The 10 Sickest U.S. Metro Areas

Related: 10 Healthiest U.S. Metro Areas

Health is wealth, and bad health is like a termite nibbling away at a client's finances. The U.S. Centers for Disease Control and Prevention has a tool you can use to get an idea of how the people in a given community are doing: results from the Behavioral Risk Factor Surveillance System. The BRFSS team interviews 400,000 people ages 18 and older every year. One of the many questions asked, in the health status class, is, "Would you say that in general your health is..." The possible answers range from "poor" to "excellent." For a look at the 10 metropolitan areas where the highest percentage of survey participants described their own health as poor, see the gallery above. For data on all 43 areas included in this analysis, see the table below.

What It Means

Bad health will hit clients in some cities harder than in others. In communities where bad health is common, clients may need more help with medical billing problems, drafting and updating health care planning documents, and understanding the programs and tax provisions available to people with high medical bills. Those clients may also be more likely to need advice about disability; retirement before age 65; and life insurance policies, annuity contracts and long-term care planning arrangements designed for people who cannot get through a conventional medical underwriting process.

Data Details

The BRFSS team asks many targeted questions related to health status, such as whether survey participants have had cancer, or whether they have had diabetes. The team also records data at many different geographic levels, including the census tract level and the state level. For this article, we used BRFSS city data. The BRFSS program gives 2020 health status answer information for 118 metropolitan areas. For the gallery above — and a more comprehensive table provided below — we included only metropolitan areas with at least 50 survey participants who described their health as poor. Because the percentage of people who describe their health as poor is relatively small, the margins of error are large. But, in general, it looks as if the communities that did poorly in terms of how people described their health also performed poorly in connection with other indicators, such as the percentage who said poor health had forced them to avoid their normal activities on 14 or more of the past 30 days.

The Context

Researchers and health insurance pricing teams will be poring over health status data for decades, to try to determine how the COVID-19 pandemic and efforts to fight the pandemic, such as lockdowns, vaccination programs and COVID-19 treatments, have affected public health. In 2020, the pandemic control efforts may have led to an improvement in the overall health of U.S. residents. In 2020, in all 118 communities included in the BRFFS data, the median level of survey participants saying they were in poor health was just 2.8%. That was down from medians of 4% both in 2015 and in 2019. For the 43 communities with 50 or more responses from people saying they were in poor health in 2020, the median poor health level fell to 2.8% in 2020, from 3.8% in 2015.

U.S. Poor Health Levels