America’s Least Healthy Cities


To determine the least healthy cities in the United States, 24/7 Tempo reviewed county-level data from the 2023 County Health Rankings & Roadmaps program of the University of Wisconsin Population Health Institute. Metropolitan statistical areas were ranked based on an index consisting of eight health measures, all using data from the CHR.

The measures are: The years of potential life lost before age 75 per 100,000 residents from 2018 to 2020; the percentage of adults reporting fair or poor health in 2020; the average number of physically unhealthy days reported in the last 30 days in 2020; the percentage of live births with low birthweight from 2014 to 2020; the percentage of adults who are current smokers in 2020; the percentage of adults reporting a body mass index of 30 or greater in 2020; the number of preventable hospital stays for ambulatory-care sensitive conditions per 100,000 Medicare enrollees in 2020; and the number of deaths due to injury per 100,000 residents from 2016 to 2020.

All data was aggregated from the county level to the metropolitan level using boundary definitions from the U.S. Census Bureau and was weighted by county population. Supplemental data on median household income is from the Census Bureau’s 2021 American Community Survey and are one-year estimates.