The obesity epidemic in the U.S. is a major health issue and it’s getting worse. Almost half of adults in the U.S. are projected to be obese, not just overweight, by 2030, according to Harvard researchers estimates published in December 2019 in the New England Journal of Medicine.
While the country is facing an obesity crisis, the problem is much more pronounced in certain places within the U.S. To identify the most obese county in each state, 24/7 Tempo reviewed county-level health data from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.
There are a multitude of social and economic factors that predispose certain populations to higher obesity rates. High obesity rates can detrimentally affect the health and life expectancy of the population.
Only two of the counties on the list have a lower share of adults reporting being in poor or fair health than their respective state. Additionally, only four of the 50 counties on this list have a diabetes rate lower than the statewide rate.
Many of the counties with high adult obesity rates also tend to have low-income populations. People with lower incomes are less able to afford proper medical care and healthy lifestyles, which include eating a healthy diet and having easy access to gyms and other options for physical activity.
Only three of the counties with the highest obesity rate in their state have a median annual household income that is higher than the statewide figure. The household income in several counties on this list is as much as $25,000 less than the state median.
Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem among Americans, among them a sedentary lifestyle. Only three of the counties on this list have more adults exercising than the statewide share.
The consumption of high-calorie diets, including large sugary beverages, is another major contributor to weight gain — these are the unhealthiest items in the most popular fast-food chains in America.
Click here to see the most obese counties in every state
To identify the most obese county in every state, 24/7 Tempo reviewed county-level data from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. A total of 3,142 counties were considered.
The obesity rates — the share of adult residents who report a body mass index of 30 or greater — came from the 2021 CHR.
We also considered other measures of health outcomes and health factors. Health factors reviewed included measures of healthy behavior such as exercise, self-reported overall health, and social and economic factors such as annual household income. Data for these measures also came from the 2021 CHR report.
The age-adjusted percentage of the total population 20 years and over diagnosed with diabetes in 2017, the latest year for which data is available, also came from the 2021 CHR.
Population figures as well as median household income came from the American Community Survey 2019 5-Year Estimates.
Alabama: Macon
> Obesity rate in Macon: 50.9% (state: 36.1%)
> Adults who don’t exercise: 32.5% (state: 29.3%)
> Adults reporting poor or fair health: 28.0% (state: 21.4%)
> Adults 20+ with diabetes: 16.8% (state: 14.5%)
> Median household income: $33,370 (state: $50,536)
> Macon population: 18,708
> Largest place in Macon: Tuskegee City
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Alaska: Aleutians East
> Obesity rate in Aleutians East: 51.9% (state: 31.9%)
> Adults who don’t exercise: 26.6% (state: 19.3%)
> Adults reporting poor or fair health: 20.9% (state: 15.6%)
> Adults 20+ with diabetes: 14.5% (state: 8.3%)
> Median household income: $69,250 (state: $77,640)
> Aleutians East population: 3,385
> Largest place in Aleutians East: Sand Point City
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Arizona: Yuma
> Obesity rate in Yuma: 37.9% (state: 27.9%)
> Adults who don’t exercise: 24.3% (state: 21.2%)
> Adults reporting poor or fair health: 26.1% (state: 18.6%)
> Adults 20+ with diabetes: 12.0% (state: 9.6%)
> Median household income: $45,243 (state: $58,945)
> Yuma population: 209,468
> Largest place in Yuma: Yuma City
Arkansas: St. Francis
> Obesity rate in St. Francis: 48.2% (state: 35.0%)
> Adults who don’t exercise: 31.0% (state: 30.4%)
> Adults reporting poor or fair health: 31.4% (state: 23.3%)
> Adults 20+ with diabetes: 15.4% (state: 13.5%)
> Median household income: $35,348 (state: $47,597)
> St. Francis population: 25,900
> Largest place in St. Francis: Forrest City
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California: Colusa
> Obesity rate in Colusa: 39.0% (state: 24.3%)
> Adults who don’t exercise: 26.2% (state: 17.7%)
> Adults reporting poor or fair health: 24.2% (state: 17.6%)
> Adults 20+ with diabetes: 15.5% (state: 8.8%)
> Median household income: $59,401 (state: $75,235)
> Colusa population: 21,454
> Largest place in Colusa: Colusa City
Colorado: Logan
> Obesity rate in Logan: 36.0% (state: 22.4%)
> Adults who don’t exercise: 22.3% (state: 14.8%)
> Adults reporting poor or fair health: 17.6% (state: 13.8%)
> Adults 20+ with diabetes: 9.9% (state: 6.6%)
> Median household income: $53,318 (state: $72,331)
> Logan population: 22,380
> Largest place in Logan: Sterling City
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Connecticut: Windham
> Obesity rate in Windham: 31.0% (state: 26.3%)
> Adults who don’t exercise: 24.0% (state: 19.9%)
> Adults reporting poor or fair health: 15.5% (state: 13.0%)
> Adults 20+ with diabetes: 11.0% (state: 9.2%)
> Median household income: $66,550 (state: $78,444)
> Windham population: 116,566
> Largest place in Windham: Willimantic CDP
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Delaware: Kent
> Obesity rate in Kent: 38.4% (state: 32.4%)
> Adults who don’t exercise: 30.9% (state: 27.3%)
> Adults reporting poor or fair health: 21.0% (state: 16.3%)
> Adults 20+ with diabetes: 13.9% (state: 11.8%)
> Median household income: $60,910 (state: $68,287)
> Kent population: 176,699
> Largest place in Kent: Dover City
Florida: Gadsden
> Obesity rate in Gadsden: 43.5% (state: 27.2%)
> Adults who don’t exercise: 35.3% (state: 25.8%)
> Adults reporting poor or fair health: 26.8% (state: 19.5%)
> Adults 20+ with diabetes: 20.5% (state: 10.8%)
> Median household income: $41,401 (state: $55,660)
> Gadsden population: 45,945
> Largest place in Gadsden: Quincy City
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Georgia: Candler
> Obesity rate in Candler: 53.7% (state: 32.3%)
> Adults who don’t exercise: 28.1% (state: 26.4%)
> Adults reporting poor or fair health: 28.1% (state: 18.4%)
> Adults 20+ with diabetes: 15.4% (state: 12.0%)
> Median household income: $33,736 (state: $58,700)
> Candler population: 10,812
> Largest place in Candler: Metter City
Hawaii: Hawaii
> Obesity rate in Hawaii: 25.8% (state: 24.6%)
> Adults who don’t exercise: 19.9% (state: 19.6%)
> Adults reporting poor or fair health: 17.1% (state: 15.4%)
> Adults 20+ with diabetes: 11.2% (state: 11.1%)
> Median household income: $62,409 (state: $81,275)
> Hawaii population: 199,459
> Largest place in Hawaii: Hilo CDP
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Idaho: Owyhee
> Obesity rate in Owyhee: 40.2% (state: 29.0%)
> Adults who don’t exercise: 26.6% (state: 20.4%)
> Adults reporting poor or fair health: 24.4% (state: 15.1%)
> Adults 20+ with diabetes: 15.5% (state: 9.3%)
> Median household income: $43,798 (state: $55,785)
> Owyhee population: 11,552
> Largest place in Owyhee: Homedale City
Illinois: Vermilion
> Obesity rate in Vermilion: 43.2% (state: 29.7%)
> Adults who don’t exercise: 29.0% (state: 21.6%)
> Adults reporting poor or fair health: 21.1% (state: 15.9%)
> Adults 20+ with diabetes: 12.4% (state: 9.9%)
> Median household income: $46,515 (state: $65,886)
> Vermilion population: 77,563
> Largest place in Vermilion: Danville City
Indiana: Martin
> Obesity rate in Martin: 45.8% (state: 33.9%)
> Adults who don’t exercise: 39.0% (state: 26.7%)
> Adults reporting poor or fair health: 20.0% (state: 18.2%)
> Adults 20+ with diabetes: 9.9% (state: 12.1%)
> Median household income: $52,726 (state: $56,303)
> Martin population: 10,212
> Largest place in Martin: Loogootee City
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Iowa: Wayne
> Obesity rate in Wayne: 48.6% (state: 34.3%)
> Adults who don’t exercise: 27.8% (state: 22.6%)
> Adults reporting poor or fair health: 17.7% (state: 13.5%)
> Adults 20+ with diabetes: 20.3% (state: 9.9%)
> Median household income: $44,768 (state: $60,523)
> Wayne population: 6,429
> Largest place in Wayne: Corydon City
Kansas: Osage
> Obesity rate in Osage: 42.4% (state: 33.0%)
> Adults who don’t exercise: 30.1% (state: 23.9%)
> Adults reporting poor or fair health: 17.7% (state: 16.3%)
> Adults 20+ with diabetes: 14.8% (state: 10.5%)
> Median household income: $54,090 (state: $59,597)
> Osage population: 15,881
> Largest place in Osage: Osage City
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Kentucky: Owsley
> Obesity rate in Owsley: 46.7% (state: 34.6%)
> Adults who don’t exercise: 27.4% (state: 28.7%)
> Adults reporting poor or fair health: 30.5% (state: 21.8%)
> Adults 20+ with diabetes: 13.5% (state: 12.7%)
> Median household income: $30,284 (state: $50,589)
> Owsley population: 4,442
> Largest place in Owsley: Booneville City
Louisiana: Sabine
> Obesity rate in Sabine: 50.8% (state: 36.3%)
> Adults who don’t exercise: 33.2% (state: 28.0%)
> Adults reporting poor or fair health: 23.9% (state: 21.4%)
> Adults 20+ with diabetes: 15.4% (state: 13.0%)
> Median household income: $40,336 (state: $49,469)
> Sabine population: 23,991
> Largest place in Sabine: Many Town
Maine: Aroostook
> Obesity rate in Aroostook: 37.7% (state: 29.8%)
> Adults who don’t exercise: 30.7% (state: 20.8%)
> Adults reporting poor or fair health: 21.7% (state: 17.1%)
> Adults 20+ with diabetes: 15.0% (state: 10.4%)
> Median household income: $41,123 (state: $57,918)
> Aroostook population: 67,809
> Largest place in Aroostook: Presque Isle City
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Maryland: Somerset
> Obesity rate in Somerset: 41.9% (state: 31.6%)
> Adults who don’t exercise: 32.5% (state: 21.9%)
> Adults reporting poor or fair health: 23.8% (state: 15.2%)
> Adults 20+ with diabetes: 15.9% (state: 11.1%)
> Median household income: $37,803 (state: $84,805)
> Somerset population: 25,729
> Largest place in Somerset: Princess Anne Town
Massachusetts: Hampden
> Obesity rate in Hampden: 30.5% (state: 25.0%)
> Adults who don’t exercise: 26.1% (state: 20.0%)
> Adults reporting poor or fair health: 19.1% (state: 13.5%)
> Adults 20+ with diabetes: 10.0% (state: 8.7%)
> Median household income: $55,429 (state: $81,215)
> Hampden population: 467,871
> Largest place in Hampden: Springfield City
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Michigan: Gratiot
> Obesity rate in Gratiot: 45.6% (state: 32.4%)
> Adults who don’t exercise: 23.0% (state: 23.1%)
> Adults reporting poor or fair health: 20.7% (state: 18.3%)
> Adults 20+ with diabetes: 10.2% (state: 11.0%)
> Median household income: $47,848 (state: $57,144)
> Gratiot population: 40,916
> Largest place in Gratiot: Alma City
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Minnesota: Marshall
> Obesity rate in Marshall: 43.5% (state: 29.0%)
> Adults who don’t exercise: 29.1% (state: 19.6%)
> Adults reporting poor or fair health: 14.6% (state: 12.9%)
> Adults 20+ with diabetes: 11.6% (state: 8.5%)
> Median household income: $60,118 (state: $71,306)
> Marshall population: 9,372
> Largest place in Marshall: Warren City
Mississippi: Sunflower
> Obesity rate in Sunflower: 53.7% (state: 39.1%)
> Adults who don’t exercise: 31.0% (state: 30.4%)
> Adults reporting poor or fair health: 32.4% (state: 22.1%)
> Adults 20+ with diabetes: 24.6% (state: 14.6%)
> Median household income: $30,838 (state: $45,081)
> Sunflower population: 26,168
> Largest place in Sunflower: Indianola City
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Missouri: Dunklin
> Obesity rate in Dunklin: 41.7% (state: 32.5%)
> Adults who don’t exercise: 42.9% (state: 25.5%)
> Adults reporting poor or fair health: 29.2% (state: 19.5%)
> Adults 20+ with diabetes: 17.9% (state: 11.4%)
> Median household income: $36,380 (state: $55,461)
> Dunklin population: 30,027
> Largest place in Dunklin: Kennett City
Montana: Hill
> Obesity rate in Hill: 39.3% (state: 27.1%)
> Adults who don’t exercise: 27.9% (state: 21.7%)
> Adults reporting poor or fair health: 20.1% (state: 14.1%)
> Adults 20+ with diabetes: 11.0% (state: 8.9%)
> Median household income: $49,321 (state: $54,970)
> Hill population: 16,436
> Largest place in Hill: Havre City
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Nebraska: Thurston
> Obesity rate in Thurston: 47.2% (state: 33.4%)
> Adults who don’t exercise: 29.2% (state: 22.7%)
> Adults reporting poor or fair health: 23.5% (state: 13.8%)
> Adults 20+ with diabetes: 18.8% (state: 10.0%)
> Median household income: $51,034 (state: $61,439)
> Thurston population: 7,181
> Largest place in Thurston: Pender Village
24/7 Wall St.
Nevada: Pershing
> Obesity rate in Pershing: 39.2% (state: 27.1%)
> Adults who don’t exercise: 28.4% (state: 22.5%)
> Adults reporting poor or fair health: 21.8% (state: 19.1%)
> Adults 20+ with diabetes: 8.0% (state: 10.5%)
> Median household income: $50,491 (state: $60,365)
> Pershing population: 6,615
> Largest place in Pershing: Lovelock City
New Hampshire: Coos
> Obesity rate in Coos: 36.7% (state: 28.6%)
> Adults who don’t exercise: 26.2% (state: 20.8%)
> Adults reporting poor or fair health: 18.5% (state: 12.8%)
> Adults 20+ with diabetes: 14.5% (state: 9.6%)
> Median household income: $47,117 (state: $76,768)
> Coos population: 31,741
> Largest place in Coos: Berlin City
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New Jersey: Salem
> Obesity rate in Salem: 39.0% (state: 27.0%)
> Adults who don’t exercise: 32.6% (state: 26.6%)
> Adults reporting poor or fair health: 19.0% (state: 15.5%)
> Adults 20+ with diabetes: 15.6% (state: 9.9%)
> Median household income: $66,842 (state: $82,545)
> Salem population: 62,990
> Largest place in Salem: Pennsville CDP
New Mexico: Guadalupe
> Obesity rate in Guadalupe: 39.6% (state: 27.3%)
> Adults who don’t exercise: 28.9% (state: 19.0%)
> Adults reporting poor or fair health: 23.6% (state: 20.3%)
> Adults 20+ with diabetes: 7.3% (state: 9.5%)
> Median household income: $24,798 (state: $49,754)
> Guadalupe population: 4,353
> Largest place in Guadalupe: Santa Rosa City
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New York: Chenango
> Obesity rate in Chenango: 39.3% (state: 26.4%)
> Adults who don’t exercise: 24.2% (state: 23.4%)
> Adults reporting poor or fair health: 17.6% (state: 16.3%)
> Adults 20+ with diabetes: 13.6% (state: 10.1%)
> Median household income: $52,002 (state: $68,486)
> Chenango population: 47,909
> Largest place in Chenango: Norwich City
North Carolina: Bladen
> Obesity rate in Bladen: 49.1% (state: 32.3%)
> Adults who don’t exercise: 30.7% (state: 23.3%)
> Adults reporting poor or fair health: 26.2% (state: 18.0%)
> Adults 20+ with diabetes: 22.3% (state: 11.5%)
> Median household income: $36,173 (state: $54,602)
> Bladen population: 33,407
> Largest place in Bladen: Elizabethtown Town
North Dakota: Rolette
> Obesity rate in Rolette: 45.5% (state: 33.9%)
> Adults who don’t exercise: 32.6% (state: 23.1%)
> Adults reporting poor or fair health: 28.6% (state: 13.6%)
> Adults 20+ with diabetes: 16.8% (state: 9.4%)
> Median household income: $43,158 (state: $64,894)
> Rolette population: 14,511
> Largest place in Rolette: Belcourt CDP
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Ohio: Jackson
> Obesity rate in Jackson: 42.8% (state: 33.5%)
> Adults who don’t exercise: 35.0% (state: 26.1%)
> Adults reporting poor or fair health: 22.5% (state: 17.8%)
> Adults 20+ with diabetes: 18.9% (state: 12.2%)
> Median household income: $47,550 (state: $56,602)
> Jackson population: 32,450
> Largest place in Jackson: Jackson City
Oklahoma: Okfuskee
> Obesity rate in Okfuskee: 58.9% (state: 34.5%)
> Adults who don’t exercise: 42.4% (state: 27.8%)
> Adults reporting poor or fair health: 28.5% (state: 20.9%)
> Adults 20+ with diabetes: 15.3% (state: 12.3%)
> Median household income: $38,411 (state: $52,919)
> Okfuskee population: 12,067
> Largest place in Okfuskee: Okemah City
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Oregon: Malheur
> Obesity rate in Malheur: 39.9% (state: 29.3%)
> Adults who don’t exercise: 23.0% (state: 17.3%)
> Adults reporting poor or fair health: 26.0% (state: 18.2%)
> Adults 20+ with diabetes: 9.7% (state: 9.7%)
> Median household income: $43,313 (state: $62,818)
> Malheur population: 30,412
> Largest place in Malheur: Ontario City
24/7 Wall St.
Pennsylvania: Armstrong
> Obesity rate in Armstrong: 44.0% (state: 30.8%)
> Adults who don’t exercise: 34.0% (state: 22.0%)
> Adults reporting poor or fair health: 18.7% (state: 17.6%)
> Adults 20+ with diabetes: 15.1% (state: 11.0%)
> Median household income: $51,410 (state: $61,744)
> Armstrong population: 65,867
> Largest place in Armstrong: Kittanning Borough
Rhode Island: Kent
> Obesity rate in Kent: 30.4% (state: 28.5%)
> Adults who don’t exercise: 23.4% (state: 23.5%)
> Adults reporting poor or fair health: 15.4% (state: 16.5%)
> Adults 20+ with diabetes: 11.0% (state: 10.1%)
> Median household income: $73,521 (state: $67,167)
> Kent population: 163,869
> Largest place in Kent: Warwick City
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South Carolina: Union
> Obesity rate in Union: 46.8% (state: 34.0%)
> Adults who don’t exercise: 33.0% (state: 26.0%)
> Adults reporting poor or fair health: 22.8% (state: 17.8%)
> Adults 20+ with diabetes: 15.9% (state: 13.3%)
> Median household income: $41,186 (state: $53,199)
> Union population: 27,490
> Largest place in Union: Union City
South Dakota: Ziebach
> Obesity rate in Ziebach: 52.5% (state: 32.4%)
> Adults who don’t exercise: 27.2% (state: 22.0%)
> Adults reporting poor or fair health: 30.5% (state: 13.4%)
> Adults 20+ with diabetes: 19.0% (state: 10.1%)
> Median household income: $37,400 (state: $58,275)
> Ziebach population: 2,791
> Largest place in Ziebach: Eagle Butte City
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Tennessee: Lauderdale
> Obesity rate in Lauderdale: 47.4% (state: 33.3%)
> Adults who don’t exercise: 36.0% (state: 27.2%)
> Adults reporting poor or fair health: 30.2% (state: 21.2%)
> Adults 20+ with diabetes: 21.5% (state: 12.5%)
> Median household income: $39,896 (state: $53,320)
> Lauderdale population: 25,989
> Largest place in Lauderdale: Ripley City
Texas: Burleson
> Obesity rate in Burleson: 46.6% (state: 31.4%)
> Adults who don’t exercise: 27.4% (state: 23.2%)
> Adults reporting poor or fair health: 21.1% (state: 18.7%)
> Adults 20+ with diabetes: 13.3% (state: 10.2%)
> Median household income: $57,731 (state: $61,874)
> Burleson population: 18,058
> Largest place in Burleson: Caldwell City
Utah: San Juan
> Obesity rate in San Juan: 38.5% (state: 27.0%)
> Adults who don’t exercise: 23.0% (state: 16.7%)
> Adults reporting poor or fair health: 25.4% (state: 14.8%)
> Adults 20+ with diabetes: 14.0% (state: 7.5%)
> Median household income: $45,394 (state: $71,621)
> San Juan population: 15,302
> Largest place in San Juan: Blanding City
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Vermont: Franklin
> Obesity rate in Franklin: 34.9% (state: 27.0%)
> Adults who don’t exercise: 26.1% (state: 18.4%)
> Adults reporting poor or fair health: 14.1% (state: 12.8%)
> Adults 20+ with diabetes: 10.9% (state: 8.8%)
> Median household income: $65,485 (state: $61,973)
> Franklin population: 49,116
> Largest place in Franklin: St. Albans City
Virginia: King and Queen
> Obesity rate in King and Queen: 48.7% (state: 30.5%)
> Adults who don’t exercise: 32.2% (state: 22.2%)
> Adults reporting poor or fair health: 21.4% (state: 16.6%)
> Adults 20+ with diabetes: 17.7% (state: 10.7%)
> Median household income: $63,982 (state: $74,222)
> King and Queen population: 7,042
> Largest place in King and Queen: N/A .
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Washington: Pend Oreille
> Obesity rate in Pend Oreille: 41.6% (state: 28.6%)
> Adults who don’t exercise: 27.7% (state: 16.4%)
> Adults reporting poor or fair health: 18.8% (state: 15.0%)
> Adults 20+ with diabetes: 12.5% (state: 9.3%)
> Median household income: $50,591 (state: $73,775)
> Pend Oreille population: 13,377
> Largest place in Pend Oreille: Newport City
West Virginia: McDowell
> Obesity rate in McDowell: 44.9% (state: 37.8%)
> Adults who don’t exercise: 36.0% (state: 28.0%)
> Adults reporting poor or fair health: 36.5% (state: 23.6%)
> Adults 20+ with diabetes: 17.0% (state: 15.1%)
> Median household income: $27,682 (state: $46,711)
> McDowell population: 18,661
> Largest place in McDowell: Welch City
Wisconsin: Columbia
> Obesity rate in Columbia: 45.7% (state: 31.7%)
> Adults who don’t exercise: 25.1% (state: 20.3%)
> Adults reporting poor or fair health: 14.4% (state: 14.8%)
> Adults 20+ with diabetes: 9.6% (state: 9.5%)
> Median household income: $68,005 (state: $61,747)
> Columbia population: 57,133
> Largest place in Columbia: Portage City
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Wyoming: Weston
> Obesity rate in Weston: 37.2% (state: 29.2%)
> Adults who don’t exercise: 25.5% (state: 23.1%)
> Adults reporting poor or fair health: 16.9% (state: 15.3%)
> Adults 20+ with diabetes: 11.1% (state: 9.0%)
> Median household income: $57,031 (state: $64,049)
> Weston population: 7,049
> Largest place in Weston: Newcastle City
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