Prevention

Cholesterol Screening by County — US Rankings

CDC PLACES 2023 · Age-adjusted prevalence · All 3,144 US counties

Cholesterol screening tracks the share of adults aged 18+ who report having had a blood-cholesterol check within the past five years. It is a standard primary-care prevention indicator that the US Preventive Services Task Force has endorsed for decades. The county-level rankings closely track insurance coverage, primary-care availability, and Medicare uptake — older counties with strong Medicare coverage often rank high. The five-year window is generous compared to clinical-guideline cycles, so the rate is high in most counties.

How this ranking is built

Source: CDC PLACES 2023 release. Methodology: BRFSS survey responses pooled across years, fitted with a small-area statistical model, age-adjusted to the 2000 US standard population. Confidence intervals (95%) are shown for each county — wider intervals indicate more uncertainty in the modeled estimate, typically driven by smaller populations.

Highest Cholesterol Screening Rates — Top 100 Counties

Counties with the highest reported cholesterol screening rates — these counties lead the nation on this measure.

#	County	Rate	95% CI	State
1	Howard County	90.4%	88.9 – 91.7	Maryland
2	District of Columbia	90.2%	88.4 – 91.8	District of Columbia
3	Norfolk County	90.0%	88.1 – 91.5	Massachusetts
4	Nantucket County	90.0%	88.2 – 91.6	Massachusetts
5	Middlesex County	90.0%	88.2 – 91.6	Massachusetts
6	Nassau County	89.8%	88.1 – 91.2	New York
7	Montgomery County	89.6%	88.0 – 91.0	Maryland
8	Westchester County	89.3%	87.6 – 90.9	New York
9	Falls Church city	89.2%	87.2 – 91.0	Virginia
10	Barnstable County	89.2%	87.1 – 91.0	Massachusetts
11	Charles County	89.2%	87.5 – 90.6	Maryland
12	Somerset County	89.1%	87.3 – 90.7	New Jersey
13	Bergen County	89.1%	87.3 – 90.7	New Jersey
14	Suffolk County	89.0%	87.3 – 90.8	New York
15	New York County	89.0%	87.2 – 90.6	New York
16	Morris County	89.0%	87.0 – 90.8	New Jersey
17	Western Connecticut Planning Region	89.0%	88.0 – 90.0	Connecticut
18	Arlington County	88.9%	87.0 – 90.5	Virginia
19	Hunterdon County	88.9%	86.9 – 90.7	New Jersey
20	Anne Arundel County	88.9%	87.1 – 90.7	Maryland
21	Putnam County	88.8%	86.9 – 90.6	New York
22	Hampshire County	88.8%	86.7 – 90.6	Massachusetts
23	Bristol County	88.7%	86.3 – 90.9	Rhode Island
24	Wake County	88.7%	86.7 – 90.4	North Carolina
25	Plymouth County	88.7%	86.6 – 90.6	Massachusetts
26	Dukes County	88.7%	86.4 – 90.8	Massachusetts
27	Prince George's County	88.7%	86.8 – 90.2	Maryland
28	Loudoun County	88.6%	86.7 – 90.3	Virginia
29	Saratoga County	88.6%	86.3 – 90.6	New York
30	Frederick County	88.6%	86.6 – 90.2	Maryland
31	Lower Connecticut River Valley Planning Region	88.6%	87.4 – 89.7	Connecticut
32	Washington County	88.5%	86.2 – 90.7	Rhode Island
33	Tompkins County	88.5%	86.6 – 90.2	New York
34	Monmouth County	88.5%	86.4 – 90.4	New Jersey
35	Oakland County	88.5%	86.5 – 90.2	Michigan
36	Fairfax County	88.4%	86.6 – 90.1	Virginia
37	Williamson County	88.4%	86.3 – 90.4	Tennessee
38	Newport County	88.4%	86.0 – 90.5	Rhode Island
39	Richmond County	88.4%	86.4 – 90.2	New York
40	Dutchess County	88.4%	86.4 – 90.1	New York
41	Suffolk County	88.4%	86.6 – 90.2	Massachusetts
42	Calvert County	88.4%	86.5 – 90.2	Maryland
43	Alexandria city	88.3%	86.3 – 90.0	Virginia
44	Hamilton County	88.3%	86.1 – 90.1	Indiana
45	Northwest Hills Planning Region	88.3%	87.1 – 89.4	Connecticut
46	Burlington County	88.2%	86.1 – 90.0	New Jersey
47	Worcester County	88.2%	86.3 – 90.0	Massachusetts
48	Essex County	88.2%	86.1 – 89.9	Massachusetts
49	Fayette County	88.2%	86.1 – 90.0	Georgia
50	Capitol Planning Region	88.2%	87.1 – 89.2	Connecticut
51	Queens County	88.1%	86.4 – 89.6	New York
52	Kings County	88.1%	86.4 – 89.6	New York
53	Harford County	88.1%	86.0 – 90.1	Maryland
54	Forsyth County	88.1%	85.9 – 90.0	Georgia
55	Albany County	88.0%	86.1 – 89.9	New York
56	Middlesex County	88.0%	86.0 – 89.8	New Jersey
57	Fulton County	88.0%	86.0 – 89.8	Georgia
58	South Central Connecticut Planning Region	88.0%	86.6 – 89.4	Connecticut
59	Kent County	87.9%	85.5 – 89.9	Rhode Island
60	Orange County	87.9%	85.6 – 89.9	North Carolina
61	Mecklenburg County	87.9%	85.9 – 89.7	North Carolina
62	Rockland County	87.9%	85.7 – 89.7	New York
63	Ontario County	87.9%	85.7 – 89.9	New York
64	Monroe County	87.9%	85.8 – 89.7	New York
65	Mercer County	87.9%	86.0 – 89.7	New Jersey
66	Talbot County	87.9%	85.6 – 89.7	Maryland
67	Baltimore County	87.9%	86.1 – 89.5	Maryland
68	Oconee County	87.9%	86.1 – 89.6	Georgia
69	DeKalb County	87.9%	85.9 – 89.6	Georgia
70	Cobb County	87.9%	85.9 – 89.8	Georgia
71	Providence County	87.8%	85.8 – 89.7	Rhode Island
72	Ulster County	87.8%	85.7 – 89.8	New York
73	Madison County	87.8%	85.7 – 89.6	Mississippi
74	St. Mary's County	87.8%	85.8 – 89.7	Maryland
75	Carroll County	87.8%	85.6 – 89.7	Maryland
76	Durham County	87.7%	85.7 – 89.6	North Carolina
77	Rensselaer County	87.7%	85.5 – 89.7	New York
78	Gloucester County	87.7%	85.7 – 89.6	New Jersey
79	Naugatuck Valley Planning Region	87.7%	86.7 – 88.7	Connecticut
80	Greater Bridgeport Planning Region	87.7%	86.3 – 89.0	Connecticut
81	York County	87.6%	85.3 – 89.6	Virginia
82	James City County	87.6%	85.6 – 89.7	Virginia
83	Schenectady County	87.6%	85.5 – 89.7	New York
84	Orange County	87.6%	85.7 – 89.4	New York
85	Onondaga County	87.6%	85.5 – 89.5	New York
86	Erie County	87.6%	85.5 – 89.5	New York
87	Union County	87.6%	85.7 – 89.4	New Jersey
88	Washtenaw County	87.6%	85.4 – 89.3	Michigan
89	Franklin County	87.6%	85.3 – 89.7	Massachusetts
90	Worcester County	87.6%	85.3 – 89.6	Maryland
91	Queen Anne's County	87.6%	85.2 – 89.7	Maryland
92	Henry County	87.6%	85.6 – 89.4	Georgia
93	Prince William County	87.5%	85.5 – 89.3	Virginia
94	Goochland County	87.5%	85.3 – 89.7	Virginia
95	Albemarle County	87.5%	85.4 – 89.5	Virginia
96	Columbia County	87.5%	85.1 – 89.5	New York
97	Sussex County	87.5%	85.2 – 89.7	New Jersey
98	Bristol County	87.5%	85.2 – 89.6	Massachusetts
99	Berkshire County	87.5%	85.1 – 89.6	Massachusetts
100	Fairfax city	87.4%	85.2 – 89.3	Virginia

Lowest Cholesterol Screening Rates — Bottom 100 CountiesCounties with the lowest reported cholesterol screening rates.

#	County	Rate	95% CI	State
1	Kalawao County	67.4%	64.4 – 70.1	Hawaii
2	Kusilvak Census Area	70.4%	66.9 – 74.0	Alaska
3	Bethel Census Area	71.7%	68.4 – 75.1	Alaska
4	Nome Census Area	74.1%	70.9 – 77.0	Alaska
5	Northwest Arctic Borough	74.1%	70.8 – 77.4	Alaska
6	Yukon-Koyukuk Census Area	74.2%	71.1 – 77.2	Alaska
7	Dillingham Census Area	74.5%	71.3 – 77.6	Alaska
8	Oglala Lakota County	74.6%	71.0 – 78.1	South Dakota
9	Sioux County	74.8%	71.4 – 78.1	North Dakota
10	Todd County	75.2%	71.5 – 78.7	South Dakota
11	Butte County	75.3%	71.8 – 78.5	Idaho
12	Glacier County	75.6%	72.5 – 78.5	Montana
13	Lake and Peninsula Borough	75.7%	72.8 – 78.7	Alaska
14	McKinley County	75.8%	72.2 – 79.1	New Mexico
15	Owyhee County	75.9%	73.0 – 78.9	Idaho
16	Benewah County	76.0%	72.5 – 79.1	Idaho
17	Roosevelt County	76.1%	73.2 – 79.1	Montana
18	Toole County	76.1%	72.5 – 79.4	Montana
19	Prince of Wales-Hyder Census Area	76.2%	73.1 – 78.9	Alaska
20	Southeast Fairbanks Census Area	76.2%	73.0 – 79.0	Alaska
21	Big Horn County	76.2%	72.7 – 79.3	Montana
22	Aleutians East Borough	76.3%	73.4 – 79.2	Alaska
23	Yakutat City and Borough	76.4%	73.5 – 79.2	Alaska
24	Shoshone County	76.4%	72.9 – 79.5	Idaho
25	Jerome County	76.6%	73.3 – 79.6	Idaho
26	San Juan County	76.6%	73.8 – 79.4	Utah
27	Gooding County	76.7%	73.6 – 79.5	Idaho
28	Prairie County	76.7%	73.4 – 79.8	Montana
29	Mellette County	76.7%	73.7 – 79.6	South Dakota
30	Apache County	76.8%	73.8 – 80.0	Arizona
31	Kenai Peninsula Borough	76.9%	73.9 – 79.7	Alaska
32	Liberty County	76.9%	73.2 – 80.6	Montana
33	Lewis County	77.0%	73.9 – 80.1	Idaho
34	Washington County	77.0%	74.0 – 79.8	Idaho
35	Piute County	77.0%	73.3 – 80.3	Utah
36	Boundary County	77.1%	73.4 – 80.3	Idaho
37	Clark County	77.1%	74.0 – 80.3	Idaho
38	Rosebud County	77.1%	74.0 – 79.8	Montana
39	Jackson County	77.1%	74.4 – 79.9	South Dakota
40	North Slope Borough	77.2%	74.1 – 79.9	Alaska
41	Powell County	77.2%	74.0 – 80.5	Montana
42	Bent County	77.3%	74.2 – 80.3	Colorado
43	Payette County	77.3%	74.3 – 80.4	Idaho
44	Corson County	77.3%	74.4 – 80.4	South Dakota
45	Uintah County	77.3%	74.4 – 80.2	Utah
46	Aleutians West Census Area	77.4%	74.6 – 80.2	Alaska
47	Hoonah-Angoon Census Area	77.4%	74.5 – 80.0	Alaska
48	Lincoln County	77.4%	74.6 – 80.0	Idaho
49	Madison County	77.4%	74.3 – 80.1	Idaho
50	Power County	77.4%	74.6 – 80.2	Idaho
51	Deer Lodge County	77.4%	74.4 – 80.4	Montana
52	Pondera County	77.4%	73.9 – 80.4	Montana
53	Clearwater County	77.5%	74.4 – 80.5	Idaho
54	Idaho County	77.5%	74.7 – 80.7	Idaho
55	Minidoka County	77.5%	74.6 – 80.3	Idaho
56	Sanders County	77.5%	74.1 – 80.4	Montana
57	Wheatland County	77.5%	74.5 – 80.5	Montana
58	Buffalo County	77.5%	74.3 – 80.5	South Dakota
59	Adams County	77.5%	74.1 – 80.6	Washington
60	Wrangell City and Borough	77.6%	74.9 – 80.3	Alaska
61	Hawaii County	77.6%	75.3 – 79.9	Hawaii
62	Blaine County	77.6%	74.8 – 80.4	Montana
63	Lincoln County	77.6%	74.4 – 80.6	Montana
64	Luna County	77.6%	74.2 – 80.7	New Mexico
65	Ziebach County	77.6%	74.6 – 80.6	South Dakota
66	Sanpete County	77.6%	74.6 – 80.5	Utah
67	Adams County	77.7%	74.5 – 80.9	Idaho
68	Elmore County	77.7%	74.4 – 80.6	Idaho
69	Wayne County	77.7%	74.2 – 80.9	Missouri
70	Navajo County	77.8%	75.0 – 80.4	Arizona
71	Rolette County	77.8%	74.5 – 80.9	North Dakota
72	Golden Valley County	77.9%	75.0 – 80.9	Montana
73	Hill County	77.9%	75.1 – 80.7	Montana
74	Bingham County	78.0%	74.9 – 80.7	Idaho
75	Cassia County	78.0%	74.9 – 80.8	Idaho
76	Bennett County	78.0%	75.1 – 80.7	South Dakota
77	Bear Lake County	78.1%	74.9 – 81.2	Idaho
78	Hickory County	78.1%	75.1 – 81.1	Missouri
79	McDonald County	78.1%	75.2 – 81.1	Missouri
80	Ozark County	78.1%	74.9 – 81.4	Missouri
81	Benson County	78.1%	75.1 – 80.9	North Dakota
82	Dimmit County	78.1%	74.9 – 81.2	Texas
83	Carbon County	78.1%	75.2 – 80.8	Utah
84	Copper River Census Area	78.2%	75.2 – 80.8	Alaska
85	Lemhi County	78.2%	75.1 – 81.1	Idaho
86	Dewey County	78.2%	75.1 – 81.1	South Dakota
87	Caribou County	78.3%	75.2 – 81.5	Idaho
88	Oregon County	78.3%	75.2 – 81.3	Missouri
89	Malheur County	78.3%	75.2 – 81.3	Oregon
90	Franklin County	78.4%	75.3 – 81.4	Idaho
91	Mahnomen County	78.4%	75.5 – 81.0	Minnesota
92	Duchesne County	78.4%	75.4 – 81.4	Utah
93	Okanogan County	78.4%	75.7 – 81.0	Washington
94	Big Horn County	78.4%	75.1 – 81.3	Wyoming
95	Weston County	78.4%	75.3 – 81.4	Wyoming
96	Wright County	78.5%	75.0 – 81.6	Missouri
97	Morrow County	78.5%	75.4 – 81.3	Oregon
98	Zavala County	78.5%	75.4 – 81.3	Texas
99	Washakie County	78.5%	75.3 – 81.5	Wyoming
100	Gem County	78.6%	75.4 – 81.7	Idaho

What this ranking suggests

Cholesterol screening is the upstream gate that makes the HIGHCHOL prevalence ranking meaningful — a county cannot diagnose hyperlipidemia in residents who have never been screened. Read the two rankings together: high screening + low diagnosis is the best cardiovascular shape, low screening + low diagnosis is hidden disease.

Methodology notes & limitations

Estimates are statistical model outputs, not direct measurements. Small counties have wider confidence intervals; treat narrow rank differences in those rows as within-noise. Counties where the underlying population is too small to support modeling are suppressed entirely (about 1% of US counties). All measures are age-adjusted to the 2000 US standard population. The PLACES dataset uses BRFSS self-reported data — self-report introduces known direction-of-bias in some measures (BMI is under-reported; binge drinking is under-reported), but the bias is roughly uniform across counties so ranking comparability is preserved. See the methodology page for full data-pipeline documentation.

By Logan Johnson, Founder & Data EditorPublished May 15, 2026Reviewed by Logan Johnson, Founder & Data Editor

Data source: CDC PLACES 2023 release. Measure ID: CHOLSCREEN.

← All rankings