These Are the Least Healthy States in America

By Michael Kasian
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According to the United Health Foundation, America ranks near the bottom for life expectancy when compared to other developed nations. At the same time, America continues to surpass other countries in vital health spending. So which states are contributing to the U.S. health crisis the most?

We compared several health rankings by state using data from the Center for Disease Control (CDC), The Journal of the American Medical Association (JAMA) and the United Health Foundation (UHF). By observing the worst fitness rankings, the highest rate of smokers, the highest populations at risk for disease, the greatest levels of obesity and the worst overall health, we determined these are the least healthy states in America.

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30. Illinois

The home of Chicago and deep dish pizzas starts off the list ranking at number 30. In the past six years, obesity increased 15%, from 27.1% to 31.1% of adults in Illinois. The state also faces high levels of air pollution and issues related to excessive drinking.

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Photo Courtesy: Brian D. Kersey/Getty Images Sport/Getty Images

CDC's Worst Physical Fitness Ranking: 35th
CDC's Highest Rate of Smokers Ranking: 35th
JAMA's Highest Risk of Disease Ranking: 30th
CDC's Highest Obesity Ranking: 27th
UHF's Worst Health Ranking: 25th

Average Score for Least Healthy State in America: 30.4

29. Maine

In the past five years, smoking decreased 15%, from 20.3% to 17.3% of adults in Maine. However, the state still ranks 18th in the country for the most smokers per state. In addition, chlamydia increased 34%, from 232.9 to 312.6 cases per every 100,000 residents.

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Photo Courtesy: Joel Page/Portland Press Herald/Getty Images

CDC's Worst Physical Fitness Ranking: 30th
CDC's Highest Rate of Smokers Ranking: 18th
JAMA's Highest Risk of Disease Ranking: 27th
CDC's Highest Obesity Ranking: 33rd
UHF's Worst Health Ranking: 34th

Average Score for Least Healthy State in America: 28.4

28. Montana (Tie)

Even though Montana has beautiful landscapes and hiking trails, its residents rank 15th on the CDC scale of least physically fit. Death by cancer increased 3%, from 178.3 to 183.3 deaths per every 100,000 residents. The state is also challenged by a lower number of primary care physicians.

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Photo Courtesy: Wolfgang Kaehler/LightRocket/Getty Images

CDC's Worst Physical Fitness Ranking: 15th
CDC's Highest Rate of Smokers Ranking: 22nd
JAMA's Highest Risk of Disease Ranking: 24th
CDC's Highest Obesity Ranking: 46th
UHF's Worst Health Ranking: 29th

Average Score for Least Healthy State in America: 27.2

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28. Florida (Tie)

The bright sunshine and beautiful Florida beaches create a relaxed, enjoyable lifestyle. Unfortunately, it may keep many Floridians from staying physically fit. In the past five years alone, obesity increased 13%, from 25.2% to 28.4% of adults.

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Photo Courtesy: Joe Raedle/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 18th
CDC's Highest Rate of Smokers Ranking: 33rd
JAMA's Highest Risk of Disease Ranking: 28th
CDC's Highest Obesity Ranking: 35th
UHF's Worst Health Ranking: 22nd

Average Score for Least Healthy State in America: 27.2

26. Wisconsin

The great state of Wisconsin ranks 26th on the list for many reasons. First, 9.1% of adults live with diabetes in the state. Second, 5.4% of the population are uninsured. Wisconsin also has a high number of residents with excessive drinking problems, with more than 24% of all adults engaging in the dangerous behavior.

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Photo Courtesy: Steve Levin/Getty Images Sport/Getty Images

CDC's Worst Physical Fitness Ranking: 24th
CDC's Highest Rate of Smokers Ranking: 26th
JAMA's Highest Risk of Disease Ranking: 36th
CDC's Highest Obesity Ranking: 21st
UHF's Worst Health Ranking: 28th

Average Score for Least Healthy State in America: 27

25. Nevada

Sin City's home state ranks 25th on the list, partially due to UHF's claim that Nevada is the 15th unhealthiest state. In the past four years, premature deaths increased 8% in Nevada, totaling 7,899 years lost before age 75 statewide.

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Photo Courtesy: Education Images/Universal Images Group/Getty Images

CDC's Worst Physical Fitness Ranking: 26th
CDC's Highest Rate of Smokers Ranking: 31st
JAMA's Highest Risk of Disease Ranking: 19th
CDC's Highest Obesity Ranking: 43rd
UHF's Worst Health Ranking: 15th

Average Score for Least Healthy State in America: 26.8

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24. Pennsylvania

The land of Philly cheesesteaks unfortunately serves up several health complications as well. In the past three years, drug deaths increased 50%, from 18.7 to 28.1 deaths per every 100,000 people. The state also has a high prevalence of frequent physical distress.

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Photo Courtesy: Ricky Carioti/The Washington Post/Getty Images

CDC's Worst Physical Fitness Ranking: 39th
CDC's Highest Rate of Smokers Ranking: 15th
JAMA's Highest Risk of Disease Ranking: 21st
CDC's Highest Obesity Ranking: 24th
UHF's Worst Health Ranking: 23rd

Average Score for Least Healthy State in America: 24.4

23. Texas (Tie)

Texas is a massive state that lives loud and proud down in the South. On the positive side, smoking and air pollution in the state decreased over the last few years. However, cardiovascular deaths and mental distress increased 4% and 28%, respectively, across the state.

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Photo Courtesy: Jana Birchum/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 23rd
CDC's Highest Rate of Smokers Ranking: 42nd
JAMA's Highest Risk of Disease Ranking: 23rd
CDC's Highest Obesity Ranking: 14th
UHF's Worst Health Ranking: 14th

Average Score for Least Healthy State in America: 23.2

23. New Mexico (Tie)

New Mexico has faced several health and wellbeing crises recently. For example, young New Mexicans experience a lower high school graduation rate in comparison to other states. New Mexico has also fallen victim to a violent crime surge in the last four years, increasing 40% from 559 to 784 offenses per every 100,000 residents.

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Photo Courtesy: Robert Alexander/Archive Photos/Getty Images

CDC's Worst Physical Fitness Ranking: 21st
CDC's Highest Rate of Smokers Ranking: 34th
JAMA's Highest Risk of Disease Ranking: 10th
CDC's Highest Obesity Ranking: 35th
UHF's Worst Health Ranking: 16th

Average Score for Least Healthy State in America: 23.2

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21. North Dakota

North Dakota ranks 21st on the list, mostly due to its low physical fitness ranking and high obesity ranking. Drug deaths are unfortunately also on the rise statewide, increasing 207% in the last three years, from 2.7 to 8.3 deaths per every 100,000 North Dakotans.

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CDC's Worst Physical Fitness Ranking: 14th
CDC's Highest Rate of Smokers Ranking: 16th
JAMA's Highest Risk of Disease Ranking: 34th
CDC's Highest Obesity Ranking: 13th
UHF's Worst Health Ranking: 37th

Average Score for Least Healthy State in America: 22.8

20. Iowa

Iowa has a lot going for it in the health department. It has a high percentage of high school graduates, a low drug death rate and a low prevalence of frequent physical distress. Unfortunately, the state also has a high prevalence of obesity, ranking fourth on the CDC's highest obesity list.

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Photo Courtesy: Melanie Stetson Freeman/Christian Science Monitor/Getty Images

CDC's Worst Physical Fitness Ranking: 19th
CDC's Highest Rate of Smokers Ranking: 19th
JAMA's Highest Risk of Disease Ranking: 38th
CDC's Highest Obesity Ranking: 4th
UHF's Worst Health Ranking: 32nd

Average Score for Least Healthy State in America: 22.4

19. Kansas

Kansas lands at number 19 on the list due to its growing obese adult population. Roughly 32.3% of all adults are currently obese in Kansas. That number is certainly troubling, especially when combined with the data that more residents drink unhealthy amounts of alcohol.

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Photo Courtesy: Mark Reinstein/Corbis Historical/Getty Images

CDC's Worst Physical Fitness Ranking: 22nd
CDC's Highest Rate of Smokers Ranking: 21st
JAMA's Highest Risk of Disease Ranking: 22nd
CDC's Highest Obesity Ranking: 18th
UHF's Worst Health Ranking: 24th

Average Score for Least Healthy State in America: 21.4

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18. Delaware

Delaware has made some great improvements over the last few years. Cancer deaths, air pollution and excessive drinking have all decreased. However, adults in Delaware demonstrate a high frequency of physical inactivity, landing them at 12th in the country for worst physical fitness ranking.

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CDC's Worst Physical Fitness Ranking: 12th
CDC's Highest Rate of Smokers Ranking: 29th
JAMA's Highest Risk of Disease Ranking: 20th
CDC's Highest Obesity Ranking: 23rd
UHF's Worst Health Ranking: 20th

Average Score for Least Healthy State in America: 20.8

17. North Carolina

In the last five years, North Carolina has gone through some major changes — and not for the better. Drug deaths have increased 25%, from 13 to 16.2 per every 100,000 residents. Obesity has also increased 8%, impacting 32.1% of adults. The state also has high incidences of chlamydia and other dangerous diseases.

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CDC's Worst Physical Fitness Ranking: 20th
CDC's Highest Rate of Smokers Ranking: 23rd
JAMA's Highest Risk of Disease Ranking: 16th
CDC's Highest Obesity Ranking: 20th
UHF's Worst Health Ranking: 18th

Average Score for Least Healthy State in America: 19.4

16. Alaska

The good news for Alaska is it has one of the most active communities across the country. The bad news is residents still have a top obesity ranking, a high percentage of smokers and an increasing rate of violent crime.

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CDC's Worst Physical Fitness Ranking: 43rd
CDC's Highest Rate of Smokers Ranking: 10th
JAMA's Highest Risk of Disease Ranking: 15th
CDC's Highest Obesity Ranking: 9th
UHF's Worst Health Ranking: 19th

Average Score for Least Healthy State in America: 19.2

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15. South Dakota

South Dakota has a major air quality problem, as the increased rate of forest fires continues to lower the air quality for most of its residents. At the same time, nearly 10% of all adult South Dakotans have reported frequent mental distress, according to the CDC.

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CDC's Worst Physical Fitness Ranking: 8th
CDC's Highest Rate of Smokers Ranking: 13th
JAMA's Highest Risk of Disease Ranking: 25th
CDC's Highest Obesity Ranking: 22nd
UHF's Worst Health Ranking: 26th

Average Score for Least Healthy State in America: 18.8

14. Michigan

Michigan is facing a drug overdose challenge. In the last 10 years, drug deaths increased 106%, from 10.1 to 20.8 deaths per every 100,000 residents. More people die of drug overdoses than car crashes throughout the state.

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Photo Courtesy: Bill Pugliano/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 25th
CDC's Highest Rate of Smokers Ranking: 14th
JAMA's Highest Risk of Disease Ranking: 17th
CDC's Highest Obesity Ranking: 19th
UHF's Worst Health Ranking: 17th

Average Score for Least Healthy State in America: 18.4

13. Georgia

Georgia has a number of challenges impacting its communities. For starters, it has a high percentage of uninsured residents. There is also low immunization coverage for children and a high prevalence of low birthweight babies born statewide. On the plus side, children living in poverty decreased 23% in the last five years.

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Photo Courtesy: Paras Griffin/Getty Images Entertainment/Getty Images

CDC's Worst Physical Fitness Ranking: 13th
CDC's Highest Rate of Smokers Ranking: 28th
JAMA's Highest Risk of Disease Ranking: 13th
CDC's Highest Obesity Ranking: 24th
UHF's Worst Health Ranking: 12th

Average Score for Least Healthy State in America: 18

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12. Missouri

Missouri is in the midst of a major crime wave. St. Louis, home of the Gateway Arch, has had the nation’s highest big-city murder rate every year since 2014. Statistically speaking, there are 530 violent crimes committed for every 100,000 Missouri residents.

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Photo Courtesy: Christopher Smith/The Washington Post/Getty Images

CDC's Worst Physical Fitness Ranking: 27th
CDC's Highest Rate of Smokers Ranking: 6th
JAMA's Highest Risk of Disease Ranking: 12th
CDC's Highest Obesity Ranking: 17th
UHF's Worst Health Ranking: 13th

Average Score for Least Healthy State in America: 15

11. Ohio

Ohio has one of the largest smoking populations in the country, with 21.1% of all adult Ohioans are smokers. At the same time, millions of people in Ohio continue to be exposed to excessive amounts of air pollution. The city of Cincinnati ranks among the 10 most populated areas with the highest levels of air pollution.

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Photo Courtesy: Rick Gershon/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 28th
CDC's Highest Rate of Smokers Ranking: 4th
JAMA's Highest Risk of Disease Ranking: 14th
CDC's Highest Obesity Ranking: 11th
UHF's Worst Health Ranking: 11th

Average Score for Least Healthy State in America: 13.6

10. South Carolina

South Carolina finds itself at number 10 on the list for several reasons. The state is challenged with a high prevalence of diabetes and a high premature death rate. It also has one of the poorest physical fitness records and an ever increasing obese population.

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Photo Courtesy: Jeff Hutchens/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 3rd
CDC's Highest Rate of Smokers Ranking: 20th
JAMA's Highest Risk of Disease Ranking: 9th
CDC's Highest Obesity Ranking: 10th
UHF's Worst Health Ranking: 8th

Average Score for Least Healthy State in America: 10

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9. Tennessee

Premature deaths and cancer deaths are top issues in Tennessee. One of the main reasons the state could be faced with such challenges is the high rate of smokers. Tennessee has the seventh highest population of smokers in the country.

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Photo Courtesy: John Greim/LightRocket/Getty Images

CDC's Worst Physical Fitness Ranking: 7th
CDC's Highest Rate of Smokers Ranking: 7th
JAMA's Highest Risk of Disease Ranking: 8th
CDC's Highest Obesity Ranking: 16th
UHF's Worst Health Ranking: 9th

Average Score for Least Healthy State in America: 9.4

8. Indiana

Indiana residents have a problem staying active, resulting in almost 30% of all adults being classified as physically inactive. Minimal physical activity puts residents at greater risk of developing the major health challenges plaguing Indiana, including obesity and frequent mental distress.

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Photo Courtesy: Zbigniew Bzdak/Chicago Tribune/Tribune News Service/Getty Images

CDC's Worst Physical Fitness Ranking: 4th
CDC's Highest Rate of Smokers Ranking: 8th
JAMA's Highest Risk of Disease Ranking: 11th
CDC's Highest Obesity Ranking: 12th
UHF's Worst Health Ranking: 10th

Average Score for Least Healthy State in America: 9

7. Oklahoma

Oklahoma has the third highest obesity rate per state, with 36.5% of residents tipping the scales. At the same time, 14% of the population are uninsured, leaving many to avoid seeing doctors for treatment. As a result, cardiovascular deaths are on the rise, increasing 5% in the past three years.

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Photo Courtesy: JEWEL SAMAD/AFP/Getty Images

CDC's Worst Physical Fitness Ranking: 10th
CDC's Highest Rate of Smokers Ranking: 17th
JAMA's Highest Risk of Disease Ranking: 5th
CDC's Highest Obesity Ranking: 3rd
UHF's Worst Health Ranking: 4th

Average Score for Least Healthy State in America: 7.8

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6. Louisiana

One of the leading challenges facing Louisianans is the high percentage of children living in poverty. An upsetting 28% of all children in the Pelican State currently live below the poverty level. This is partly caused by a statewide lack of access to enough food, good jobs and education for its citizens statewide.

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CDC's Worst Physical Fitness Ranking: 16th
CDC's Highest Rate of Smokers Ranking: 9th
JAMA's Highest Risk of Disease Ranking: 4th
CDC's Highest Obesity Ranking: 6th
UHF's Worst Health Ranking: 1st

Average Score for Least Healthy State in America: 7.2

5. Alabama

Alabama has faced many challenges in the last few years. Obesity increased 13%, diabetes increased 19% and drug deaths increased 26%. The state also has a high cardiovascular death rate and ranks third for contracting the most dangerous diseases.

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Photo Courtesy: Jeff Greenberg/Universal Images Group/Getty Images

CDC's Worst Physical Fitness Ranking: 11th
CDC's Highest Rate of Smokers Ranking: 12th
JAMA's Highest Risk of Disease Ranking: 3rd
CDC's Highest Obesity Ranking: 5th
UHF's Worst Health Ranking: 3rd

Average Score for Least Healthy State in America: 6.8

4. Arkansas

Arkansas is the first state in the countdown to rank in the top 10 on each of the ranking lists. That puts residents of the state at risk of some major health challenges. According to the United Health Foundation, the people of Arkansas suffer physical and mental distress at dangerous levels.

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CDC's Worst Physical Fitness Ranking: 5th
CDC's Highest Rate of Smokers Ranking: 3rd
JAMA's Highest Risk of Disease Ranking: 6th
CDC's Highest Obesity Ranking: 7th
UHF's Worst Health Ranking: 5th

Average Score for Least Healthy State in America: 5.2

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3. Kentucky

Kentucky ranks third on the list due to its number of smokers and poor physical fitness rankings. It also faces a major life expectancy challenge. The top eight counties in America with the largest declines in life expectancy since 1980 are all in Kentucky.

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Photo Courtesy: Sam Owens/Bloomberg/Getty Images

CDC's Worst Physical Fitness Ranking: 2nd
CDC's Highest Rate of Smokers Ranking: 2nd
JAMA's Highest Risk of Disease Ranking: 7th
CDC's Highest Obesity Ranking: 8th
UHF's Worst Health Ranking: 6th

Average Score for Least Healthy State in America: 5

2. West Virginia

West Virginia comes in second on the overall list but ranks highest in number of smokers and rate of obesity. About 26% of all West Virginians are smokers, and almost 40% of all adults qualify as obese. Unfortunately, West Virginia’s next generation risks following in those dangerous footsteps, as more than 25% of children live with limited resources.

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Photo Courtesy: Joe Raedle/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 6th
CDC's Highest Rate of Smokers Ranking: 1st
JAMA's Highest Risk of Disease Ranking: 2nd
CDC's Highest Obesity Ranking: 1st
UHF's Worst Health Ranking: 7th

Average Score for Least Healthy State in America: 3.4

1. Mississippi

Mississippi ranks as the least healthy state in America. They rank the highest for physical inactivity and highest risk of disease. Diabetes and cancer are both on the rise, and the state has one of the highest infant mortality rates.

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Photo Courtesy: Win McNamee/Getty Images News/Getty Images

CDC's Worst Physical Fitness Ranking: 1st
CDC's Highest Rate of Smokers Ranking: 5th
JAMA's Highest Risk of Disease Ranking: 1st
CDC's Highest Obesity Ranking: 2nd
UHF's Worst Health Ranking: 2nd

Average Score for Least Healthy State in America: 2.2

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