The American
Health Map

Here is the map the title promises. Every state is shaded by the share of adults who are obese - a body-mass index of 30 or higher, from self-reported height and weight. Nationally the figure sits near 33.9%; the darkest states below run past forty. A clear band of the highest prevalence follows the lower Mississippi and into Appalachia, the leanest states cluster in the Mountain West and the Northeast.

Every state, all four indicators

State	Obesity	Smoking	Diabetes	Skipped care
West Virginia WV	41.0	21.0	16.2	12.9
Mississippi MS	40.1	18.0	15.1	16.2
Louisiana LA	39.9	18.0	14.2	14.1
Arkansas AR	38.7	18.5	13.8	13.5
Alabama AL	38.3	17.5	14.6	13.8
Oklahoma OK	38.0	18.0	13.2	14.0
Kentucky KY	37.7	19.5	14.0	12.8
Indiana IN	37.2	17.0	12.1	12.3
Ohio OH	36.8	17.0	12.0	11.9
Delaware DE	36.5	15.0	12.3	11.6
Tennessee TN	36.5	18.0	13.6	13.1
Iowa IA	36.4	15.5	9.5	8.2
South Carolina SC	36.3	16.5	13.1	13.6
Nebraska NE	35.9	14.0	9.6	9.4
Georgia GA	35.7	15.5	12.4	15.0
South Dakota SD	35.6	15.0	9.0	9.1
Texas TX	35.5	13.5	12.4	15.7
Missouri MO	35.4	17.0	11.7	12.6
Kansas KS	35.3	15.0	10.4	11.0
Michigan MI	35.2	16.0	11.5	11.2
North Dakota ND	35.1	15.0	9.2	7.3
North Carolina NC	34.9	15.0	12.0	13.9
Wisconsin WI	34.7	14.0	9.8	8.0
Maine ME	34.4	15.5	11.2	10.3
Pennsylvania PA	34.4	15.5	11.4	10.5
Maryland MD	34.3	11.0	11.4	10.1
Virginia VA	34.0	13.5	11.0	11.1
Minnesota MN	33.7	12.5	8.3	7.9
Illinois IL	33.4	14.5	10.8	10.9
Idaho ID	33.1	13.5	9.6	12.5
Alaska AK	32.1	17.0	8.2	12.1
Wyoming WY	32.0	14.5	8.7	11.5
New Hampshire NH	31.6	13.5	10.1	9.2
New Mexico NM	31.5	14.0	11.9	13.4
Arizona AZ	31.3	13.5	11.0	12.8
Florida FL	30.9	14.0	11.6	15.1
Rhode Island RI	30.8	12.5	10.2	9.6
Montana MT	30.7	14.5	8.1	11.4
Washington WA	30.7	10.0	9.4	9.8
Nevada NV	30.6	15.5	11.4	14.2
Connecticut CT	30.4	11.0	9.3	10.2
Oregon OR	30.4	13.0	9.7	11.0
New York NY	30.1	12.0	10.7	10.4
Utah UT	30.0	7.0	8.0	11.3
New Jersey NJ	28.5	11.0	10.4	10.6
Vermont VT	28.4	12.0	7.9	8.1
California CA	28.1	9.5	10.5	11.2
Massachusetts MA	27.9	10.0	9.0	7.0
Hawaii HI	25.9	10.0	10.7	7.6
Colorado CO	25.1	12.0	7.2	10.5
District of Columbia DC	24.7	11.5	8.6	8.4
United States US	33.9	13.5	11.3	11.6

All figures are percent of adults, latest survey year. Obesity shades the map; the other three columns are the same states read on the other indicators (their own maps would tell a different story - smoking peaks in Appalachia, skipped-care in the non-expansion South). Illustrative stand-ins until the real ingest lands - see Methodology.

The map tells you where obesity is heavy; it does not tell you how far apart the states have drifted. Stack the fifty-one reporting places by prevalence and the country spreads across 16.3 points - from District of Columbia near 24.7% to West Virginia past forty. The pile is not centered on the national mean of 33.9%; it leans heavy, a long tail of states running well above it.

Bin counts

Band (% obese)	States	Which
24-26	3	CO DC HI
26-28	1	MA
28-30	3	CA NJ VT
30-32	12	AZ CT FL MT NV NH NM NY OR RI UT WA
32-34	5	AK ID IL MN WY
34-36	14	GA KS ME MD MI MO NE NC ND PA SD TX VA WI
36-38	7	DE IN IA KY OH SC TN
38-40	4	AL AR LA OK
40-42	2	MS WV

One metric can flatter a state. This ranks each of the 51 places on all four indicators - obesity, smoking, diabetes, and skipped care - then averages the four ranks into a single burden score, where 1.00 is best. The chips show where a state lands on each measure; a low score everywhere is how you top the list.

Score = the mean of a state's rank (1 = lowest prevalence) across the four indicators. Bar length is the score relative to the worst state. Chips read Obe/Smk/Dia/Cost with each sub-rank out of 51.

Over the decade, adult smoking fell in 51 of the 51 reporting places - the clearest public-health win in the whole dataset. Nationally it dropped 6.1 points. The bars run from a shared center: teal to the left is a decline (good), warm to the right a rise. The catch: obesity moved the other way over the same years, up 6.1 points nationally. Smoking is the story of a habit beaten; weight is the story it did not touch.

Read the decade a second way. Each line ties a state's 2011 obesity rate to its latest - and there is no down-slope to find. Obesity climbed in all 51 of the 51 reporting places, the nation as a whole up +6.1 points. The heaviest states did not run away from the pack so much as the whole pack moved up together; West Virginia rose fastest, at +8.6 points, but even the slowest riser, Hawaii, still gained +2.3.

Every state, 2011 to latest

State	2011	Latest	Change
West Virginia WV	32.4	41.0	+8.6
Minnesota MN	25.7	33.7	+8.0
Arkansas AR	30.9	38.7	+7.8
Delaware DE	28.8	36.5	+7.7
Georgia GA	28.0	35.7	+7.7
Nebraska NE	28.4	35.9	+7.5
South Dakota SD	28.1	35.6	+7.5
Iowa IA	29.0	36.4	+7.4
North Dakota ND	27.8	35.1	+7.3
Ohio OH	29.6	36.8	+7.2
Wisconsin WI	27.7	34.7	+7.0
Oklahoma OK	31.1	38.0	+6.9
Arizona AZ	24.7	31.3	+6.6
Maine ME	27.8	34.4	+6.6
Louisiana LA	33.4	39.9	+6.5
Indiana IN	30.8	37.2	+6.4
Kentucky KY	31.3	37.7	+6.4
Alabama AL	32.0	38.3	+6.3
Illinois IL	27.1	33.4	+6.3
Texas TX	29.2	35.5	+6.3
Idaho ID	27.0	33.1	+6.1
Montana MT	24.6	30.7	+6.1
Nevada NV	24.5	30.6	+6.1
Virginia VA	27.9	34.0	+6.1
Wyoming WY	25.9	32.0	+6.1
Maryland MD	28.3	34.3	+6.0
Connecticut CT	24.5	30.4	+5.9
North Carolina NC	29.1	34.9	+5.8
Pennsylvania PA	28.6	34.4	+5.8
Kansas KS	29.6	35.3	+5.7
Tennessee TN	30.8	36.5	+5.7
Utah UT	24.3	30.0	+5.7
Mississippi MS	34.5	40.1	+5.6
New York NY	24.5	30.1	+5.6
South Carolina SC	30.8	36.3	+5.5
Rhode Island RI	25.4	30.8	+5.4
Massachusetts MA	22.7	27.9	+5.2
Missouri MO	30.3	35.4	+5.1
New Mexico NM	26.4	31.5	+5.1
New Hampshire NH	26.7	31.6	+4.9
Alaska AK	27.4	32.1	+4.7
Vermont VT	23.7	28.4	+4.7
Colorado CO	20.7	25.1	+4.4
California CA	23.8	28.1	+4.3
Florida FL	26.6	30.9	+4.3
Washington WA	26.4	30.7	+4.3
Michigan MI	31.3	35.2	+3.9
New Jersey NJ	24.6	28.5	+3.9
Oregon OR	26.5	30.4	+3.9
District of Columbia DC	21.9	24.7	+2.8
Hawaii HI	23.6	25.9	+2.3
United States US	27.8	33.9	+6.1

The map freezes one year. These four lines run the whole span nationally. Smoking is in steep retreat; obesity and diagnosed diabetes climb without a pause; the cost barrier to care stepped down after 2014 and then held. Each panel is on its own scale - read the endpoint numbers, not the heights across panels.

Obesity and diabetes are not independent readings of a state - they are close to the same reading twice. Plot one against the other and the fifty-one places fall into a tight upward band (a correlation of r = 0.73): every added point of obesity comes with roughly 0.39 points more diagnosed diabetes. The lower-Mississippi and Appalachian states sit together in the upper right; the Mountain West clusters low on both.

Every state: obesity and diabetes

State	Obesity	Diabetes
West Virginia WV	41.0	16.2
Mississippi MS	40.1	15.1
Louisiana LA	39.9	14.2
Arkansas AR	38.7	13.8
Alabama AL	38.3	14.6
Oklahoma OK	38.0	13.2
Kentucky KY	37.7	14.0
Indiana IN	37.2	12.1
Ohio OH	36.8	12.0
Delaware DE	36.5	12.3
Tennessee TN	36.5	13.6
Iowa IA	36.4	9.5
South Carolina SC	36.3	13.1
Nebraska NE	35.9	9.6
Georgia GA	35.7	12.4
South Dakota SD	35.6	9.0
Texas TX	35.5	12.4
Missouri MO	35.4	11.7
Kansas KS	35.3	10.4
Michigan MI	35.2	11.5
North Dakota ND	35.1	9.2
North Carolina NC	34.9	12.0
Wisconsin WI	34.7	9.8
Maine ME	34.4	11.2
Pennsylvania PA	34.4	11.4
Maryland MD	34.3	11.4
Virginia VA	34.0	11.0
Minnesota MN	33.7	8.3
Illinois IL	33.4	10.8
Idaho ID	33.1	9.6
Alaska AK	32.1	8.2
Wyoming WY	32.0	8.7
New Hampshire NH	31.6	10.1
New Mexico NM	31.5	11.9
Arizona AZ	31.3	11.0
Florida FL	30.9	11.6
Rhode Island RI	30.8	10.2
Montana MT	30.7	8.1
Washington WA	30.7	9.4
Nevada NV	30.6	11.4
Connecticut CT	30.4	9.3
Oregon OR	30.4	9.7
New York NY	30.1	10.7
Utah UT	30.0	8.0
New Jersey NJ	28.5	10.4
Vermont VT	28.4	7.9
California CA	28.1	10.5
Massachusetts MA	27.9	9.0
Hawaii HI	25.9	10.7
Colorado CO	25.1	7.2
District of Columbia DC	24.7	8.6
United States US	33.9	11.3

Fold the fifty-one places into the four Census regions and the map's gradient resolves into a plain hierarchy. The South carries the heaviest load on all four indicators at once; the Northeast and West sit lightest. Read each column on its own - the shading is scaled within a burden, so a dark cell means heavy for that indicator, not across them.

Within a column: lighter → heavier

The other three burdens are about bodies and habits. This one is about money: the share of adults who could not see a doctor in the past year because of the cost. Nationally it runs near 11.6%, but the spread is wide - from under eight percent in the Northeast and Upper Midwest to the mid-teens across the South. Each dot is a state; the axis is the only ranking that matters.