Americans’ healthy eating habits vary widely by region, according to a recent Gallup poll. Gallup asked more than 350,000 Americans in all 50 states, “Did you eat healthy all day yesterday?” And whether a person lives in Santa Cruz, California or Wichita, Kansas, the answers and the likelihood of healthy eating were markedly different.

Published by Gallup-Sharecare, a partnership between the polling organization and the digital health company, the “2016 Community Rankings for Healthy Eating” report shows how key aspects of well-being relate to healthy eating.

24/7 Wall St. reviewed the 25 cities with the lowest shares of residents reporting healthy eating habits. We also examined several other factors research has shown are tied to diet and associated health outcomes.

Click here to see the cities with the worst diets.

Click here to see our methodology.

Of the 25 cities with the lowest share of residents eating healthy diets, all but one are in either the South or Midwest. Resident of the Lubbock, Texas metro area report the worst diets in the nation with only 53.8% of residents reporting healthy eating. By contrast, 75.3% of Naples-Immokalee-Marco Island, Florida residents report healthy eating habits.

Dan Witters, research director of the Gallup-Sharecare Well-being Index, in an interview with 24/7 Wall St. noted that while health literacy can influence how people respond to this question, “most people have a pretty good idea of what it means to eat healthy or not.”

To a large extent, in other words, healthy eating decisions are conscious choices, albeit often constrained by other factors such as money, access, and stress among others. Several key well-being metrics, including the presence of someone who encourages you to be healthy, and notably stress levels, support healthy diets.

Nationwide, 40% of adults report daily stress. In most of the cities with the worst diets, daily stress is more common.

Income levels and money management are closely related to dietary decisions. The ability to pay for high quality food is often a limiting factor for low income families. Fruits, vegetables, and fresh produce — some of the most beneficial additions to a healthy diet — also often happen to be, on a per calories basis, among the higher priced items at the grocery store.

The median household income in 22 of the 25 cities with the worst diets is lower than the national median of $55,775 annually. In addition, in most of these cities a higher share of households receive food stamps than across the nation as a whole.

In the areas where residents report the worst diets, adverse health outcomes are considerably more common than in populations reporting healthy eating habits. The probability of being obese, for example, increases substantially for people with unhealthy diets. All but one of the 25 cities with the worst diets have a greater obesity rate than the nationwide figure.

These are the cities with the worst diets.

Correction: Due to a transcription error, the percentages of adults with daily stress were incorrect in a previous version of this article. The error has been corrected. 

25. Columbus, OH
> Adults who eat healthy all day: 58.7%
> Median household income: $58,192
> Adults with daily stress: 42.6%
> Obesity rate: 30.5%

[in-text-ad]

24. Tallahassee, FL
> Adults who eat healthy all day: 58.7%
> Median household income: $44,295
> Adults with daily stress: 33.8%
> Obesity rate: 28.7%

23. Omaha-Council Bluffs, NE
> Adults who eat healthy all day: 58.6%
> Median household income: $61,024
> Adults with daily stress: 42.0%
> Obesity rate: 29.7%

22. Columbia, SC
> Adults who eat healthy all day: 58.5%
> Median household income: $51,369
> Adults with daily stress: 37.3%
> Obesity rate: 33.2%

[in-text-ad-2]

21. Erie, PA
> Adults who eat healthy all day: 58.5%
> Median household income: $47,386
> Adults with daily stress: 43.7%
> Obesity rate: 31.2%

20. Indianapolis-Carmel-Anderson, IN
> Adults who eat healthy all day: 58.5%
> Median household income: $54,322
> Adults with daily stress: 39.1%
> Obesity rate: 31.2%

[in-text-ad]

19. Killeen-Temple, TX
> Adults who eat healthy all day: 58.4%
> Median household income: $48,612
> Adults with daily stress: 37.3%
> Obesity rate: 29.2%

18. Jackson, MS
> Adults who eat healthy all day: 58.2%
> Median household income: $46,757
> Adults with daily stress: 40.3%
> Obesity rate: 33.3%

17. Canton-Massillon, OH
> Adults who eat healthy all day: 58.1%
> Median household income: $49,313
> Adults with daily stress: 41.5%
> Obesity rate: 31.0%

[in-text-ad-2]

16. Lafayette, LA
> Adults who eat healthy all day: 58.0%
> Median household income: $48,370
> Adults with daily stress: 45.1%
> Obesity rate: 32.5%

15. Oklahoma City, OK
> Adults who eat healthy all day: 57.8%
> Median household income: $52,221
> Adults with daily stress: 42.5%
> Obesity rate: 31.7%

[in-text-ad]

14. Shreveport-Bossier City, LA
> Adults who eat healthy all day: 57.7%
> Median household income: $43,292
> Adults with daily stress: 35.5%
> Obesity rate: 34.8%

13. Springfield, MO
> Adults who eat healthy all day: 57.7%
> Median household income: $44,786
> Adults with daily stress: 42.3%
> Obesity rate: 31.5%

12. Montgomery, AL
> Adults who eat healthy all day: 57.5%
> Median household income: $45,636
> Adults with daily stress: 36.4%
> Obesity rate: 35.1%

[in-text-ad-2]

11. Augusta-Richmond County, GA
> Adults who eat healthy all day: 57.4%
> Median household income: $49,721
> Adults with daily stress: 36.1%
> Obesity rate: 32.3%

10. Tulsa, OK
> Adults who eat healthy all day: 57.2%
> Median household income: $51,352
> Adults with daily stress: 42.0%
> Obesity rate: 31.4%

[in-text-ad]

9. Little Rock-North Little Rock-Conway, AR
> Adults who eat healthy all day: 57.1%
> Median household income: $49,066
> Adults with daily stress: 37.3%
> Obesity rate: 32.7%

8. Topeka, KS
> Adults who eat healthy all day: 57.0%
> Median household income: $51,674
> Adults with daily stress: 41.1%
> Obesity rate: 32.9%

7. Wichita, KS
> Adults who eat healthy all day: 56.9%
> Median household income: $51,591
> Adults with daily stress: 42.5%
> Obesity rate: 31.4%

[in-text-ad-2]

6. Lexington-Fayette, KY
> Adults who eat healthy all day: 56.9%
> Median household income: $53,117
> Adults with daily stress: 43.1%
> Obesity rate: 28.6%

5. Clarksville, TN
> Adults who eat healthy all day: 56.7%
> Median household income: $46,070
> Adults with daily stress: 36.3%
> Obesity rate: 31.2%

[in-text-ad]

4. Hickory-Lenoir-Morganton, NC
> Adults who eat healthy all day: 56.4%
> Median household income: $40,380
> Adults with daily stress: 42.7%
> Obesity rate: 31.4%

3. Cincinnati, OH
> Adults who eat healthy all day: 56.3%
> Median household income: $56,826
> Adults with daily stress: 40.4%
> Obesity rate: 30.4%

2. Memphis, TN
> Adults who eat healthy all day: 55.9%
> Median household income: $48,524
> Adults with daily stress: 36.3%
> Obesity rate: 33.7%

[in-text-ad-2]

1. Lubbock, TX
> Adults who eat healthy all day: 53.8%
> Median household income: $47,291
> Adults with daily stress: 45.7%
> Obesity rate: 27.7%

Methodology

To identify the 25 cities with the worst diets, 24/7 Wall St. reviewed the metro areas with the lowest percentages of adults reporting eating a healthy diet all day the previous day from Gallup-Sharecare Well-being Index.

Gallup conducted 354,473 telephone interviews with U.S. adults across all 50 states and the District of Columbia from January 2, 2015 to December 30, 2016. Metropolitan Statistical Areas (MSAs) are based on the U.S. Office of Management and Budget definitions. Only MSAs with at least 300 completed interviews were considered.

The percentage of adults reporting daily stress also came from Gallup. The median household income was obtained from the U.S. Census Bureau’s 2015 American Community Survey. The adult obesity rate is from the Centers for Disease Control and Prevention for 2013, the latest year for which data is available.

Thank you for reading! Have some feedback for us?
Contact the 24/7 Wall St. editorial team.