
> Median household income: $39,914 (state: $45,869)
Pine Bluff is the least healthy metro area in Arkansas and one of the least healthy nationwide. Of the 382 metro areas in the United States, Pine Bluff is one of only two where over 40% of adults are obese. Obesity is a risk factor for a number of potentially deadly diseases and conditions, including diabetes, heart disease, and certain cancers, and premature death is far more common in Pine Bluff than it is across the state as a whole. For every 100,000 people in the metro area, there are 561 deaths before age 75 annually, compared to a rate of 462 deaths per 100,000 people across Arkansas.
Lower-income Americans have less access to quality health care options than those with higher incomes, and are less able to afford many of the components of a healthy lifestyle. In Pine Bluff, the typical household earns just $39,914 a year, compared to the median income of $45,869 statewide and $60,336 nationwide.
5. California: Bakersfield
> Premature death rate (per 100,000): 398.6 (state: 272.3)
> Adult obesity rate: 30.6% (state: 22.7%)
> Adult smoking rate: 16.2% (state: 11.0%)
> Median household income: $49,854 (state: $71,805)
Of the 26 metro areas in California, Bakersfield is the least healthy. Smoking is the leading cause of preventable death in the United States, and in Bakersfield, 16.2% of adults are smokers, the largest share of any metro area in the state and higher than the statewide smoking rate of 11.0%. Bakersfield residents are also far less likely to exercise than the typical Californian. Just 77.0% of metro area adults engage in some leisure-time physical activity, compared to 82.6% of adults across the state.
The prevalence of sedentary lifestyles in Bakersfield may be due in part to a lack of exercise opportunities. Less than 80% of metro area residents have access to places for exercise like parks or recreation centers, compared to over 90% of all Californians.