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Why Southerners in the US are Less Healthy — An In Depth Look – Opinion

The Centers for Disease Control (CDC) reports that the Southern US population ranks amongst the least healthy in the country. Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee collectively have the highest number of deaths from heart diseases, cancer, chronic lower respiratory diseases, cerebrovascular diseases, and unintentional injuries.

In this article, I’ll explore the main reasons, in my opinion, why the Southern States rank so poorly in health relative to the rest of the US population.

High Poverty Rate

The South has some of the poorest states in the country, Mississippi leading the way with 21% of its population below the poverty line. This is closely followed by Louisiana (20%), Kentucky (18.5%), West Virginia (17.9%), Arkansas (17.2%), Alabama (17.1%) and Georgia (16%).

Since income is closely related to health, poor people have higher mortality rates and a higher chance of developing acute or chronic diseases and emotional and behavioral issues.

In fact, according to a 2011 report released by the U.S. Senate Subcommittee on Primary Health and Aging, people in the lowest income group die on average of 6.5 years earlier than those in the highest income group. 

Unhealthy Eating Habits

This high poverty rate contributes to the unhealthy eating habits of the Southerners as well. In fact, based on Consumer Protect’s report, 8 of the top 10 most obese states are from the South.

West Virginia leads the way with a 38.1% obesity rate, with Mississippi, Oklahoma, Alabama, Louisiana, Arkansas, Kentucky, and South Carolina at its heels. As you can see, most of these states are also included in the country’s poorest states.

Jeff Levi of Trust for American explained that people with low-income have high-calorie diets in general since fruits and vegetables are more expensive. The CDC’s report that a significantly higher number of adults in this region eat less than a piece of fruit per day supports this. Impoverished neighborhoods also tend to have more convenience stores rather than grocery stores.

Sedentary Lifestyle

The poor eating habits of the Southerners are exacerbated by a sedentary lifestyle. In the same report by Consumer Protect, the top 10 states which have the highest percentage of adults engaging in zero physical exercise are all from the Southern states.

However, it’s not just the lack of physical exercise that increases the obesity rate in the South. In a study done by Walkscore of 141 US cities, 9 Southern cities occupied the top 10 spots in the least walkable neighborhood index.

Public transportation in the South is meager so most people get around by cars. This is an often-overlooked factor but a couple of blocks people walk to get to the bus or train station do add up over time. 

The Southern states also do not have a lot of sidewalks and what they do have are quite narrow. People who are interested in biking or jogging will often find themselves too close to the traffic for comfort.

With a high rate of sedentary behavior in the South comes serious health consequences. According to relevant statistics, a sedentary lifestyle increases the chances of death by 71%, and heart disease by 147%. The risks of cancer is also greatly increased as a result.

Poor Lifestyle Choices

Apart from a sedentary lifestyle and unhealthy eating habits, Southerners are more likely to have poor lifestyle habits.

For example, according to the CDC, the South has the highest number of cigarette smokers out of all regions.  Plus, out of the 26 states that have 100% indoor smoking bans, not a single Southern state is included.

Smoking which has been linked to heart disease, stroke, cancer, and lung diseases contributes to the high number of preventable deaths in this region.

In addition, in Wallethub’s ranking of the most stressed states, 7 of the top 10 are from the South due to the high poverty rate, long hours of work, and poor health. Over time, chronic stress can lead to mental health problems, cardiovascular diseases, eating disorders, and gastrointestinal issues.

A 24/7 Wall St. research also showed that half of the 10 states getting the least sleep are from the Southern region. Lack of sleep greatly diminishes a person’s cognitive abilities, putting them at a higher risk of car and workplace accidents.  It is associated with adverse health effects such as obesity, high blood pressure, stroke, coronary heart disease, and chronic stress as well.

Low Access to Health Care and Insurance

A 2014 Kaiser Family Foundation report showed that Southerners are less likely to be insured and covered compared to those in the Northeast and Midwest regions. The same report also mentioned that adults in the South are more likely to report difficulty in obtaining healthcare services and prescription drugs.

These issues are mainly due to the fact that a majority of Southern adults work in low-paying jobs or small firms that often do not include health coverage benefits. 22% of the region’s population lives in a primary care Health Professional Shortage Area (HPSA) as well.

The Affordable Care Act can help bridge this health gap by providing affordable healthcare insurance to low-income households and lowering the costs in general. However, as of 2019, only 8 of the 17 Southern states have implemented the Medicaid expansion.

At the end of the day, data shows a clear picture of why Southerners are living shorter and sicker lives. What the region needs is a comprehensive strategy that can slowly reverse the long history of poor health in the area.

A multipronged approach that includes increasing the minimum wage, improving education and promoting a healthier diet and lifestyle should be considered to tackle the complex and deadly challenges faced by Southerners.


Jon Muller

Author Bio:  Jon Muller is the founder of Ergonomic Trends where he blogs about ergonomics, office productivity, and ways to stay healthy at the office. During his spare time, he loves walking his dog and hiking with his friends and family.

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