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.
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 the most sleep deprived metro area in every state. Four states — Delaware, New Hampshire, Rhode Island, and Vermont — have only one metro area. As a result, these areas rank as the most sleep deprived in the state by default only.
Though each metro area on this list has the highest sleep deprivation rate in the state, the share of adults sleeping less than seven hours per night varies considerably — from as low as 29.8% up to 47.1%. Nationwide, 35.2% of adults are not getting enough sleep.
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 majority of metro areas on this list, rates of both diabetes and obesity are higher than they are across the state as a whole. 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 the most sleep deprived metro area in every state
Click here to read our detailed methodology
Alabama: Tuscaloosa
> Adults reporting insufficient sleep (<7 hours): 41.9% (Alabama: 39.6%)
> Adults reporting poor or fair health: 22.4% (Alabama: 21.4%)
> Avg. number of mentally unhealthy days reported in past month: 5.0 (Alabama: 4.9)
> Adult obesity rate: 36.9% (Alabama: 36.1%)
> Adults with diabetes: 13.1% (Alabama: 14.5%)
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Alaska: Anchorage
> Adults reporting insufficient sleep (<7 hours): 34.1% (Alaska: 33.3%)
> Adults reporting poor or fair health: 14.8% (Alaska: 15.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Alaska: 3.7)
> Adult obesity rate: 31.3% (Alaska: 31.9%)
> Adults with diabetes: 8.5% (Alaska: 8.3%)
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Arizona: Lake Havasu City-Kingman
> Adults reporting insufficient sleep (<7 hours): 39.3% (Arizona: 34.9%)
> Adults reporting poor or fair health: 22.5% (Arizona: 18.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Arizona: 4.0)
> Adult obesity rate: 30.7% (Arizona: 27.9%)
> Adults with diabetes: 14.0% (Arizona: 9.6%)
Arkansas: Pine Bluff
> Adults reporting insufficient sleep (<7 hours): 39.7% (Arkansas: 37.2%)
> Adults reporting poor or fair health: 28.0% (Arkansas: 23.3%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Arkansas: 5.3)
> Adult obesity rate: 42.5% (Arkansas: 35.0%)
> Adults with diabetes: 14.7% (Arkansas: 13.5%)
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California: Riverside-San Bernardino-Ontario
> Adults reporting insufficient sleep (<7 hours): 38.0% (California: 34.5%)
> Adults reporting poor or fair health: 22.2% (California: 17.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.4 (California: 3.7)
> Adult obesity rate: 29.5% (California: 24.3%)
> Adults with diabetes: 10.0% (California: 8.8%)
Colorado: Pueblo
> Adults reporting insufficient sleep (<7 hours): 36.1% (Colorado: 30.0%)
> Adults reporting poor or fair health: 20.1% (Colorado: 13.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.4 (Colorado: 3.7)
> Adult obesity rate: 31.0% (Colorado: 22.4%)
> Adults with diabetes: 10.0% (Colorado: 6.6%)
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Connecticut: Norwich-New London
> Adults reporting insufficient sleep (<7 hours): 37.9% (Connecticut: 33.8%)
> Adults reporting poor or fair health: 13.6% (Connecticut: 13.0%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Connecticut: 3.8)
> Adult obesity rate: 30.4% (Connecticut: 26.3%)
> Adults with diabetes: 9.8% (Connecticut: 9.2%)
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Delaware: Dover*
> Adults reporting insufficient sleep (<7 hours): 39.3% (Delaware: 36.5%)
> Adults reporting poor or fair health: 21.0% (Delaware: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Delaware: 4.2)
> Adult obesity rate: 38.4% (Delaware: 32.4%)
> Adults with diabetes: 13.9% (Delaware: 11.8%)
*Because Dover is the only eligible metro in Delaware, it is the most sleep deprived metro by default.
Florida: Homosassa Springs
> Adults reporting insufficient sleep (<7 hours): 42.9% (Florida: 37.3%)
> Adults reporting poor or fair health: 19.8% (Florida: 19.5%)
> Avg. number of mentally unhealthy days reported in past month: 5.3 (Florida: 4.2)
> Adult obesity rate: 28.7% (Florida: 27.2%)
> Adults with diabetes: 13.3% (Florida: 10.8%)
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Georgia: Hinesville
> Adults reporting insufficient sleep (<7 hours): 43.0% (Georgia: 38.3%)
> Adults reporting poor or fair health: 22.3% (Georgia: 18.4%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Georgia: 4.2)
> Adult obesity rate: 36.5% (Georgia: 32.3%)
> Adults with diabetes: 12.4% (Georgia: 12.0%)
Hawaii: Urban Honolulu
> Adults reporting insufficient sleep (<7 hours): 47.1% (Hawaii: 43.2%)
> Adults reporting poor or fair health: 17.0% (Hawaii: 15.4%)
> Avg. number of mentally unhealthy days reported in past month: 3.6 (Hawaii: 3.4)
> Adult obesity rate: 24.4% (Hawaii: 24.6%)
> Adults with diabetes: 11.3% (Hawaii: 11.1%)
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Idaho: Coeur d’Alene
> Adults reporting insufficient sleep (<7 hours): 34.9% (Idaho: 33.4%)
> Adults reporting poor or fair health: 15.9% (Idaho: 15.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Idaho: 4.0)
> Adult obesity rate: 26.1% (Idaho: 29.0%)
> Adults with diabetes: 9.1% (Idaho: 9.3%)
Illinois: Kankakee
> Adults reporting insufficient sleep (<7 hours): 36.6% (Illinois: 33.5%)
> Adults reporting poor or fair health: 19.2% (Illinois: 15.9%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Illinois: 3.8)
> Adult obesity rate: 38.0% (Illinois: 29.7%)
> Adults with diabetes: 13.2% (Illinois: 9.9%)
Indiana: Michigan City-La Porte
> Adults reporting insufficient sleep (<7 hours): 39.0% (Indiana: 38.0%)
> Adults reporting poor or fair health: 21.5% (Indiana: 18.2%)
> Avg. number of mentally unhealthy days reported in past month: 5.0 (Indiana: 4.7)
> Adult obesity rate: 37.4% (Indiana: 33.9%)
> Adults with diabetes: 15.2% (Indiana: 12.1%)
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Iowa: Davenport-Moline-Rock Island
> Adults reporting insufficient sleep (<7 hours): 34.9% (Iowa: 33.1%)
> Adults reporting poor or fair health: 15.6% (Iowa: 13.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Iowa: 3.5)
> Adult obesity rate: 34.1% (Iowa: 34.3%)
> Adults with diabetes: 11.5% (Iowa: 9.9%)
Kansas: Wichita
> Adults reporting insufficient sleep (<7 hours): 34.6% (Kansas: 34.0%)
> Adults reporting poor or fair health: 17.3% (Kansas: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Kansas: 4.1)
> Adult obesity rate: 33.4% (Kansas: 33.0%)
> Adults with diabetes: 11.3% (Kansas: 10.5%)
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Kentucky: Elizabethtown-Fort Knox
> Adults reporting insufficient sleep (<7 hours): 43.1% (Kentucky: 42.1%)
> Adults reporting poor or fair health: 21.7% (Kentucky: 21.8%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Kentucky: 5.0)
> Adult obesity rate: 38.8% (Kentucky: 34.6%)
> Adults with diabetes: 12.1% (Kentucky: 12.7%)
Louisiana: Lake Charles
> Adults reporting insufficient sleep (<7 hours): 41.7% (Louisiana: 38.0%)
> Adults reporting poor or fair health: 20.8% (Louisiana: 21.4%)
> Avg. number of mentally unhealthy days reported in past month: 5.0 (Louisiana: 5.0)
> Adult obesity rate: 35.8% (Louisiana: 36.3%)
> Adults with diabetes: 11.8% (Louisiana: 13.0%)
Maine: Lewiston-Auburn
> Adults reporting insufficient sleep (<7 hours): 40.4% (Maine: 34.5%)
> Adults reporting poor or fair health: 17.8% (Maine: 17.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Maine: 5.0)
> Adult obesity rate: 33.4% (Maine: 29.8%)
> Adults with diabetes: 12.2% (Maine: 10.4%)
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Maryland: Cumberland
> Adults reporting insufficient sleep (<7 hours): 41.4% (Maryland: 37.7%)
> Adults reporting poor or fair health: 20.3% (Maryland: 15.2%)
> Avg. number of mentally unhealthy days reported in past month: 5.3 (Maryland: 3.7)
> Adult obesity rate: 35.2% (Maryland: 31.6%)
> Adults with diabetes: 14.1% (Maryland: 11.1%)
Massachusetts: Worcester
> Adults reporting insufficient sleep (<7 hours): 38.5% (Massachusetts: 34.3%)
> Adults reporting poor or fair health: 14.8% (Massachusetts: 13.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Massachusetts: 4.3)
> Adult obesity rate: 28.6% (Massachusetts: 25.0%)
> Adults with diabetes: 9.4% (Massachusetts: 8.7%)
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Michigan: Niles
> Adults reporting insufficient sleep (<7 hours): 41.9% (Michigan: 40.4%)
> Adults reporting poor or fair health: 19.0% (Michigan: 18.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Michigan: 4.7)
> Adult obesity rate: 34.3% (Michigan: 32.4%)
> Adults with diabetes: 11.5% (Michigan: 11.0%)
Minnesota: St. Cloud
> Adults reporting insufficient sleep (<7 hours): 31.2% (Minnesota: 29.1%)
> Adults reporting poor or fair health: 13.6% (Minnesota: 12.9%)
> Avg. number of mentally unhealthy days reported in past month: 3.7 (Minnesota: 3.5)
> Adult obesity rate: 30.0% (Minnesota: 29.0%)
> Adults with diabetes: 8.6% (Minnesota: 8.5%)
Mississippi: Gulfport-Biloxi
> Adults reporting insufficient sleep (<7 hours): 38.7% (Mississippi: 37.8%)
> Adults reporting poor or fair health: 21.3% (Mississippi: 22.1%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Mississippi: 4.8)
> Adult obesity rate: 35.3% (Mississippi: 39.1%)
> Adults with diabetes: 12.1% (Mississippi: 14.6%)
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Missouri: St. Joseph
> Adults reporting insufficient sleep (<7 hours): 36.9% (Missouri: 35.2%)
> Adults reporting poor or fair health: 20.9% (Missouri: 19.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Missouri: 4.5)
> Adult obesity rate: 37.0% (Missouri: 32.5%)
> Adults with diabetes: 12.4% (Missouri: 11.4%)
Montana: Great Falls
> Adults reporting insufficient sleep (<7 hours): 35.9% (Montana: 30.9%)
> Adults reporting poor or fair health: 16.8% (Montana: 14.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.4 (Montana: 3.9)
> Adult obesity rate: 31.1% (Montana: 27.1%)
> Adults with diabetes: 9.8% (Montana: 8.9%)
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Nebraska: Lincoln
> Adults reporting insufficient sleep (<7 hours): 32.4% (Nebraska: 32.3%)
> Adults reporting poor or fair health: 12.5% (Nebraska: 13.8%)
> Avg. number of mentally unhealthy days reported in past month: 3.8 (Nebraska: 3.6)
> Adult obesity rate: 30.0% (Nebraska: 33.4%)
> Adults with diabetes: 8.2% (Nebraska: 10.0%)
Nevada: Las Vegas-Henderson-Paradise
> Adults reporting insufficient sleep (<7 hours): 38.7% (Nevada: 37.3%)
> Adults reporting poor or fair health: 21.6% (Nevada: 19.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Nevada: 4.0)
> Adult obesity rate: 27.3% (Nevada: 27.1%)
> Adults with diabetes: 10.9% (Nevada: 10.5%)
New Hampshire: Manchester-Nashua*
> Adults reporting insufficient sleep (<7 hours): 36.3% (New Hampshire: 35.3%)
> Adults reporting poor or fair health: 12.2% (New Hampshire: 12.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (New Hampshire: 4.6)
> Adult obesity rate: 28.5% (New Hampshire: 28.6%)
> Adults with diabetes: 9.7% (New Hampshire: 9.6%)
*Because Manchester-Nashua is the only eligible metro in New Hampshire, it is the most sleep deprived metro by default.
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New Jersey: Vineland-Bridgeton
> Adults reporting insufficient sleep (<7 hours): 42.6% (New Jersey: 37.5%)
> Adults reporting poor or fair health: 25.2% (New Jersey: 15.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (New Jersey: 3.8)
> Adult obesity rate: 36.5% (New Jersey: 27.0%)
> Adults with diabetes: 12.7% (New Jersey: 9.9%)
New Mexico: Las Cruces
> Adults reporting insufficient sleep (<7 hours): 33.4% (New Mexico: 33.1%)
> Adults reporting poor or fair health: 23.5% (New Mexico: 20.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (New Mexico: 4.5)
> Adult obesity rate: 26.4% (New Mexico: 27.3%)
> Adults with diabetes: 9.6% (New Mexico: 9.5%)
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New York: Utica-Rome
> Adults reporting insufficient sleep (<7 hours): 40.9% (New York: 38.9%)
> Adults reporting poor or fair health: 18.2% (New York: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (New York: 3.6)
> Adult obesity rate: 33.5% (New York: 26.4%)
> Adults with diabetes: 13.5% (New York: 10.1%)
North Carolina: Fayetteville
> Adults reporting insufficient sleep (<7 hours): 41.5% (North Carolina: 36.1%)
> Adults reporting poor or fair health: 22.2% (North Carolina: 18.0%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (North Carolina: 4.1)
> Adult obesity rate: 32.6% (North Carolina: 32.3%)
> Adults with diabetes: 12.0% (North Carolina: 11.5%)
North Dakota: Grand Forks
> Adults reporting insufficient sleep (<7 hours): 32.0% (North Dakota: 32.8%)
> Adults reporting poor or fair health: 15.7% (North Dakota: 13.6%)
> Avg. number of mentally unhealthy days reported in past month: 3.8 (North Dakota: 3.8)
> Adult obesity rate: 33.6% (North Dakota: 33.9%)
> Adults with diabetes: 9.2% (North Dakota: 9.4%)
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Ohio: Youngstown-Warren-Boardman
> Adults reporting insufficient sleep (<7 hours): 43.2% (Ohio: 40.6%)
> Adults reporting poor or fair health: 20.0% (Ohio: 17.8%)
> Avg. number of mentally unhealthy days reported in past month: 5.2 (Ohio: 4.8)
> Adult obesity rate: 36.2% (Ohio: 33.5%)
> Adults with diabetes: 13.4% (Ohio: 12.2%)
Oklahoma: Lawton
> Adults reporting insufficient sleep (<7 hours): 41.7% (Oklahoma: 37.5%)
> Adults reporting poor or fair health: 22.2% (Oklahoma: 20.9%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Oklahoma: 4.8)
> Adult obesity rate: 32.9% (Oklahoma: 34.5%)
> Adults with diabetes: 11.8% (Oklahoma: 12.3%)
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Oregon: Albany-Lebanon
> Adults reporting insufficient sleep (<7 hours): 37.0% (Oregon: 32.8%)
> Adults reporting poor or fair health: 19.2% (Oregon: 18.2%)
> Avg. number of mentally unhealthy days reported in past month: 5.2 (Oregon: 4.8)
> Adult obesity rate: 34.9% (Oregon: 29.3%)
> Adults with diabetes: 10.2% (Oregon: 9.7%)
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Pennsylvania: Scranton–Wilkes-Barre
> Adults reporting insufficient sleep (<7 hours): 41.4% (Pennsylvania: 38.6%)
> Adults reporting poor or fair health: 19.3% (Pennsylvania: 17.6%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Pennsylvania: 4.7)
> Adult obesity rate: 31.4% (Pennsylvania: 30.8%)
> Adults with diabetes: 11.5% (Pennsylvania: 11.0%)
Rhode Island: Providence-Warwick*
> Adults reporting insufficient sleep (<7 hours): 37.2% (Rhode Island: 36.7%)
> Adults reporting poor or fair health: 16.8% (Rhode Island: 16.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Rhode Island: 4.2)
> Adult obesity rate: 28.6% (Rhode Island: 28.5%)
> Adults with diabetes: 10.1% (Rhode Island: 10.1%)
*Because Providence-Warwick is the only eligible metro in Rhode Island, it is the most sleep deprived metro by default.
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South Carolina: Spartanburg
> Adults reporting insufficient sleep (<7 hours): 41.4% (South Carolina: 38.8%)
> Adults reporting poor or fair health: 18.9% (South Carolina: 17.8%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (South Carolina: 4.7)
> Adult obesity rate: 35.5% (South Carolina: 34.0%)
> Adults with diabetes: 12.9% (South Carolina: 13.3%)
South Dakota: Rapid City
> Adults reporting insufficient sleep (<7 hours): 29.8% (South Dakota: 30.1%)
> Adults reporting poor or fair health: 14.2% (South Dakota: 13.4%)
> Avg. number of mentally unhealthy days reported in past month: 3.5 (South Dakota: 3.3)
> Adult obesity rate: 29.3% (South Dakota: 32.4%)
> Adults with diabetes: 9.8% (South Dakota: 10.1%)
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Tennessee: Memphis
> Adults reporting insufficient sleep (<7 hours): 43.7% (Tennessee: 40.8%)
> Adults reporting poor or fair health: 22.8% (Tennessee: 21.2%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Tennessee: 5.2)
> Adult obesity rate: 36.3% (Tennessee: 33.3%)
> Adults with diabetes: 12.5% (Tennessee: 12.5%)
Texas: Beaumont-Port Arthur
> Adults reporting insufficient sleep (<7 hours): 40.5% (Texas: 34.4%)
> Adults reporting poor or fair health: 22.2% (Texas: 18.7%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Texas: 3.8)
> Adult obesity rate: 41.5% (Texas: 31.4%)
> Adults with diabetes: 13.6% (Texas: 10.2%)
Utah: Logan
> Adults reporting insufficient sleep (<7 hours): 33.6% (Utah: 31.2%)
> Adults reporting poor or fair health: 15.2% (Utah: 14.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Utah: 3.9)
> Adult obesity rate: 25.0% (Utah: 27.0%)
> Adults with diabetes: 6.1% (Utah: 7.5%)
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Vermont: Burlington-South Burlington*
> Adults reporting insufficient sleep (<7 hours): 30.6% (Vermont: 30.1%)
> Adults reporting poor or fair health: 11.8% (Vermont: 12.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.1 (Vermont: 4.2)
> Adult obesity rate: 25.4% (Vermont: 27.0%)
> Adults with diabetes: 7.7% (Vermont: 8.8%)
*Because Burlington-South Burlington is the only eligible metro in Vermont, it is the most sleep deprived metro by default.
Virginia: Virginia Beach-Norfolk-Newport News
> Adults reporting insufficient sleep (<7 hours): 40.1% (Virginia: 38.6%)
> Adults reporting poor or fair health: 17.6% (Virginia: 16.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.3 (Virginia: 4.0)
> Adult obesity rate: 33.3% (Virginia: 30.5%)
> Adults with diabetes: 11.9% (Virginia: 10.7%)
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Washington: Longview
> Adults reporting insufficient sleep (<7 hours): 37.1% (Washington: 31.8%)
> Adults reporting poor or fair health: 19.5% (Washington: 15.0%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Washington: 4.0)
> Adult obesity rate: 37.7% (Washington: 28.6%)
> Adults with diabetes: 13.2% (Washington: 9.3%)
West Virginia: Beckley
> Adults reporting insufficient sleep (<7 hours): 45.5% (West Virginia: 42.5%)
> Adults reporting poor or fair health: 25.6% (West Virginia: 23.6%)
> Avg. number of mentally unhealthy days reported in past month: 6.2 (West Virginia: 5.8)
> Adult obesity rate: 38.9% (West Virginia: 37.8%)
> Adults with diabetes: 17.9% (West Virginia: 15.1%)
Wisconsin: Wausau-Weston
> Adults reporting insufficient sleep (<7 hours): 34.4% (Wisconsin: 32.7%)
> Adults reporting poor or fair health: 14.3% (Wisconsin: 14.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Wisconsin: 4.0)
> Adult obesity rate: 33.5% (Wisconsin: 31.7%)
> Adults with diabetes: 9.2% (Wisconsin: 9.5%)
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Wyoming: Cheyenne
> Adults reporting insufficient sleep (<7 hours): 35.3% (Wyoming: 33.8%)
> Adults reporting poor or fair health: 15.4% (Wyoming: 15.3%)
> Avg. number of mentally unhealthy days reported in past month: 3.9 (Wyoming: 4.0)
> Adult obesity rate: 30.1% (Wyoming: 29.2%)
> Adults with diabetes: 9.9% (Wyoming: 9.0%)
Methodology
To determine the most sleep deprived metro in every state, 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.
We used the 384 metropolitan statistical areas as delineated by the United States Office of Management and Budget and used by the Census Bureau as our definition of metros.
Metros were ranked within their state based on the share of adults reporting insufficient sleep. Since many metros cross state lines, the metro was assigned to the state of its first-listed principal city. Thus, the Washington-Arlington-Alexandria, DC-VA-MD-WV metro area was excluded as it is principally in the District of Columbia.
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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