The 10 Sickest (and 10 Healthiest) States in the U.S.

From measles outbreaks to Ebola and the annual flu season, the concern over major health issues continues to grow around the world. But it’s not just outbreaks of highly contagious viruses we have to be concerned with. Lack of physical activity, smoking, and poor diet are lifestyle habits contributing to poor health throughout the U.S. and abroad.

Are some states healthier than others? Are residents of some regions in the U.S. less likely to develop major conditions like diabetes and heart disease? To answer these questions, we evaluated data from AmericasHealthRankings.org to identify the 10 sickest states and, alternatively, the 10 healthiest states in the United States. We also evaluated data from Sickweather.com, consulting a report appearing on Fox News ranking the sickest states for 2014 based on the number of sick reports per thousand residents.

Click here for a custom graphic highlighting the key data points from AmericasHealthRankings.org used to compile this list.

The 10 Sickest States

1. Mississippi

Mississippi

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Mississippi, located in the Southern U.S., comes in dead-last in terms of overall health among all 50 states, according to AmericasHealthRankings.org. Over 35 percent (35.1%) of Mississippi residents are considered obese, with a Body Mass Index (BMI) of 30 or higher. Correspondingly, just over 35 percent (35.2%) of residents in Mississippi report participating in little to no physical activity. Mississippi also lands at number 50 in terms of the most years of potential life lost prior to age 75 due to premature death, with a total of 10,354 estimated years lost for every 100,000 residents. Nearly one-fourth of Mississippi residents smoke (24.8%). Mississippi has a low prevalence of binge drinking, but interestingly, a high rate of immunization coverage among children but a low rate of immunization among teens. There is also a high prevalence of low birth weight in Mississippi. Interestingly, Mississippi was among the healthiest states in 2014 according to Sickweather.com, with 1.22 sick reports per thousand residents.

2. Arkansas

Arkansas

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Arkansas lands at number 48 in terms of obesity, with 34.6 percent of Arkansas residents considered obese. This state also lands at 48 in terms of physical inactivity (31.5 percent of residents report participating in little to no physical activity) and smoking (29.1 percent of Arkansas residents smoke). The state ranks 47th in terms of estimated years of life lost due to premature death, with 9,656 estimated years lost per 100,000 residents. Arkansas boasts high per-capita public health funding, a low prevalence of binge drinking, and a small disparity in health status among educational achievement. However, Arkansas faces a number of challenges, such as a high incidence of infectious disease and low immunization coverage among children. Additionally, dentists are of limited availability in Arkansas.

3. Louisiana

Louisiana

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About one-third of Louisiana’s population has a BMI of 30 or higher, considered obese. Fewer Louisiana residents (30.4 percent) say they participate in little to no physical activity, and just under one-quarter (23.5 percent) smoke. AmericasHealthRankings.org estimates approximately 9,625 years of life are lost due to premature death for every 100,000 residents. Louisiana has a few things going for it in terms of health, including high immunization coverage among teens and a low incidence of pertussis. However, there is a high incidence of infectious disease in Louisiana, a high incidence of low birth weight, and a high rate of preventable hospitalizations in the state.

4. Kentucky

Kentucky

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About one-third of Kentucky residents (33.2%) are considered obese, with a BMI of 30 or higher. A lower number (27.4%) say they participate in no physical activity outside of their regular jobs. About 9,575 years of life are lost for every 100,000 Kentucky residents. Kentucky has the second-highest smoking rate among all 50 states: 26.5 percent. The violent crime rate in Kentucky is low, and there’s also a low prevalence of binge drinking in Kentucky. Immunization coverage among children is high. However, there is a high percentage of children in poverty in Kentucky, as well as a high rate of preventable hospitalizations. Kentucky ranked third among the sickest states in 2014 per Sickweather.com’s data, with 3.25 sick reports per thousand residents.

5. Oklahoma

Oklahoma

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Fewer Oklahoma residents smoke (23.7%) compared to Kentucky, Arkansas, and Mississippi. Just under one-third (32.5%) of Oklahoma residents are considered obese, while 31.1 percent say they participate in no physical activity, such as gardening, golf, running, or walking, outside of their regular jobs. All in all, it’s estimated that 9,654 years of life are lost per 100,000 Oklahoma residents due to premature death. Oklahoma has a low rate of binge drinking and a low prevalence of low birth weight, as well as a low incidence of pertussis. In addition to a high rate of physical inactivity, Oklahoma has low immunization coverage among children, and primary care physicians are limited in availability in the state.

6. Tennessee

Tennessee

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Tennessee is bordered by eight different states, four of which also land in the top 10 sickest states: Kentucky, Alabama, Mississippi, and Arkansas. Tennessee lands second-to-last in terms of physical inactivity, with 33.6 percent of residents participating in no physical activity outside of what is typically required at their regular jobs. Only one state, Mississippi, has a higher rate of physical inactivity than Tennessee. Just under one-quarter (24.3%) of Tennessee residents smoke. Overall, it’s estimated that 9,163 years of life are lost for every 100,000 Tennessee residents due to premature death. In Tennesse, there’s a low prevalence of binge drinking and a low incidence of pertussis. Primary care physicians are readily available in the state. However, in addition to high rates of physical inactivity and obesity, there is also a high crime rate in Tennessee.

7. West Virginia

West Virginia

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West Virginia doesn’t border Tennessee like many of our other top 10 sickest states; however, it sits just on the other side of Kentucky from Tennessee, placing it in the same region of states many in the U.S. consider to be “Southern” states. West Virginia is often considered the Northern-most Southern state, and sometimes the Southern-most Northern state. More West Virginia residents report having smoked at least 100 cigarettes in their lifetimes and currently smoke (27.3%) than any other state in the U.S. West Virginia is also tied with Mississippi as a state with the second-highest rate of obesity: 35.1 percent of West Virginia residents have a BMI of 30 or higher. A high rate of smoking and a high rate of obesity likely contributes to the fact that West Virginia also has the second-highest number of estimated years of life lost due to premature death: 10, 159 years for every 100,000 residents. There’s a low prevalence of both binge drinking and infectious disease in West Virginia, as well as high per-capita public health funding. But, in addition to high rates of smoking and obesity, there is a high rate of drug-related deaths in the state. Children in poverty increased 23 percent in the last year, while violent crime has increased by 44 percent in the past 15 years in West Virginia. In 2014, West Virginia had 2.99 sick reports per thousand residents, ranking at number five among the sickest states per Sickweather.com.

8. Alabama

Alabama

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Another Southern state landing in the top 10 sickest states, Alabama is situated on the Southern border of Tennessee, next to Mississippi. Less than one-third (32.4%) of Alabama residents are considered obese, while 29.2 percent say they participate in no physical activity outside of their regular jobs. Alabama has a lower rate of smoking than all other states ranking in the top 10 sickest states; just 21.5 percent of Alabama residents smoke. Still, Alabama ranks at number 48 in terms of premature death, with an estimated 10,008 years of life lost per 100,000 residents. Alabama has a low prevalence of binge drinking and high immunization coverage among children. There’s also a small disparity in health status by educational attainment. But, there’s a high prevalence of low birth weight in Alabama, a high prevalence of diabetes, and limited availability of dentists.

9. South Carolina

South Carolina

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South Carolina is situated between North Carolina and Georgia (North Carolina to the North, Georgia to the South) along the East Coast of the United States, both of which border Tennessee on the East. South Carolina has a lower rate of physical inactivity than all the other states in the 10 sickest states, with just 24.8 percent of residents reporting that they participate in no physical activity outside of activities at their regular jobs. Only 22 percent of South Carolina residents smoke, also a lower rate than many of the other 10 sickest states. Less than one-third (31.7%) of South Carolina residents are considered obese. An estimated 8,645 years of life are lost due to premature death for every 100,000 South Carolina residents. South Carolina has a few things going for it, such as a low prevalence of both binge drinking and pertussis, as well as a low rate of preventable hospitalizations. However, challenges include a low rate of high school graduation and a high prevalence of both low birth weight and diabetes.

10. Indiana

Indiana

 

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Rounding out our list of the 10 sickest states is Indiana. While not a Southern state like most of the other 10 sickest states, Indiana does sit just North of Kentucky. Just over 20 percent (21.9%) of Indiana residents smoke, while 28.3 percent are physically inactive (participating in no physical activity outside of their regular jobs). However, 31.8 percent of Indiana residents are considered obese. These factors, as well as others, contribute to an estimated 7,993 years of life lost due to premature death. There’s a low rate of infectious disease in Indiana, a low percentage of children in poverty, and high immunization coverage among teens in Indiana. On the downside, there’s a high prevalence of both physical inactivity and obesity, as well as a high rate of air pollution.

Trends Among the Sickest States

There’s a clear regional trend among the 10 sickest states: 8 of 10 of the states named above are considered Southern states, and nine of the 10 are physically connected to at least one other state in the top 10 sickest states. The exception is South Carolina, which doesn’t actually border Tennessee but is separated only by a narrow strip comprised of parts of Georgia and North Carolina.

It’s also clear that states with the highest rates of obesity generally correlate with the states with the highest number of lives lost due to premature death. All 10 sickest states rank among the 10 states with the highest rates of obesity. Additionally, nine out of 10 states among the sickest states also rank among the 10 states with the highest rates of physical inactivity. It makes sense: Physical activity contributes to obesity, which in turn contributes to other health conditions such as heart disease and diabetes — diseases often linked to premature death.

The 10 Healthiest States

1. Hawaii

Hawaii

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Topping the list of the 10 healthiest states is Hawaii, which is not a part of the continental U.S. Hawaii boasts the second-lowest rate of obesity among all 50 states, with just 21.8 percent of residents considered obese. Hawaii ranks third in terms of the lowest smoking rates; just 13.3 percent of Hawaiians smoke. Just over 20 percent (20.7%) of Hawaiians participate in no physical activity outside of their regular jobs. In terms of estimated years of life lost due to premature death, Hawaii is ranked 9th by AmericasHealthRankings.org, with 5,685 years of life lost per 100,000 residents due to premature death. In Hawaii, there’s also a low rate of preventable hospitalizations and a low rate of cancer deaths. Binge drinking and infectious disease are problems in Hawaii, however, and the state also has low immunization coverage among children.

2. Vermont

Vermont

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Vermont ranks second among the healthiest states, with just under one-quarter (24.7%) of residents falling into the obese category. Just 18.8 percent of residents in Vermont say they don’t participate in any physical activity, such as running, walking, or gardening, outside of their regular jobs. Vermont also boasts low rates of smoking, with 16.6 percent of residents saying they have smoked at least 100 cigarettes in their lifetime and currently smoke. Overall, 5,679 estimated years of life are lost per 100,000 Vermont residents due to premature death. There’s a high rate of high school graduation in Vermont, a low percentage of children in poverty, and a low violent crime rate. On the downside, there’s a high prevalence of binge drinking in Vermont and low immunization coverage among children. Additionally, there’s a large disparity in health status by educational attainment, meaning people with higher levels of education are generally healthier than those who may have only graduated high school or attended trade school. Vermont was also among the healthiest states in 2014 according to Sickweather.com, which reports 1.38 sick reports per thousand residents.

3. Massachusetts

Massachusetts

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Ranking third among the 10 healthiest states is Massachusetts, where, like Vermont, 16.6 percent of residents smoke. Just over one-fifth of Massachusetts residents (21%) participate in no physical activity outside of their regular jobs, while 23.6 percent of residents have a BMI of 30 or higher, placing them in the obese category. An estimated 5,345 years of life are lost due to premature death among residents of Massachusetts. Massachusetts boasts a low percentage of uninsured individuals and families, and primary care physicians are readily available in the state. There’s also a low infant mortality rate in Massachusetts. However, there is a high rate of preventable hospitalizations and a high prevalence of binge drinking, as well as a large disparity in health status by educational attainment. Interestingly, Massachusetts ranked ninth among the sickest states in 2014 per Sickweather.com, based on 2.63 sick reports per thousand residents.

4. Connecticut

Connecticut

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Another New England state ranking in the top 10 healthiest states, Connecticut has a low rate of smoking, with just 15.5 percent of residents reporting that they have smoked at least 100 cigarettes in their lifetime and currently smoke. Physical inactivity and obesity also fall under 25 percent, with 22.8 percent of Connecticut residents considered obese and 24.9 percent considered obese. It’s estimated that 5,603 years of life are lost due to premature death in Connecticut. There is also a low rate of occupational fatalities in Connecticut, as well as high immunization coverage among children. On the downside, there’s a high prevalence of both binge drinking and preventable hospitalizations. Like Massachusetts and Vermont, there’s a high disparity in health status by educational attainment in Connecticut.

5. Utah

utah

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Utah has the lowest rate of smoking among all 50 states, with just 10.3 percent of residents currently smoking. Less than one-fifth (19.1%) are physically inactive, while 24.1 percent of residents of Utah are considered obese. An estimated 6,143 years of life are lost due to premature death among Utah residents. There’s also a low rate of children in poverty in Utah, as well as a low rate of preventable hospitalizations. There is, however, a high rate of drug-related deaths in the state, low immunization coverage among teens, and limited availability of primary care physicians.

6. Minnesota

Minnesota

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In Minnesota, less than one-fifth (18%) of residents smoke. While 25.5 percent of Minnesota residents are considered obese, less (21.2%) say they don’t participate in any physical activity outside of what’s required at their regular jobs. An estimated 5,358 years of life are lost due to premature death in Minnesota. There is a low rate of drug-related deaths in Minnesota, as well as a low prevalence of diabetes. And, according to AmericasHealthRankings.org, Minnesota residents experience few poor physical health days. Binge drinking is prevalent in the state, and there is a high incidence of pertussis. Public health funding in Minnesota is low per-capita, as well.

7. New Hampshire

New Hampshire

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New Hampshire has a slightly higher rate of obesity (26.7%) than the states ranking higher among the 10 healthiest states, but just about one-fifth (20.5%) of residents in New Hampshire say they don’t participate in any physical activity outside of their regular jobs. Just 16.2 percent of New Hampshire residents smoke, placing the state at number 8 overall, among all 50 states, for smoking. An estimated 5,580 years of life are lost due to premature death in New Hampshire. In New Hampshire, there’s a low incidence of infectious disease and high immunization coverage among teens, as well as a low infant mortality rate. However, there is also a high prevalence of binge drinking, a high rate of drug-related deaths, and low per-capita public health funding. New Hampshire was one of the healthiest states in 2014 per Sickweather.com, with 1.48 sick reports per thousand residents, landing the state ninth overall.

8. Colorado

Colorado

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Colorado is an active state, ranking at number one among all 50 states for the lowest rate of physical inactivity. Just 16.2 percent of Colorado residents say they don’t participate in any physical activity outside of their regular jobs. More than one-fifth (21.3%) of Colorado residents are considered obese, while 17.7 percent of residents smoke. It’s estimated that 5,991 years of life are lost due to premature death in Colorado. Colorado also has a low prevalence of diabetes. Binge drinking is prevalent in the state, however, as well as low birth weight. There’s also a large disparity in health status by educational attainment.

9. North Dakota

North Dakota

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North Dakota lands at number 9 among the 10 healthiest states in the U.S. Thirty-one percent of residents in North Dakota have a BMI of 30 or higher, and are therefore classified as obese. Just over one-quarter (25.8%) are physically inactive, meaning they participate in no physical activity, such as gardening, running, or golfing, outside of their regular jobs. Just over one-fifth (21.2%) of North Dakota residents smoke, and an estimated 6,878 years of life are lost due to premature death in North Dakota. There’s a low rate of drug-related deaths in North Dakota, as well as a low prevalence of low birth weight. Additionally, North Dakota has high immunization coverage among teens. Binge drinking is prevalent in North Dakota, however, as it is in many other states landing in the top 10 healthiest states, and there’s a high rate of occupational fatalities in the state.

10. Nebraska

Nebraska

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Rounding out the top 10 healthiest states in the U.S. is Nebraska, where just under 30 percent (29.6%) of residents are considered obese. Less than one-fourth of residents (23.5%) are physically inactive, participating in no physical activity outside of their regular jobs. Less than 20 percent (18.5%) of Nebraska residents smoke, and an estimated 6,224 years of life are lost due to premature death in Nebraska. There’s a low rate of drug-related deaths in Nebraska, as well as a high rate of high school graduation and high immunization coverage among children. However, there is a high prevalence of binge drinking and a high incidence of Salmonella in the state, as well as a large disparity in health status by educational attainment. Nebraska ranked 10th among the sickest states according to Sickweather.com in 2014, with 2.48 sick reports per thousand residents.

Trends Among the Healthiest States

While the regional trends among the healthiest states are not as clear-cut as those with the sickest states, overall, most of the states landing in the top 10 healthiest states are located in New England and the Midwest U.S. Colorado, Utah, and Nebraska are all located in the Midwest, with North Dakota also positioned in the Central U.S. but North to the other Midwest states in the top 10. Several top 10 healthiest states are located in New England, including Vermont, Massachusetts, Connecticut, and New Hampshire.

The correlation among the health risk factors discussed are also not as cut-and-dry among the 10 healthiest states, although seven out of the 10 healthiest states also rank in the top 10 for low rates of obesity, while five out of 10 rank in the top 10 for low rates of physical activity. Only three of the top 10 rank in the top 10 for low smoking rates, but an additional two states are tied for the 11th position in terms of the percentage of residents who currently smoke.

Whether you live in a state considered among the sickest, the healthiest, or somewhere in the middle, there are both controllable and uncontrollable factors that may impact your health. If your state has high amounts of air pollution, for instance, there’s little you can do short of moving to a healthier state. That said, there are many factors well within your control for managing your own health and wellness. Being more physically active, participating in regular exercise, eating a healthy diet, and choosing not to smoke (or quitting if you already do), are just a few of the things within reach that can improve your overall health, no matter where you live.

Health of U.S. States Graphic

Is your state not in the top 10 sickest or the top 10 healthiest states? You can find out where all 50 individual states rank in terms of health in the data graphic below, which also highlights the key data points from AmericasHealthRankings.org used to compile this list.

 

Sickest and healthiest states in America
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