The WalletHub scores examine overall obesity rates, health indicators such as diabetes and cholesterol, and habits such as fruit and vegetable consumption.
Southern states took up 8 of the top 10 spots in WalletHub’s 2016 “Fattest States in America,” an analysis that looks at obesity rates, unhealthy habits, and how well the state’s children are faring.
Mississippi, Louisiana, and Arkansas occupied the top 3 spots of WalletHub’s index, which scored states both on current and projected obesity rates; rates of overweight and obese children; health indicators such as diabetes, hypertension, and cholesterol; and even habits, such as how much soda people drink and how few vegetables they eat.
All 3 states consistently rank at or near the top on CDC tables that track the percentage of residents who have been diagnosed with diabetes or who are obese, which is defined as having a body mass index (BMI) of 30 kg/m2 or higher. Those with a BMI of 25 to >30 are considered overweight.
Besides their health profile, the states in the top 10 are overwhelmingly poor. The group PovertyUSA reports that all but 4 states have poverty rates of 17% or higher, and the others have rates of 15% to 17%, the next most impoverished group.
Five states in the top 10 are also among the 19 that have declined to expand Medicaid under the Affordable Care Act (ACA), leaving them with uninsured rates well above the record low 8.6% now being reported nationwide. Mississippi, Tennessee, South Carolina, Texas, and Oklahoma are in this group; Louisiana did not expand Medicaid until July 1, 2016.
Of the remaining states, 2 had among the highest uninsured rates in 2013 and through expansion achieved some of the largest drops seen in the country; however, both states are looking at adjustments to their original expansion programs
Go to the next page for a closer look at the states in the top 10.
Oklahoma’s ranking of 10th the WalletHub index is higher than its overall obesity ranking, which is 11th. But Oklahoma fared poorly in the area of the survey that looked at healthy food availability. It was in the middle among states for the area of the survey that examined health indicators.
Texas’ overall ranking on the WalletHub index matches its obesity ranking at ninth. Texas remains the largest state to not expand Medicaid and has the largest number of uninsured children, according to a new report from Georgetown University. Trust for America’s Health puts the obesity percentage at 32.4%, and finds data on children incomplete.
Alabama ranked better on overall health indicators and food availability patterns, even though its obesity ranking on WalletHub remained relatively high, at sixth overall. Trust for America’s Health still ranks Alabama second in obesity. At 18.6%, its share of obese children age 10 to 17 is below that of Mississippi and Louisiana, which also have overall obesity rates above 35%.
7. South Carolina
While South Carolina still ranks fourth in overall obesity, it’s getting closer to the middle of the pack among states for health indicators and proximity of healthy food sources (compared with unhealthy ones, like fast food). That could be a sign things are moving in the right direction. WalletHub found South Carolina is still tied for third for the percentage of residents with high low-density lipoprotein (LDL) cholesterol. Trust for America’s Health found its obesity rate was flattening.
6. West Virginia
Like the next 2 states on this list, West Virginia had one of the highest uninsured rates before the ACA and has made progress in getting people covered. But the WalletHub survey finds it still ranks second in the percentage of people with diabetes, fifth in the share of residents with high LDL cholesterol, fourth in the share who are physically inactive, and fourth in the percentage with high blood pressure.
While the state ranks ninth in overall obesity, there are troubling signs—the obesity rate among children ages 10 to 17 is 20.5%, on par with states like Mississippi and Louisiana. The other bad news in Tennessee is the condition of its health insurance marketplace for consumers purchasing coverage on the exchange. Citing $500 million in losses, BlueCross BlueShield pulled out of 3 major markets, and premiums will be much higher for many consumers who have only 1 option.
The state ranks fifth in overall obesity and seventh in the category that examines health measures such as hypertension and LDL cholesterol. Former Governor Steve Beshear took aim at Kentucky’s unhealthy habits and high cancer rates when he expanded Medicaid in 2013. If there’s good news to report, it’s that Kentucky’s overall obesity rate no longer appears to be climbing at the pace it once was, and childhood obesity rates have been flat in recent years.
Arkansas’ score came down to the state’s showing on measures of overall obesity and its top showing in the area of the survey that scored states based on how easy it is to find a supermarket with healthy food (apparently not very easy) compared with a fast food restaurant. Governor Asa Hutchinson has had a program in place for more than a year to address the state’s high obesity rates, ever since Trust for America’s Health designated Arkansas the nation’s most obese state.
Louisiana ranked fourth in both the share of adults and children who are obese. It was tied for fifth in the percentage of residents with diabetes, tied for first for the share with high blood pressure, and ranked third for the percentage who are physically inactive. Well-known for its cuisine that often features native greens and vegetables, Louisiana nonetheless ranked second for the percentage of adults eating less than serving of fruits or vegetables per day.
WalletHub rated the state highest in the percentage of people with diabetes, third in the share of adults who are obese, and first in the percentage of obese children. It tied for first for the share of residents with high blood pressure. Mississippi also had the highest percentage of residents who were physically inactive, was tied for third for the share with high LDL cholesterol, and ranked first for the share of adults who eat less than a serving of fruits or vegetables per day.