This Unhealthy American City Has a 42.9% Obesity Rate

Although personal choices matter, where you live can have an impact on your health. Some cities are known for being walkable, having safe bike lanes, access to good quality healthcare, and other factors that can improve well-being. However, other cities have higher pollution rates, less access to healthcare, and a limited amount of green spaces in which to exercise outdoors. Read on to see if your town made our list of unhealthy American cities. (Also see the most obese states in the US.)

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.

To determine the least healthy one in every state 384 metro areas were considered. Rhode Island, New Hampshire, Vermont, and Delaware each have only one metro area, and it is therefore listed here by default – though by default, it is also the state's healthiest metro area. (Note that the cities listed for some states are core cities for metro areas that extend across state borders; these are identified as such.)

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)