The unhealthiest county in each US state

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

More articles on rankings and ratings:
The 282 hospitals with 1 star from CMS
The 293 hospitals with 5 stars from CMS
IBM Watson names 100 top hospitals

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