Sleep is a key component of a healthy lifestyle. The Centers for Disease Control and Prevention recommends that adults get at least seven hours of sleep each night — and falling short of this target carries a number of risks. Still, nearly 90 million American adults are not getting enough sleep.
Americans who do not get enough sleep are at increased risk of making mistakes in their day-to-day lives — and mistakes at work or while driving can have serious consequences. Insufficient sleep is also linked to chronic diseases, including type 2 diabetes, heart disease, obesity, and depression.
Nationwide, 35.2% of adults are not getting enough sleep. But in some parts of the country, sleep deprivation is even more common.
Using data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program, 24/7 Tempo identified America’s 50 most sleep deprived counties. Counties and county equivalents are ranked by the share of adults not getting enough sleep — which ranges on this list from 45.1% up to 49.1%.
Research has shown that sleep duration is linked to both regulation of blood sugar as well as metabolic changes — and that adults who regularly sleep less than seven hours a night are at increased risk of diabetes and obesity. In the vast majority of counties with the highest levels of sleep deprivation, rates of both diabetes and obesity are higher than the national shares of 10.5% and 29.7%, respectively. Here is a look at what happens to your body when you don’t get enough sleep.
To improve sleep habits, the CDC recommends developing a routine of going to bed at the same time each night and waking up at the same time every day. The CDC also advises regular exercise and avoiding caffeine, large meals, and alcohol before bed time. Removing electronic devices, such as TVs and computers, from the bedroom can also help improve sleep habits. Here is a list of 19 secrets to sleep better at night.
Click here to see America’s most sleep deprived counties
Click here to see our detailed methodology
50. Wirt County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.1%
> Adults reporting poor or fair health: 27.2% — 287th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 19th highest of 3,106 counties
> Adult obesity rate: 34.7% — 1,343rd highest of 3,106 counties
> Adults with diabetes: 14.5% — 791st highest of 3,106 counties
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49. Scioto County, Ohio
> Adults reporting insufficient sleep (<7 hours): 45.1%
> Adults reporting poor or fair health: 24.2% — 666th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.7 — 171st highest of 3,106 counties
> Adult obesity rate: 38.6% — 566th highest of 3,106 counties
> Adults with diabetes: 15.6% — 546th highest of 3,106 counties
48. Allendale County, South Carolina
> Adults reporting insufficient sleep (<7 hours): 45.1%
> Adults reporting poor or fair health: 30.7% — 87th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.5 — 344th highest of 3,106 counties
> Adult obesity rate: 36.9% — 870th highest of 3,106 counties
> Adults with diabetes: 22.3% — 42nd highest of 3,106 counties
47. Barbour County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.1%
> Adults reporting poor or fair health: 25.7% — 458th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.2 — 30th highest of 3,106 counties
> Adult obesity rate: 39.9% — 392nd highest of 3,106 counties
> Adults with diabetes: 15.0% — 669th highest of 3,106 counties (tied)
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46. Roane County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.1%
> Adults reporting poor or fair health: 28.9% — 156th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 17th highest of 3,106 counties
> Adult obesity rate: 41.4% — 250th highest of 3,106 counties
> Adults with diabetes: 14.5% — 788th highest of 3,106 counties
45. Claiborne County, Mississippi
> Adults reporting insufficient sleep (<7 hours): 45.3%
> Adults reporting poor or fair health: 35.8% — 20th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.6 — 243rd highest of 3,106 counties
> Adult obesity rate: 47.4% — 35th highest of 3,106 counties
> Adults with diabetes: 18.6% — 187th highest of 3,106 counties
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44. Philadelphia County, Pennsylvania
> Adults reporting insufficient sleep (<7 hours): 45.3%
> Adults reporting poor or fair health: 23.6% — 786th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.6 — 253rd highest of 3,106 counties
> Adult obesity rate: 28.9% — 650th lowest of 3,106 counties
> Adults with diabetes: 11.3% — 1,350th lowest of 3,106 counties
43. Lawrence County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.4%
> Adults reporting poor or fair health: 29.6% — 127th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.7 — 158th highest of 3,106 counties
> Adult obesity rate: 44.8% — 89th highest of 3,106 counties
> Adults with diabetes: 17.6% — 280th highest of 3,106 counties
42. Raleigh County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.4%
> Adults reporting poor or fair health: 24.5% — 631st highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.9 — 88th highest of 3,106 counties
> Adult obesity rate: 38.0% — 672nd highest of 3,106 counties
> Adults with diabetes: 17.2% — 322nd highest of 3,106 counties
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41. Trumbull County, Ohio
> Adults reporting insufficient sleep (<7 hours): 45.4%
> Adults reporting poor or fair health: 20.6% — 1,332nd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.4 — 393rd highest of 3,106 counties
> Adult obesity rate: 39.2% — 473rd highest of 3,106 counties
> Adults with diabetes: 13.5% — 1,024th highest of 3,106 counties
40. Webster County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.4%
> Adults reporting poor or fair health: 27.6% — 249th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.6 — 267th highest of 3,106 counties
> Adult obesity rate: 38.7% — 562nd highest of 3,106 counties
> Adults with diabetes: 8.7% — 465th lowest of 3,106 counties
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39. Tensas Parish, Louisiana
> Adults reporting insufficient sleep (<7 hours): 45.5%
> Adults reporting poor or fair health: 36.0% — 18th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.2 — 43rd highest of 3,106 counties
> Adult obesity rate: 36.7% — 929th highest of 3,106 counties
> Adults with diabetes: 14.1% — 871st highest of 3,106 counties
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38. Portsmouth city, Virginia
> Adults reporting insufficient sleep (<7 hours): 45.5%
> Adults reporting poor or fair health: 22.8% — 918th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 4.8 — 1,424th highest of 3,106 counties
> Adult obesity rate: 42.3% — 189th highest of 3,106 counties
> Adults with diabetes: 13.7% — 965th highest of 3,106 counties
37. Lincoln County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.5%
> Adults reporting poor or fair health: 29.7% — 121st highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.7 — 6th highest of 3,106 counties
> Adult obesity rate: 43.0% — 145th highest of 3,106 counties
> Adults with diabetes: 16.1% — 466th highest of 3,106 counties
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36. Fulton County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.5%
> Adults reporting poor or fair health: 31.0% — 82nd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.8 — 149th highest of 3,106 counties
> Adult obesity rate: 35.2% — 1,244th highest of 3,106 counties
> Adults with diabetes: 10.7% — 1,147th lowest of 3,106 counties
35. Casey County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.5%
> Adults reporting poor or fair health: 30.9% — 84th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.0 — 80th highest of 3,106 counties
> Adult obesity rate: 28.9% — 645th lowest of 3,106 counties
> Adults with diabetes: 14.0% — 897th highest of 3,106 counties
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34. Hamblen County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 45.6%
> Adults reporting poor or fair health: 25.3% — 521st highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.7 — 190th highest of 3,106 counties
> Adult obesity rate: 34.7% — 1,356th highest of 3,106 counties
> Adults with diabetes: 14.6% — 780th highest of 3,106 counties
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33. Holmes County, Mississippi
> Adults reporting insufficient sleep (<7 hours): 45.6%
> Adults reporting poor or fair health: 37.0% — 10th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.9 — 102nd highest of 3,106 counties
> Adult obesity rate: 50.7% — 10th highest of 3,106 counties
> Adults with diabetes: 20.5% — 85th highest of 3,106 counties
32. Fayette County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 45.6%
> Adults reporting poor or fair health: 27.6% — 248th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.7 — 5th highest of 3,106 counties
> Adult obesity rate: 40.4% — 334th highest of 3,106 counties
> Adults with diabetes: 19.0% — 156th highest of 3,106 counties
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31. Randolph County, Georgia
> Adults reporting insufficient sleep (<7 hours): 45.7%
> Adults reporting poor or fair health: 31.2% — 72nd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.4 — 456th highest of 3,106 counties
> Adult obesity rate: 37.9% — 705th highest of 3,106 counties
> Adults with diabetes: 24.2% — 15th highest of 3,106 counties
30. Wolfe County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.7%
> Adults reporting poor or fair health: 34.6% — 30th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 14th highest of 3,106 counties
> Adult obesity rate: 37.6% — 759th highest of 3,106 counties
> Adults with diabetes: 12.0% — 1,506th highest of 3,106 counties (tied)
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29. Breathitt County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.7%
> Adults reporting poor or fair health: 32.2% — 54th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 21st highest of 3,106 counties
> Adult obesity rate: 40.0% — 378th highest of 3,106 counties (tied)
> Adults with diabetes: 17.3% — 314th highest of 3,106 counties
28. Boyd County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.7%
> Adults reporting poor or fair health: 23.6% — 778th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.7 — 211th highest of 3,106 counties
> Adult obesity rate: 39.7% — 422nd highest of 3,106 counties
> Adults with diabetes: 15.5% — 556th highest of 3,106 counties
27. Macon County, Georgia
> Adults reporting insufficient sleep (<7 hours): 45.8%
> Adults reporting poor or fair health: 29.6% — 123rd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.0 — 919th highest of 3,106 counties
> Adult obesity rate: 30.3% — 874th lowest of 3,106 counties
> Adults with diabetes: 15.9% — 485th highest of 3,106 counties
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26. Lake County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 45.8%
> Adults reporting poor or fair health: 30.4% — 97th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.8 — 133rd highest of 3,106 counties
> Adult obesity rate: 34.9% — 1,318th highest of 3,106 counties
> Adults with diabetes: 9.9% — 871st lowest of 3,106 counties
25. Shelby County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 45.9%
> Adults reporting poor or fair health: 23.2% — 844th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.1 — 792nd highest of 3,106 counties
> Adult obesity rate: 34.9% — 1,311th highest of 3,106 counties
> Adults with diabetes: 11.5% — 1,423rd lowest of 3,106 counties
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24. Hancock County, Georgia
> Adults reporting insufficient sleep (<7 hours): 45.9%
> Adults reporting poor or fair health: 31.1% — 77th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 4.9 — 1,092nd highest of 3,106 counties
> Adult obesity rate: 30.1% — 847th lowest of 3,106 counties
> Adults with diabetes: 23.2% — 25th highest of 3,106 counties
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23. Martin County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 45.9%
> Adults reporting poor or fair health: 29.5% — 132nd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.9 — 103rd highest of 3,106 counties
> Adult obesity rate: 40.7% — 310th highest of 3,106 counties
> Adults with diabetes: 17.8% — 258th highest of 3,106 counties
22. Emporia city, Virginia
> Adults reporting insufficient sleep (<7 hours): 45.9%
> Adults reporting poor or fair health: 31.5% — 64th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.5 — 354th highest of 3,106 counties
> Adult obesity rate: 28.8% — 640th lowest of 3,106 counties
> Adults with diabetes: 11.6% — 1,443rd lowest of 3,106 counties
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21. Jefferson County, Mississippi
> Adults reporting insufficient sleep (<7 hours): 46.0%
> Adults reporting poor or fair health: 37.9% — 7th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.8 — 144th highest of 3,106 counties
> Adult obesity rate: 50.9% — 7th highest of 3,106 counties
> Adults with diabetes: 16.7% — 379th highest of 3,106 counties
20. Haywood County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 46.0%
> Adults reporting poor or fair health: 28.7% — 169th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.6 — 264th highest of 3,106 counties
> Adult obesity rate: 47.0% — 40th highest of 3,106 counties
> Adults with diabetes: 17.7% — 264th highest of 3,106 counties
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19. Summers County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 46.1%
> Adults reporting poor or fair health: 27.6% — 251st highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 15th highest of 3,106 counties
> Adult obesity rate: 41.1% — 273rd highest of 3,106 counties
> Adults with diabetes: 16.2% — 447th highest of 3,106 counties
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18. East Carroll Parish, Louisiana
> Adults reporting insufficient sleep (<7 hours): 46.3%
> Adults reporting poor or fair health: 40.5% — 3rd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.2 — 28th highest of 3,106 counties
> Adult obesity rate: 47.1% — 38th highest of 3,106 counties
> Adults with diabetes: 22.1% — 46th highest of 3,106 counties
17. Lauderdale County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 46.3%
> Adults reporting poor or fair health: 30.2% — 103rd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.9 — 91st highest of 3,106 counties
> Adult obesity rate: 47.4% — 34th highest of 3,106 counties
> Adults with diabetes: 21.5% — 59th highest of 3,106 counties
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16. Logan County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 46.4%
> Adults reporting poor or fair health: 30.0% — 110th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.5 — 12th highest of 3,106 counties
> Adult obesity rate: 42.7% — 161st highest of 3,106 counties
> Adults with diabetes: 20.9% — 78th highest of 3,106 counties
15. Lowndes County, Alabama
> Adults reporting insufficient sleep (<7 hours): 46.4%
> Adults reporting poor or fair health: 31.1% — 76th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.7 — 193rd highest of 3,106 counties
> Adult obesity rate: 43.6% — 116th highest of 3,106 counties
> Adults with diabetes: 17.0% — 355th highest of 3,106 counties
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14. Clay County, Georgia
> Adults reporting insufficient sleep (<7 hours): 46.6%
> Adults reporting poor or fair health: 31.8% — 60th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.5 — 315th highest of 3,106 counties
> Adult obesity rate: 40.7% — 311th highest of 3,106 counties
> Adults with diabetes: 12.5% — 1,339th highest of 3,106 counties (tied)
13. Wayne County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 46.7%
> Adults reporting poor or fair health: 27.1% — 306th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.6 — 8th highest of 3,106 counties
> Adult obesity rate: 42.7% — 162nd highest of 3,106 counties
> Adults with diabetes: 18.6% — 194th highest of 3,106 counties
12. Harlan County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 46.9%
> Adults reporting poor or fair health: 34.6% — 32nd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.4 — 18th highest of 3,106 counties
> Adult obesity rate: 40.2% — 357th highest of 3,106 counties
> Adults with diabetes: 20.1% — 103rd highest of 3,106 counties
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11. Petersburg city, Virginia
> Adults reporting insufficient sleep (<7 hours): 46.9%
> Adults reporting poor or fair health: 28.2% — 195th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.1 — 895th highest of 3,106 counties
> Adult obesity rate: 39.8% — 406th highest of 3,106 counties
> Adults with diabetes: 17.1% — 333rd highest of 3,106 counties
10. Letcher County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 47.1%
> Adults reporting poor or fair health: 30.4% — 99th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.3 — 26th highest of 3,106 counties
> Adult obesity rate: 38.6% — 575th highest of 3,106 counties
> Adults with diabetes: 20.3% — 94th highest of 3,106 counties
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9. Honolulu County, Hawaii
> Adults reporting insufficient sleep (<7 hours): 47.1%
> Adults reporting poor or fair health: 17.0% — 957th lowest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 3.6 — 184th lowest of 3,106 counties
> Adult obesity rate: 24.4% — 212th lowest of 3,106 counties
> Adults with diabetes: 11.3% — 1,353rd lowest of 3,106 counties
8. Clay County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 47.1%
> Adults reporting poor or fair health: 35.7% — 21st highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.3 — 23rd highest of 3,106 counties
> Adult obesity rate: 37.5% — 775th highest of 3,106 counties
> Adults with diabetes: 12.3% — 1,410th highest of 3,106 counties
7. McDowell County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 47.4%
> Adults reporting poor or fair health: 36.5% — 11th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 7.3 — the highest of 3,106 counties
> Adult obesity rate: 44.9% — 81st highest of 3,106 counties
> Adults with diabetes: 17.0% — 340th highest of 3,106 counties
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6. Hardeman County, Tennessee
> Adults reporting insufficient sleep (<7 hours): 47.4%
> Adults reporting poor or fair health: 30.2% — 104th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.8 — 150th highest of 3,106 counties
> Adult obesity rate: 35.3% — 1,223rd highest of 3,106 counties
> Adults with diabetes: 20.3% — 96th highest of 3,106 counties
5. Pike County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 47.6%
> Adults reporting poor or fair health: 30.3% — 100th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.1 — 58th highest of 3,106 counties
> Adult obesity rate: 39.7% — 419th highest of 3,106 counties
> Adults with diabetes: 17.7% — 268th highest of 3,106 counties
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4. Boone County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 47.6%
> Adults reporting poor or fair health: 28.5% — 175th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 7.0 — 3rd highest of 3,106 counties
> Adult obesity rate: 42.4% — 180th highest of 3,106 counties
> Adults with diabetes: 20.9% — 76th highest of 3,106 counties
3. Greene County, Alabama
> Adults reporting insufficient sleep (<7 hours): 47.8%
> Adults reporting poor or fair health: 34.5% — 33rd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 5.8 — 108th highest of 3,106 counties
> Adult obesity rate: 38.0% — 663rd highest of 3,106 counties
> Adults with diabetes: 21.8% — 53rd highest of 3,106 counties
2. Mingo County, West Virginia
> Adults reporting insufficient sleep (<7 hours): 48.7%
> Adults reporting poor or fair health: 32.9% — 48th highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 7.1 — 2nd highest of 3,106 counties
> Adult obesity rate: 41.9% — 221st highest of 3,106 counties
> Adults with diabetes: 22.1% — 48th highest of 3,106 counties
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1. McCreary County, Kentucky
> Adults reporting insufficient sleep (<7 hours): 49.1%
> Adults reporting poor or fair health: 35.4% — 23rd highest of 3,106 counties
> Avg. number of mentally unhealthy days reported in past month: 6.5 — 10th highest of 3,106 counties
> Adult obesity rate: 37.7% — 728th highest of 3,106 counties
> Adults with diabetes: 17.1% — 335th highest of 3,106 counties
Methodology
To determine America’s most sleep deprived counties, 24/7 Tempo reviewed the share of adults reporting fewer than seven hours of sleep on average from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report. While the CHR report is from 2021, insufficient sleep figures published in the report are from 2018.
Of the 3,220 counties or county equivalents, 3,142 had boundaries that fell within one of the 50 states or the District of Columbia. Counties with a 2019 five-year population estimate from the U.S. Census Bureau of less than 1,000 were excluded.
The remaining 3,106 places were ranked based on the share of adults reporting insufficient sleep. Additional information on the share of adults reporting poor or fair health, the average number of mentally unhealthy days reported in the past 30 days, adults 20 years and older who report a body mass index of 30 kg/m2 or higher (considered obese), and the share of adults 20 years and older with diagnosed diabetes are also from the 2021 CHR.
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