While much attention goes to the healthiest counties, understanding the least healthy counties is equally important. These communities face the greatest public health challenges and stand to benefit most from targeted interventions. We identified the 25 counties with the worst health rankings to understand where help is needed most.
These counties are concentrated in the Deep South, Appalachia, and parts of the Southwest. Texas (14 counties), Georgia (5 counties), Mississippi (3 counties), Alaska (1 counties), South Dakota (1 counties) are most represented in the bottom 25.
The 25 Counties with the Worst Health Rankings
Kenedy County, TX has the lowest health score in America at 0. The counties at the bottom of the rankings consistently struggle with high chronic disease rates, limited healthcare access, and economic hardship.
| Rank | County | State | Health Score | Life Expectancy | Uninsured Rate |
|---|---|---|---|---|---|
| 1 | Kenedy County | TX | 0 | N/A | 37.68% |
| 2 | Edwards County | TX | 1 | N/A | 29.42% |
| 3 | Issaquena County | MS | 1.9 | N/A | 22.95% |
| 4 | Briscoe County | TX | 2.5 | N/A | 21.47% |
| 5 | King County | TX | 3.9 | N/A | 20.3% |
| 6 | Atkinson County | GA | 4 | 69.12 | 20.71% |
| 7 | Jefferson County | GA | 4.4 | 68.79 | 18.6% |
| 8 | Crosby County | TX | 4.4 | 69.33 | 22.01% |
| 9 | Candler County | GA | 4.6 | 67.8 | 20.23% |
| 10 | Dawson County | TX | 4.7 | 70.69 | 22.11% |
| 11 | Terry County | TX | 4.7 | 70.84 | 23.59% |
| 12 | Yukon-Koyukuk Census Area | AK | 4.8 | 67.34 | 19.13% |
| 13 | Swisher County | TX | 4.9 | 70.3 | 28.06% |
| 14 | Humphreys County | MS | 5.2 | 66.57 | 15.47% |
| 15 | Brooks County | TX | 5.2 | 70.3 | 17.91% |
| 16 | Zavala County | TX | 5.2 | 69.88 | 17.14% |
| 17 | Cochran County | TX | 5.3 | 71.37 | 23.49% |
| 18 | Duval County | TX | 5.4 | 70.31 | 17.96% |
| 19 | Potter County | TX | 5.4 | 70.82 | 22.89% |
| 20 | Dimmit County | TX | 5.5 | 70.97 | 19.45% |
| 21 | Clinch County | GA | 5.7 | 69.76 | 18.5% |
| 22 | Dewey County | SD | 5.7 | 56.66 | 17.61% |
| 23 | Quitman County | MS | 6 | 66.91 | 15.2% |
| 24 | Treutlen County | GA | 6.1 | 70.3 | 19.49% |
| 25 | Coal County | OK | 6.2 | 70.01 | 19.23% |
Common Challenges in Low-Ranked Counties
The counties with the worst health outcomes face a consistent set of interconnected challenges:
- High uninsured rates: Many bottom-ranked counties have uninsured rates above 15%, with some exceeding 25%.
- Physician shortages: Primary care provider ratios in these counties are often below 40 per 100,000 residents.
- Economic distress: Poverty rates, unemployment, and food insecurity are consistently higher than national averages.
- Limited mental health resources: Mental health provider ratios in these counties are frequently among the lowest in the nation.
- Environmental factors: Higher rates of air pollution, limited access to healthy food, and fewer opportunities for physical activity compound health problems.
Methodology
Health scores use CDC County Health Rankings (2024) percentile-rank methodology on a 0-100 scale, where 0 represents the worst health outcomes relative to all US counties. Metrics include life expectancy, premature death, poor/fair health rate, uninsured rate, and provider access.
Data sources: CDC County Health Rankings & Roadmaps (2024), a Robert Wood Johnson Foundation program, and U.S. Census Bureau American Community Survey (2019-2023). All figures are estimates and may differ from other published analyses due to methodology differences. This content is informational only and does not constitute medical advice.