Most Unhealthy States in the U.S. 2025

“Health” is generally defined as being free from illness or injury or as a person’s mental or physical condition, but the whole subject is much more complicated than that. For example, the World Health Organization takes it a step further and defines health as a state of complete physical, mental, and social well-being, not just as the absence of disease or infirmity. The social definition tends to side with the WHO and sees general health on a much bigger scale.

Today, being healthy is a multifaceted undergoing that looks different for everyone in each region. It’s also measured differently for everyone. You can easily find people who value changing their appearance, gaining weight, losing weight, creating the absence of medical conditions, preserving mental well-being, or achieving “physical fitness” all in one sitting. Physical fitness itself has many different definitions and depends completely on who you ask.

Yet even with all these intentions present, the United States annually outspends every other country on healthcare. The U.S. also continues to struggle with a high prevalence of chronic health conditions and preventable deaths, and that shows in the data below.

Levels of Health Among States

Like many other things, health levels and statistics are not uniform across all 50 states. This is evident in the obesity rates growing across the country. Obesity is a major health problem in the United States. It can lead to other serious health problems, such as certain types of cancer, type 2 diabetes, heart disease, and stroke. The Centers for Disease Control and Prevention (CDC) reported that the adult obesity rate in the U.S. was 42.4% in 2017-2018. This is a significant increase from 30.5% in 1999-2000.

As of 2021, Health Rankings from the United Health Foundation found that the states with the highest rates of obesity are Alabama, West Virginia, and Mississippi. Not only is obesity the most prevalent disease in the nation, but it’s also the most expensive. In 2019 alone, the obesity epidemic cost Americans over 179 billion dollars.

Additionally, the prevalence of diabetes in the U.S. has increased from 9.5% to 10.9% from 2012 to 2018. While healthy behaviors and active lifestyles are the largest contributors to good health, health can be affected by several factors, including housing, financial safety (especially household income](/state-rankings/per-capita-income-by-state)), lifestyle/culture, employment, community safety, education, and environment. Because these factors can vary greatly between states, each state has a different overall level of health and well-being](/state-rankings/healthiest-states).

Most Unhealthy U.S. States

With all that said, which states are the unhealthiest? To determine that, data representing all sorts of issues were taken into account from 2019 America’s Health Rankings to the American Diabetes Association’s data on how many prediabetics there are in each state. The ranking specifically includes factors such as healthy behaviors, quality of health care, health policy, the presence of disease, and deaths from illnesses.

Additional data in the table below includes other criteria that indicate health issues beyond obesity and diabetes, including frequency of mental distress, the percent of the population with multiple chronic conditions, the percent of the population that is prediabetic, life expectancy, and overall COVID-19 cases with the percentage of the population affected for scale. Below you’ll find the ten most unhealthy states in the United States, and you’ll see a sad trend where most of the unhealthiest states in the U.S. are mostly located in the South.

1. Louisiana

Overtaking Mississippi, Louisiana is the most unhealthy state according to data collected in 2021. They have the second-highest rate of mental distress (17.6%), the third-lowest life expectancy of 73.1, the eighth-highest rate of multiple chronic disorders (12.3%), and over 30% of their population has gotten a confirmed COVID-19 case. About 30.8% of Louisiana’s residents report no regular exercise, the fifth-highest for that statistic.

2. Alabama

Alabama is the second most unhealthy state in the United States. Over 15% of the population experiences frequent mental distress, 14.3% experience multiple chronic conditions, and the fourth lowest life expectancy of 73.2 years. Even though the state has a high percentage of high school graduation and a low prevalence of excessive drinking, it has the third highest rate of obesity at 39%. Alabama also has the second-highest infant mortality rate at 8.2 deaths per 100,000 people.

3. West Virginia

Coming in at number three, we have West Virginia. It has the highest number of drug deaths of any state at 48.3 deaths per 100,000 people. West Virginia also has the second-highest obesity rate at 39.1% and the highest adult smoking rate at 25.2%. Other figures that set them back include the rate of frequent mental distress (17.5%), the percentage of prediabetics in the state (34.8%), and the second-lowest life expectancy of 72.8.

4. Kentucky

Kentucky residents struggle with a high prevalence of issues. They have the second-highest rate of multiple chronic conditions (16.1%), the third-highest rate of COVID-19 cases over the course of the pandemic (35.7%), and the fifth-lowest life expectancy of 73.5. Kentucky also has an adult smoking rate is 23.4%, the second-highest in the country. Kentucky, however, does have a high percentage of high school graduation, a low prevalence of excessive drinking, and a low violent crime rate.

5. Arkansas

The fifth most unhealthy state is Arkansas, with the highest rate of frequent mental distress, the fourth-highest rate of multiple chronic conditions, and the ninth-highest rate of obesity of 36.4%. Sadly, Arkansas residents also have the 6th lowest life expectancy in the nation at 73.8.

6. South Carolina

Even though South Carolina does not perform the worst in any one category, they do have relatively poor health across the board, securing its number six spot. They have the 10th lowest life expectancy of 74.8 and the 11th highest rate of both obesity and prediabetics, 36.2% and 34.9%, respectively. Additionally, they have the 7th highest rates of overall COVID-19 cases and multiple chronic conditions across the nation.

7. Oklahoma

With the 7th highest rate of frequent mental distress, Oklahoma is the seventh-most unhealthy state in the U.S. Like South Carolina, Oklahoma doesn’t have very poor performances in any one category, but rather badly, generally, in each category. Their 7th spot in the most unhealthy states is secured by their high amounts of people with obesity, prediabetes, and multiple chronic conditions. They also have the eighth-lowest life expectancy of 74.1.

8. Mississippi

Mississippi has one of the worst track records for health as it is often considered the most unhealthy state in the United States. Even though it only has the 11th-highest rate of COVID cases and the 7th-highest rate of people suffering from multiple chronic conditions, the state has the fifth-highest rate of prediabetes at 35.6%. Mississippi also has the highest rate of obesity (39.7%) and the lowest life expectancy (71.9) in the country.

9. Missouri

While Missouri does pretty well in some categories, like overall COVID-19 cases and the rate of prediabetics, it does poorly in others. They have the 19th-highest rate of obesity in adults, the 12th-highest rate of frequent mental distress, and the 12th-highest rate of multiple chronic conditions across the states. Additionally, they have the twelfth-lowest life expectancy at 75.1.

10. Tennessee

Tennessee does very poorly in regard to overall health when you look at each category. The least problematic statistics include the percentage of the population that is prediabetic, where they rank 23rd. The amount of obesity isn’t horrible, ranking 13th. But Tennessee did have the seventh-lowest life expectancy (73.8) and overall COVID-19 cases, as well as the 6th-highest rate of frequent mental distress (16.1%) and the 5th-highest rate of multiple chronic conditions (13.8%).