Health Outcomes

High Cholesterol Prevalence by County — US Rankings

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

High cholesterol is a diagnosis-anchored measure: adults ever told they had high blood cholesterol. Because the diagnosis requires a lipid panel, the prevalence rankings are sensitive to who has been screened. The CHOLSCREEN measure (also in this dataset) lets you read the two side by side — a county with high screening + low diagnosed prevalence is in much better cardiovascular shape than a county with low screening and the same diagnosed prevalence. PLACES age-adjusts, which matters because cholesterol prevalence rises sharply with age. Treatment status is not captured at the county level.

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.

Lowest High Cholesterol Rates — Top 100 Counties

Counties with the lowest reported high cholesterol prevalence — these counties show the most favorable position on this measure.

#	County	Rate	95% CI	State
1	Lamoille County	25.0%	21.8 – 28.2	Vermont
2	Twin Falls County	25.9%	22.8 – 29.2	Idaho
3	Chittenden County	25.9%	23.6 – 28.4	Vermont
4	Windsor County	25.9%	23.1 – 28.7	Vermont
5	Lake County	26.0%	22.9 – 29.2	Montana
6	Carver County	26.3%	23.1 – 29.6	Minnesota
7	Grand Isle County	26.3%	22.6 – 30.0	Vermont
8	Windham County	26.3%	23.5 – 29.5	Vermont
9	Bennington County	26.4%	23.3 – 29.6	Vermont
10	Rutland County	26.5%	23.6 – 29.4	Vermont
11	Sheridan County	26.5%	23.2 – 29.9	Wyoming
12	Mesa County	26.6%	23.2 – 30.0	Colorado
13	Jefferson County	26.6%	23.1 – 30.5	Montana
14	Teton County	26.6%	23.1 – 30.3	Wyoming
15	Crow Wing County	26.7%	23.5 – 30.1	Minnesota
16	Richland County	26.7%	23.2 – 30.3	Montana
17	Rosebud County	26.7%	23.4 – 30.2	Montana
18	Summit County	26.8%	23.0 – 30.7	Colorado
19	Kalawao County	26.8%	22.8 – 31.1	Hawaii
20	Idaho County	26.8%	23.6 – 30.1	Idaho
21	Big Horn County	26.8%	23.3 – 30.4	Montana
22	Gallatin County	26.8%	23.7 – 29.8	Montana
23	Treasure County	26.8%	23.0 – 30.9	Montana
24	Dawson County	26.9%	23.3 – 30.7	Montana
25	Fergus County	26.9%	23.6 – 30.8	Montana
26	Sheridan County	26.9%	23.6 – 30.6	Nebraska
27	Duchesne County	26.9%	23.6 – 30.5	Utah
28	St. Louis County	27.0%	24.3 – 29.9	Minnesota
29	Flathead County	27.0%	24.1 – 30.1	Montana
30	Custer County	27.1%	23.5 – 30.9	Montana
31	Park County	27.1%	23.5 – 31.0	Montana
32	Cedar County	27.1%	24.1 – 30.4	Nebraska
33	Pueblo County	27.2%	23.9 – 30.6	Colorado
34	Hubbard County	27.2%	23.7 – 30.8	Minnesota
35	Deer Lodge County	27.2%	23.3 – 31.2	Montana
36	Glacier County	27.2%	23.6 – 30.7	Montana
37	Ravalli County	27.2%	23.9 – 30.7	Montana
38	Silver Bow County	27.2%	23.8 – 30.8	Montana
39	Sweet Grass County	27.2%	23.5 – 31.2	Montana
40	Custer County	27.2%	23.7 – 30.5	Nebraska
41	Carbon County	27.2%	23.7 – 30.9	Utah
42	Franklin County	27.3%	23.7 – 31.0	Idaho
43	Itasca County	27.3%	24.0 – 30.7	Minnesota
44	Nicollet County	27.3%	23.7 – 31.0	Minnesota
45	Fallon County	27.3%	23.2 – 31.9	Montana
46	Madison County	27.3%	23.7 – 31.2	Montana
47	Musselshell County	27.3%	23.5 – 31.3	Montana
48	Petroleum County	27.3%	23.5 – 31.6	Montana
49	Sanders County	27.3%	23.7 – 30.9	Montana
50	Cheshire County	27.3%	24.3 – 30.5	New Hampshire
51	Hawaii County	27.4%	24.5 – 30.4	Hawaii
52	Granite County	27.4%	23.5 – 31.5	Montana
53	Meagher County	27.4%	23.6 – 31.6	Montana
54	Yellowstone County	27.4%	24.7 – 30.3	Montana
55	Summit County	27.4%	24.1 – 30.8	Utah
56	Dane County	27.4%	24.7 – 30.3	Wisconsin
57	Polk County	27.5%	23.9 – 31.0	Minnesota
58	Broadwater County	27.5%	23.7 – 31.5	Montana
59	Carbon County	27.5%	23.9 – 31.3	Montana
60	Garfield County	27.5%	23.7 – 31.7	Montana
61	Stillwater County	27.5%	23.8 – 31.5	Montana
62	Cass County	27.5%	24.2 – 31.1	Nebraska
63	Kearney County	27.5%	23.8 – 31.3	Nebraska
64	Santa Fe County	27.5%	24.5 – 31.1	New Mexico
65	Orange County	27.5%	24.3 – 30.7	Vermont
66	Boulder County	27.6%	24.7 – 30.7	Colorado
67	Washtenaw County	27.6%	25.0 – 30.4	Michigan
68	Daniels County	27.6%	23.7 – 31.9	Montana
69	Powder River County	27.6%	23.8 – 31.5	Montana
70	Butler County	27.6%	24.1 – 31.3	Nebraska
71	Logan County	27.6%	23.7 – 31.7	Nebraska
72	Wasatch County	27.6%	24.2 – 31.0	Utah
73	Washington County	27.6%	24.7 – 30.6	Vermont
74	Clear Creek County	27.7%	23.8 – 32.0	Colorado
75	Montezuma County	27.7%	23.9 – 31.6	Colorado
76	Gem County	27.7%	24.0 – 31.6	Idaho
77	Prairie County	27.7%	23.9 – 31.9	Montana
78	Dawes County	27.7%	23.9 – 31.8	Nebraska
79	Polk County	27.7%	24.1 – 31.6	Nebraska
80	San Juan County	27.7%	24.4 – 31.0	New Mexico
81	Addison County	27.7%	24.7 – 30.7	Vermont
82	Fremont County	27.7%	24.5 – 31.1	Wyoming
83	Arapahoe County	27.8%	25.0 – 30.8	Colorado
84	Eagle County	27.8%	23.9 – 31.7	Colorado
85	Gilpin County	27.8%	23.8 – 32.1	Colorado
86	Hinsdale County	27.8%	23.7 – 31.8	Colorado
87	La Plata County	27.8%	24.0 – 31.7	Colorado
88	Adams County	27.8%	24.1 – 31.7	Idaho
89	Nez Perce County	27.8%	24.5 – 31.1	Idaho
90	Lewis and Clark County	27.8%	24.8 – 30.9	Montana
91	Phillips County	27.8%	24.0 – 31.7	Montana
92	Pondera County	27.8%	24.1 – 31.7	Montana
93	Clackamas County	27.8%	24.7 – 30.7	Oregon
94	Larimer County	27.9%	25.0 – 31.0	Colorado
95	Fremont County	27.9%	24.1 – 32.0	Idaho
96	Brown County	27.9%	24.2 – 31.7	Minnesota
97	Clearwater County	27.9%	24.2 – 31.8	Minnesota
98	Lincoln County	27.9%	23.9 – 31.8	Minnesota
99	Meeker County	27.9%	24.6 – 31.4	Minnesota
100	Golden Valley County	27.9%	24.4 – 32.4	Montana

Highest High Cholesterol Rates — Bottom 100 CountiesCounties with the highest reported high cholesterol prevalence.

#	County	Rate	95% CI	State
1	Mingo County	37.9%	33.5 – 42.4	West Virginia
2	Wyoming County	37.8%	33.4 – 42.4	West Virginia
3	Franklin County	37.7%	33.2 – 42.3	Alabama
4	Chilton County	37.7%	33.3 – 42.2	Alabama
5	Fayette County	37.6%	33.2 – 42.3	West Virginia
6	Ritchie County	37.5%	33.0 – 42.1	West Virginia
7	Mercer County	37.5%	33.4 – 41.7	West Virginia
8	Logan County	37.5%	33.1 – 42.0	West Virginia
9	Gilmer County	37.5%	32.9 – 42.1	West Virginia
10	Winston County	37.5%	33.0 – 42.1	Alabama
11	Raleigh County	37.4%	33.3 – 41.7	West Virginia
12	DeSoto County	37.4%	33.2 – 41.5	Florida
13	Sussex County	37.4%	33.6 – 41.2	Delaware
14	Marengo County	37.3%	32.8 – 41.7	Alabama
15	Wetzel County	37.2%	32.7 – 41.7	West Virginia
16	Webster County	37.2%	32.7 – 41.8	West Virginia
17	Tyler County	37.2%	32.6 – 41.8	West Virginia
18	Mason County	37.2%	32.8 – 41.7	West Virginia
19	Barbour County	37.2%	32.7 – 41.5	West Virginia
20	Upshur County	37.1%	32.7 – 41.7	West Virginia
21	Taylor County	37.1%	32.5 – 41.7	West Virginia
22	McDowell County	37.1%	32.5 – 41.7	West Virginia
23	Jackson County	37.1%	32.8 – 41.3	West Virginia
24	Bullock County	37.1%	32.7 – 41.7	Alabama
25	Monroe County	37.0%	32.3 – 41.9	West Virginia
26	Tuscaloosa County	37.0%	33.2 – 41.0	Alabama
27	Randolph County	36.9%	32.3 – 41.6	Alabama
28	Lamar County	36.9%	32.3 – 41.7	Alabama
29	Roane County	36.8%	32.2 – 41.4	West Virginia
30	Clay County	36.8%	32.2 – 41.5	West Virginia
31	Boone County	36.8%	32.4 – 41.5	West Virginia
32	St. Clair County	36.8%	32.6 – 41.4	Alabama
33	Marshall County	36.8%	32.4 – 41.3	Alabama
34	Cherokee County	36.8%	32.3 – 41.7	Alabama
35	Harrison County	36.7%	32.6 – 41.2	West Virginia
36	Carter County	36.7%	32.4 – 41.5	Tennessee
37	Marion County	36.7%	32.4 – 41.2	Alabama
38	Dallas County	36.7%	32.2 – 41.2	Alabama
39	Dale County	36.7%	32.3 – 41.2	Alabama
40	Covington County	36.7%	32.4 – 41.2	Alabama
41	Bibb County	36.7%	32.2 – 41.4	Alabama
42	Pendleton County	36.6%	32.2 – 41.2	West Virginia
43	Marion County	36.6%	32.3 – 40.8	West Virginia
44	Kanawha County	36.6%	33.0 – 40.6	West Virginia
45	Doddridge County	36.6%	32.0 – 41.3	West Virginia
46	Calhoun County	36.6%	32.1 – 41.2	West Virginia
47	Montgomery County	36.6%	34.1 – 39.2	Maryland
48	Pickens County	36.6%	32.3 – 40.9	Alabama
49	Escambia County	36.6%	32.3 – 41.1	Alabama
50	Clay County	36.6%	31.6 – 41.0	Alabama
51	Wirt County	36.5%	31.8 – 41.2	West Virginia
52	Putnam County	36.5%	32.2 – 40.8	West Virginia
53	Pocahontas County	36.5%	32.5 – 40.8	West Virginia
54	Hardy County	36.5%	32.1 – 41.1	West Virginia
55	Union County	36.5%	32.0 – 41.0	Mississippi
56	Hamilton County	36.5%	32.5 – 40.6	Florida
57	Tallapoosa County	36.5%	32.1 – 41.2	Alabama
58	DeKalb County	36.5%	32.1 – 41.2	Alabama
59	Barbour County	36.5%	32.1 – 41.1	Alabama
60	Pleasants County	36.4%	31.9 – 41.1	West Virginia
61	Holmes County	36.4%	32.4 – 40.5	Florida
62	Russell County	36.4%	32.2 – 40.9	Alabama
63	Perry County	36.4%	32.2 – 41.1	Alabama
64	Choctaw County	36.4%	32.0 – 40.9	Alabama
65	Preston County	36.3%	32.1 – 40.7	West Virginia
66	Queens County	36.3%	33.7 – 38.9	New York
67	Hillsborough County	36.3%	32.7 – 39.9	Florida
68	Autauga County	36.3%	31.8 – 40.7	Alabama
69	Hampshire County	36.2%	31.9 – 40.9	West Virginia
70	Richmond County	36.2%	33.2 – 39.4	New York
71	Greene County	36.2%	31.8 – 40.8	Alabama
72	Geneva County	36.2%	32.0 – 40.6	Alabama
73	Cleburne County	36.2%	31.4 – 40.9	Alabama
74	Summers County	36.1%	31.7 – 40.8	West Virginia
75	Cabell County	36.1%	32.3 – 40.2	West Virginia
76	Lake County	36.1%	31.6 – 40.8	Tennessee
77	Alcorn County	36.1%	31.6 – 40.4	Mississippi
78	Morehouse Parish	36.1%	30.9 – 41.4	Louisiana
79	Tucker County	36.0%	31.8 – 40.6	West Virginia
80	Nicholas County	36.0%	31.6 – 40.7	West Virginia
81	Lewis County	36.0%	31.4 – 40.7	West Virginia
82	Braxton County	36.0%	31.4 – 40.6	West Virginia
83	Angelina County	36.0%	32.5 – 39.5	Texas
84	Hancock County	36.0%	31.5 – 40.7	Tennessee
85	Etowah County	36.0%	31.7 – 40.4	Alabama
86	Conecuh County	36.0%	31.5 – 40.5	Alabama
87	Butler County	36.0%	31.5 – 40.4	Alabama
88	Wayne County	35.9%	31.7 – 40.3	West Virginia
89	Virginia Beach city	35.9%	32.1 – 39.6	Virginia
90	Scott County	35.9%	31.4 – 40.5	Tennessee
91	Delaware County	35.9%	31.8 – 40.2	Oklahoma
92	Bergen County	35.9%	33.0 – 39.2	New Jersey
93	Vernon Parish	35.9%	31.2 – 40.6	Louisiana
94	St. Mary Parish	35.9%	31.6 – 40.3	Louisiana
95	Tippecanoe County	35.9%	32.2 – 39.7	Indiana
96	Greene County	35.9%	31.7 – 40.3	Indiana
97	Wilcox County	35.9%	31.3 – 40.5	Alabama
98	Morgan County	35.9%	31.6 – 40.4	Alabama
99	Lawrence County	35.9%	31.4 – 40.7	Alabama
100	Jackson County	35.9%	31.4 – 40.4	Alabama

What this ranking suggests

A high-prevalence ranking does not tell you whether the county is being treated. For the treatment side of the same population, see the BPMED ranking (which is about blood-pressure medication but tracks a similar primary-care engagement signal) and the routine-checkup ranking on each county page.

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: HIGHCHOL.

← All rankings