While most of the counties with the highest prevalence of chronic illnesses are concentrated in the South, chronic conditions have been trending up across the entire U.S.

According to the Centers for Disease Control and Prevention, 6 in 10 Americans have a chronic disease, and 4 in 10 Americans are living with at least two chronic conditions. What is a chronic disease? Chronic diseases and illnesses are defined as conditions that last a year or more and call for ongoing medical attention. Most are caused by behavioral factors like poor nutrition and a lack of physical activity, but other chronic illnesses do have a genetic or hereditary basis. These conditions can be expensive, as healthcare costs can increase as chronic illnesses worsen, which is why preventing and managing chronic conditions is so important. To prevent chronic diseases, remember the basics: eat healthy foods, get adequate exercise, get enough sleep, get screened for common conditions, limit your alcohol intake, and quit smoking. The Calcium research team analyzed data on the prevalence of obesity, heart disease, chronic obstructive pulmonary disease (COPD), diabetes, and chronic kidney disease to see which U.S. counties have the highest overall prevalence of chronic conditions.  

Counties with the Highest Chronic Disease Prevalence

Based on our analysis of federal health data, the following are the top 10 counties with the highest rate of one or more chronic diseases:

1. Harlan County, KY: 66.2%
2. Humphreys County, MS: 65.0%
3. East Carroll Parish, LA: 64.8%
4. Tensas Parish, LA: 64.8%
5. Logan County, WV: 64.6%
6. Jefferson County, MS: 64.3%
7. Letcher County, KY: 64.2%
8. McCreary County, KY: 64.1%
9. McDowell County, WV: 63.7%
10. Sharkey County, MS: 63.3%

Of the top 10 counties, three are located in Kentucky, three in Mississippi, two in Louisiana, and two in West Virginia.

Counties with the Highest Obesity Rates

The most common chronic condition in all of these counties (and across the nation) is obesity, affecting between 39% and 49% of the population. According to the Centers for Disease Control and Prevention, obesity for adults is defined as a body mass index (BMI) of at least 30. To calculate your BMI, check out the BMI Calculator provided by the CDC. The counties with the highest obesity rates in the U.S. are the following:

1. Jefferson County, MS: 49.9%
2. Humphreys County, MS: 49.2%
3. East Carroll Parish, LA: 49.2%
4. Holmes County, MS: 48.9%
5. Wilkinson County, MS: 48.6%
6. Issaquena County, MS: 47.4%
7. Tensas Parish, LA: 46.9%
8. Corson County, SD: 46.8%
9. Lawrence County, KY: 46.3%
10. Harlan County, KY: 46.2%

Half of the counties with the highest obesity rates also rank in the top 10 for the highest overall rate of chronic diseases.

Counties with the Highest Heart Disease Rates:

1. McDowell County, WV: 15.1%
2. Tensas Parish, LA: 14.8%
3. Wolfe County, KY: 13.9%
4. Harlan County, KY: 13.6%
5. Pendleton County, WV: 13.4%
6. Webster County, WV: 13.3%
7. Lee County, KY: 13.1%
8. Clay County, WV: 13.1%
9. McCreary County, KY: 13.0%
10. Owsley County, KY: 12.9%

Counties with the Highest COPD Rates

1. McDowell County, WV: 19.9%
2. Wolfe County, KY: 18.2%
3. Harlan County, KY: 18.2%
4. Mingo County, WV: 17.3%
5. Lee County, KY: 17.2%
6. Breathitt County, KY: 17.0%
7. Clay County, KY: 17.0%
8. Webster County, WV: 16.8%
9. Clay County, WV: 16.8%
10. McCreary County, KY: 16.8%

Note: this list is dominated by West Virginia and Kentucky, states where coal mining is prevalent. COPD is an inflammatory lung disease that causes breathing issues.

Counties with the Highest Diabetes Rates

1. Greene County, AL: 25.6%
2. Tensas Parish, LA: 25.3%
3. Jefferson County, MS: 24.0%
4. Sharkey County, MS: 23.1%
5. Humphreys County, MS: 22.8%
6. Perry County, AL: 22.7%
7. East Carroll Parish, LA: 22.4%
8. Quitman County, MS: 22.4%
9. Lowndes County, AL: 22.3%
10. Holmes County, MS: 21.9%

Counties with the Highest Chronic Kidney Disease Rates

1. Tensas Parish, LA: 6.2%
2. Greene County, AL: 5.8%
3. Jefferson County, MS: 5.7%
4. Sharkey County, MS: 5.5%
5. Humphreys County, MS: 5.4%
6. Perry County, AL: 5.3%
7. East Carroll Parish, LA: 5.3%
8. Quitman County, MS: 5.2%
9. Holmes County, MS: 5.2%
10. Mellette County, SD: 5.1%

Several counties appear in the top 10 of multiple chronic medical conditions lists, including Humphreys County, MS, and Tensas Parish, LA.

Chronic Condition Prevention and Care Management

While most of the counties with the highest prevalence of the chronic disease among adults may be concentrated in the southern parts of the United States, the fact is that the prevalence of chronic illnesses has been rising throughout the entire U.S. With the right care and attention, however, most chronic diseases and illnesses need not result in death or permanent impairment. They do require long-term changes to the way in which individuals eat, drink and maintain active lifestyles. But even small changes have the potential to generate lasting benefits for individuals dealing with chronic conditions.