The 10 Sickest U.S. Metro Areas: 2023

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Returning to work after the COVID-19 pandemic-period shutdowns may have hurt some Americans’ health.

In metropolitan and “micropolitan” areas throughout the United States, the median percentage of adults who told the U.S. Centers for Disease Control and Prevention that their health was poor jumped to 3.5% in 2021, from 3% in 2020, according to a new batch of CDC data posted in September.

One sign that working from home helped many people feel better: The percentage of city residents who classified their health as poor in 2020 was down from 4.1% in 2019, and down from a range of 4% to 4.6% during the period from 2011 through 2019.

In 2021, the median percentage of people in urban areas who said they were in poor health ranged from 1.52, in the Des Moines, Iowa, area — the unofficial capital of the U.S. annuity industry — up to more than 8% in two communities.

For a look at the 10 “metropolitan statistical areas,” or big city areas, with the highest percentage of adult residents who classified their health as poor in 2021, see the gallery above.

For 2021 data on 103 big city areas, see the table below. (The medians shown are only for the communities included in the table.)

What it means: If health is wealth, the figures could explain part of the gap between how U.S. consumers and U.S. economists see the economy: Some consumers may have suffered a return-to-work-related drop in health wealth.

The same conditions that cause poor health could hurt people’s income, ability to work and retirement savings, and poor health could keep potential clients who still have substantial assets and income from taking the time to buy insurance or plan for retirement.

The data: The CDC asks about 400,000 people ages 18 and older per year about their health status through its Behavioral Risk Factor Surveillance System survey program

The BRFSS team prompts participants to classify their health status as poor, fair, good or excellent, in addition to asking about many other topics, such as arthritis, asthma and binge drinking.

The BRFSS team publishes its data in files that are available to the public and free from copyright protection.

Financial professionals with the tools needed to handle big data can get statistics for some variables at the census tract level. Information can also be broken down at many other levels, including the state, regional, city and county level.

The BRFSS team has already released state-level data for 2022.

The newest data for specific urban areas is for 2021.

One obstacle to using the local-level data is that the number of people who describe their health as poor tends to be low. That means the margins of error for the poor health figures are relatively large.

Another challenge is that people in some areas may have different ideas about health than people in other areas do. It’s possible that people who say they’re in poor health in one city may, on average, be healthier than people who say they’re in poor health in another city.

U.S. Poor Health Levels

Credit: Adobe Stock

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