The Most Unhealthy Counties in America

by | April 6, 2012 at 1:41 PM | Health

By 24/7 Wall St.

The United States is often compared to other countries when it comes to health care. Among developed countries, we spend more than any other nation, while Americans remain relatively unhealthy. But what about within the U.S.? Do all regions suffer from poor health? The answer, obviously, is no. In fact, the difference in health from one area to the other is striking.

A report published by the County Health Rankings & Roadmaps ranks the overall health of the residents living in the country’s 3,141 counties. The rank measures health outcomes based on the residents’ length of life (mortality) and quality of life (morbidity). According to the report, the four factors that comprise this are lifestyle, health care, environment and social and economic conditions, such as education and income. 24/7 Wall St. ranked the 1,000 largest counties by population to identify the counties with the best and worst health.

The environment is one of the major factors affecting the health of the population. This includes exposure to air pollution and access to healthy food and recreational facilities. The counties with the worst health were not among the worst in terms of pollution, but they had relatively poor access to healthy activity and healthy food. In three of the least healthy counties, 15% or more did not have access to healthy choices. For example, in nine of the 10 regions, fast-food restaurants represented more than half of the available eating out options.

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Clinical care is another factor measured by the study that had a clear impact on health. This is the actual availability and use of health care facilities and physicians. According to the data, the ratio of physicians to residents in several of these counties with the poorest health is worse than 2,000 to one. The rate of preventable hospital stays is also very high in these counties, meaning they did not receive effective care before forced to stay in a hospital. As a result, six of the 10 counties are in the top 10% for having the highest rate of preventable hospital stays.

Not surprisingly, healthy behavior is another important factor. Unhealthy behavior includes smoking, poor eating and a lack of exercise. According to Patrick Remington, MD, director of the project, smoking and obesity are among the biggest risk factors that contribute to poor health: “If you don’t smoke, you exercise, and you eat right — you’ve done about two-thirds of what you can do to live a long and healthy life.”

Health data of the most unhealthy counties supports this. Five of the 10 counties with the worst health were in the top 30 (out of 1,000) for obesity. Four were in the top 50 for smoking, including Scioto County, Ohio, which had the highest rate of smoking of the 1,000 counties.

None of these factors, however, were as strong an indicator of poor health as the socioeconomic conditions of the residents of these counties. Unemployment rates in seven of the 10 counties are greater than 10% — far above the national average. All 10 are among the highest 10% for children living below the poverty line. In nine of the 10 least healthy counties, 19% or more could not afford to even see a doctor. In three counties with the worst health, 28% of the residents could not afford to see a physician.

According to Dr. Remington, improving healthy behavior requires improving the economy. “If you don’t have jobs, you don’t have the tax base, and you don’t have the utility to fund schools,” which are needed to encourage healthy behavior. “Without a fundamental economic base, it’s really hard to grow a healthy community.”

These are the most unhealthy counties in America:

10. Pearl River, Miss.
> Premature deaths (years of life lost per 100,000): 12,162 (16th highest)
> Percent reporting fair or poor health: 22% (77th highest)
> Infants born with low birth weight: 9.4% (144th highest)
> Children in poverty: 32% (87th highest)
> Largest municipality: Picayune

Pearl River County stands out as particularly unhealthy compared to the rest of the country in a number of categories. Perhaps most striking is the vast number of residents dying prematurely. Of the 1,000 counties in the report, Pearl River ranks 16th worst in this category. The residents’ unhealthy lifestyle contributes to their poor health. Thirty-two percent of adults in the region smoke — the country’s fifth-highest rate. At 63%, the county also has one of the highest rates of fast-food restaurants among all restaurants. Additionally, the county has one of the highest rates of preventable hospital stays among medicare enrollees.

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9. Russell, Ala.
> Premature deaths (years of life lost per 100,000): 11,929 (21st highest)
> Percent reporting fair or poor health: 23% (71st highest)
> Infants born with low birth weight: 10.5% (71st highest)
> Children in poverty: 36% (34th highest)
> Largest municipality: Phenix City

Alabama’s Russell County is among the country’s most unhealthy regions in a number of areas. Its obesity rate of 39% is one of the nation’s highest, as is its physical inactivity rate of 37%. Nearly one in every two households with children in Russell is a single parent household, and 36% of children in the county are living in poverty — among the country’s highest rates. In addition to all of this, 64% of restaurants in the county serve fast food, reflecting a generally unhealthy environment.

8. Scioto, Ohio
> Premature deaths (years of life lost per 100,000): 11,262 (44th highest)
> Percent reporting fair or poor health: 26% (27th highest)
> Infants born with low birth weight: 9.7% (118th highest)
> Children in poverty: 32% (84th highest)
> Largest municipality: Portsmouth

On average, residents of Scioto, Ohio, report being physically unhealthy 7.1 days out of each month — the second-highest rate in the country. They also report being mentally unhealthy 6.2 days each month, which is the fifth-highest rate in the country. As is the case with many other counties on this list, Scioto has a number of particularly unhealthy behavioral traits. For example, 36% of residents are smokers — the country’s highest rate. The county also has among the highest rates of preventable hospital stays among medicare enrollees.

7. Cabell, W.V.
> Premature deaths (years of life lost per 100,000): 11,787 (26th highest)
> Percent reporting fair or poor health: 21% (131st highest)
> Infants born with low birth weight: 11.3% (38th highest)
> Children in poverty: 35% (tied for 39th highest)
> Largest municipality: Huntington

Cabell’s health failings are numerous and perhaps most apparent in the high rate of births with low weight. The county ranks among the worst in the country in that category with more than 11% of babies born with low birth weight. The county also has relatively high rates for the number of days residents report being physically unhealthy and mentally unhealthy each month at 4.8 and 4.7, respectively. Additionally, 14% of adults in the area are diabetic, which is among the nation’s highest rates.

6. Halifax, N.C.
> Premature deaths (years of life lost per 100,000): 11,680 (31st highest)
> Percent reporting fair or poor health: 29% (11th highest)
> Infants born with low birth weight: 13.5% (fifth highest)
> Children in poverty: 37% (tied for 26th highest)
> Largest municipality: Roanoke Rapids

According to the CDC’s Behavioral Risk Factor Surveillance System, nearly one in every three residents in Halifax County reports being in fair or poor health. The county has the fifth-highest rate of infants born with low birth weight in the country at 13.5% — a strong indicator of poor health. The county also has an obesity rate of 39%, which is one of the country’s highest. A whopping 37% of adults in Halifax report lacking social or emotional support — the highest rate in the nation.

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5. Walker, Ala.
> Premature deaths (years of life lost per 100,000): 15,601 (the highest)
> Percent reporting fair or poor health: 31% (third highest)
> Infants born with low birth weight: 9.9% (105th highest)
> Children in poverty: 35% (tied for 39th highest)
> Largest municipality: Jasper

Walker County has the worst rate of premature deaths in the country, according to the National Center for Health Statistics. Among county residents, 31% report having fair or poor health — the nation’s third-highest rate. They report being physically unhealthy an average of 5.9 days each month and mentally unhealthy 5.0 days each month. Both of these rates are among the country’s worst. At 32%, the county has the fifth-highest rate of residents who have limited access to healthy food, as well as the fifth-highest rate of physically inactive adults at 38%.

4. Mercer, W.V.
> Premature deaths (years of life lost per 100,000): 12,022 (18th highest)
> Percent reporting fair or poor health: 25% (33rd highest)
> Infants born with low birth weight: 12.3% (18th highest)
> Children in poverty: 31% (99th highest)
> Largest municipality: Bluefield

Mercer County is among the worst in the country in a variety of health metrics. The rate of premature death is particularly high, as is the rate of infants born with low birth weight and the percentage of people who report being physically inactive. One in four residents claim to be in fair or poor health, with the average person reportedly being physically unhealthy 5.6 days each month. On average, each resident is mentally unhealthy 4.6 days out of each month.

3. Columbus, N.C.
> Premature deaths (years of life lost per 100,000): 12,501 (11th highest)
> Percent reporting fair or poor health: 28% (14th highest)
> Infants born with low birth weight: 11.6% (29th highest)
> Children in poverty: 41% (14th highest)
> Largest municipality: Whiteville

There are a number of health-related areas in which Columbus performs particularly poorly. Most notable is its high rate of prematurely lost life, which ranks 11th worst. This can, in part, be explained by the county’s exceptionally high rate of motor vehicle deaths at 42 per 1,000 people. In addition, 31% of adults feel they lack social or emotional support and 41% — one of the highest rates in the country. The percentage of children living below the poverty level is also extremely high at 41%.

2. Pike, Ky.
> Premature deaths (years of life lost per 100,000): 13,251 (eighth highest)
> Percent reporting fair or poor health: 36% (the highest)
> Infants born with low birth weight: 10.6% (63rd highest)
> Children in poverty: 37% (tied for 26th highest)
> Largest municipality: Pikeville

Of the 1,000 counties in the report, Kentucky’s Pike is absolute worst in a number of categories. For example, 36% of residents report being in fair or poor health, which is the highest recorded rate. Additionally, residents report being physically unhealthy an average of 7.9 days per month and mentally unhealthy 7.0 days per month — the highest amounts in the country. Pike residents also have the highest rate of diabetes, the highest rate of physical inactivity, and the highest rate of preventable hospital stays among medicare enrollees.

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1. Talladega, Ala.
> Premature deaths (years of life lost per 100,000): 12,212 (14th highest)
> Percent reporting fair or poor health: 30% (tied, seventh highest)
> Infants born with low birth weight: 12.7% (13th highest)
> Children in poverty: 34% (63rd highest)
> Largest municipality: Talladega

Talladega County is, by many counts, the most unhealthy county in the country. Thirty percent of adults report being in fair or poor health, among the country’s highest rates. A particularly high 12.7% of children are born with low birth weight. The county also has among the highest rates of residents who report fair or poor health, are obese, have no social or emotional support and have diabetes. The average number of days residents report being physically unhealthy each month is 5.3, and the number of days residents report being mentally unhealthy is 5.2. Both of these are among the worst in the country.

Michael B. Sauter, Charles B. Stockdale

The opinions expressed are solely those of the author and do not necessarily reflect the views of XFINITY.