Secure, affordable housing plays a major role in health outcomes, according to The Robert Wood Johnson Foundation's 2019 County Health Rankings.
The report, released March 19, found 11 percent of U.S. households spend more than half their income on housing costs. An increase in severe housing cost burden was also associated with more food insecurity, child poverty and people in fair or poor health.
The Robert Wood Johnson Foundation, in collaboration with the University of Wisconsin Population Health Institute in Madison, has shared updated County Health Rankings annually since 2010.
The rankings use state and national data to compare U.S. counties on more than 30 measures across four areas: health behaviors, clinical care, physical environment, and social and environmental factors. Measures include access to care, income, and alcohol or drug use. The list ranks counties in all 50 states based on their performance on these health measures relative to the health of other counties in each state.
Below is a list of the county with the worst health outcomes in each state. Take a deep dive into county health outcomes per state by clicking here. To see a list of the healthiest county in each state, click here.
Alabama
Lowndes County
Alaska
Kusilvak County
Arizona
Apache County
Arkansas
Phillips County
California
Lake County
Colorado
Costilla County
Connecticut
Windham County
Delaware
Kent County
Florida
Union County
Georgia
Warren County
Hawaii
Hawaii County
Idaho
Owyhee County
Illinois
Vermilion County
Indiana
Fayette County
Iowa
Appanoose County
Kansas
Chautauqua County
Kentucky
Owsley County
Louisiana
East Carroll County
Maine
Washington County
Maryland
Baltimore City County
Massachusetts
Hampden County
Michigan
Crawford County
Minnesota
Mahnomen County
Mississippi
Quitman County
Missouri
Pemiscot County
Montana
Big Horn County
Nebraska
Thurston County
Nevada
Nye County
New Hampshire
Coos County
New Jersey
Cumberland County
New Mexico
McKinley County
New York
Bronx County
North Carolina
Robeson County
North Dakota
Sioux
Ohio
Adams County
Oklahoma
Choctaw County
Oregon
Klamath County
Pennsylvania
Philadelphia County
Rhode Island
Providence County
South Carolina
Lee County
South Dakota
Oglala Lakota County
Tennessee
Clay County
Texas
San Augustine County
Utah
San Juan County
Vermont
Essex County
Virginia
Petersburg City County
Washington
Ferry County
West Virginia
McDowell County
Wisconsin
Menominee County
Wyoming
Fremont County