Health Insurance
Louisiana Residents Have the Most Bad Habits — Here Are the States That Follow
Many Americans developed bad habits during the COVID-19 pandemic. In fact, a 2021 ValuePenguin survey found that 61% of Americans were working to overcome unhealthy behaviors they developed during the crisis.
However, bad habits aren’t easy to shake, and you may be more prone to developing them depending on where you live. According to the newest ValuePenguin study, Louisiana residents exhibit the most unhealthy behaviors, while New Hampshire residents have the healthiest habits.
Here’s what else we found.
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Key findings
- Louisiana residents exhibit the most negative habits — and it’s not particularly close. ValuePenguin researchers examined six factors, from binge drinking and smoking to consuming fruits and vegetables. Louisiana’s ranking is largely due to unhealthy eating habits, with residents in the state least likely to eat vegetables and second least likely to eat fruits at least once a day. Mississippi ranks second for its bad habits, while Indiana, Alabama and Ohio tie for third.
- New Hampshire residents have the healthiest habits compared to other states. New Hampshire residents are the third most likely to eat vegetables and the seventh most likely to eat fruits at least once a day. Additionally, 80.0% of residents participated in physical activities in the past 30 days at the time of the Centers for Disease Control and Prevention (CDC) survey — ranking it seventh among the states with the most physically active residents. Utah and Washington are the next states with the healthiest habits.
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Residents in some states excel in some categories but fall behind in others. For example, Washington, D.C., has the highest percentage of residents who exercised in the past 30 days (84.2%), but it also has the highest rate of binge drinkers (22.5%). Similarly, West Virginia has the lowest percentage of binge drinkers (11.6%), yet it has the highest rate of smokers (22.0%).
How did we determine which states have the most bad habits?
To determine which states exhibit the most unhealthy habits, ValuePenguin researchers analyzed Centers for Disease Control and Prevention (CDC) 2021 Behavioral Risk Factor Surveillance System (BRFSS) data. Specifically, researchers looked at the following factors in each state:
- The percentage of binge drinkers (defined as men having five or more drinks on one occasion and women having four or more drinks on one occasion over 30 days).
- The percentage of adults who are current smokers.
- The percentage of adults who consume fruits and vegetables less than once a day.
- The percentage of residents who didn’t participate in physical activities in the past 30 days.
While most data was reported in 2021 — the latest available — researchers used 2020 CDC BRFSS data to determine the percentage of adults who reported getting less than seven hours of sleep a night.
Florida was excluded in all metrics except for sleep deprivation. Per the CDC BRFSS, "Florida was unable to collect BRFSS data over enough months to meet the minimum requirements for inclusion in the 2021 annual aggregate data set."
Louisiana residents have the most bad habits
By state, Louisiana residents exhibit the most negative habits by a long shot. That’s largely due to unhealthy eating habits: Just 74.4% of Louisiana residents eat vegetables at least once a day, making them the least likely to do so. Meanwhile, 51.4% of the Bayou State’s residents eat fruit at least once a day — second-worst across the U.S.
According to the CDC, adults should consume one-and-a-half to two cups of fruits and two to three cups of vegetables daily. This supports a healthier immune system and helps to prevent obesity, Type 2 diabetes, cardiovascular diseases and some cancers.
There are several reasons why residents in Louisiana may be less likely to eat enough fruits and vegetables, the first being access. Generally speaking, income is strongly linked to health (particularly when it comes to diet). The median income in Louisiana is $53,571, which compares with the national median income of $69,021. Additionally, Louisiana has a poverty rate of 19.6% — significantly higher than the national rate of 11.6%. Because healthy food is often more expensive, many residents in Louisiana — particularly those in low-income rural areas — may be unable to afford fruits and vegetables.
States with the highest percentage of residents who eat vegetables less than once a day
Rank | State | % of residents who eat vegetables less than once a day | % of residents who eat vegetables one or more times a day |
|---|---|---|---|
| 1 | Louisiana | 25.6% | 74.4% |
| 2 | Texas | 24.1% | 75.9% |
| 3 | Nevada | 24.0% | 76.0% |
| 4 | Mississippi | 23.2% | 76.8% |
| 5 | Iowa | 23.0% | 77.0% |
Source: ValuePenguin analysis of Centers for Disease Control and Prevention (CDC) 2021 Behavioral Risk Factor Surveillance System (BRFSS) data.
It’s also worth noting that Louisiana's food culture and traditions don’t revolve around fruits and vegetables. Louisiana cuisine is heavily influenced by French, Spanish and African cultures, which led to the creation of the state’s signature Cajun and Creole cooking. These cooking traditions often involve rich, hearty meals like gumbo and jambalaya — dishes that can focus on meats and seafood more than fruits and vegetables.
States with the highest percentage of residents who eat fruits less than once a day
Rank | State | % of residents who eat fruits less than once a day | % of residents who eat fruits one or more times a day |
|---|---|---|---|
| 1 | Oklahoma | 48.7% | 51.3% |
| 2 | Louisiana | 48.6% | 51.4% |
| 3 | Mississippi | 46.8% | 53.2% |
| 4 | Tennessee | 46.1% | 53.9% |
| 5 | West Virginia | 46.0% | 54.0% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
Following Louisiana, Mississippi ranks second for its bad habits. Similarly, residents in Mississippi are the fourth least likely to eat vegetables and the third least likely to eat fruits. And again, financial barriers are to blame — the median income in the state is $49,111 and the poverty rate is 19.4%. Additionally, according to 2021 data from the nonprofit Feeding America, the food insecurity rate (the rate of residents with limited or uncertain availability of healthy foods) in Mississippi is 16.3%. That compares with a national rate of 10.4%.
Food culture also plays a role here. Mississippi is known for dishes that focus on fried meats and carb-heavy sides, which are prevalent in dishes stemming from Mississippi's African American heritage.
After Mississippi, Indiana, Alabama and Ohio tie for third. Indiana, Ohio and Alabama each rank among the 10 states with the highest rates of sleep-deprived residents and current smokers, while Alabama also has the highest rate of physical inactivity and the third-highest rate of sleep deprivation. It’s also worth noting that all three states’ poverty rates are higher than the national rate.
Residents in West Virginia are the least likely to get a full night’s sleep
Sleepless in Seattle? Try looking east to find out who’s missing out on their Zs. In 2020 (the latest available data on this metric), 42.8% of West Virginia residents got less than seven hours of sleep a night, on average — the highest percentage of any state.
That could be a side effect of other health issues. According to the CDC, West Virginia has the highest obesity rate in the country at 40.6% among adults (as of 2021). Obesity has been linked to sleep disorders such as sleep apnea, insomnia and more.
States with the highest percentage of sleep-deprived residents
Rank | State | % of adults who get less than 7 hours of sleep a night | % of adults who get at least 7 hours of sleep a night |
|---|---|---|---|
| 1 | West Virginia | 42.8% | 57.2% |
| 2 | Hawaii | 41.9% | 58.1% |
| 3 | Alabama | 41.2% | 58.8% |
| 4 | Kentucky | 40.5% | 59.5% |
| 5 | Pennsylvania | 39.3% | 60.7% |
Source: ValuePenguin analysis of CDC 2020 BRFSS data.
Following West Virginia, residents in Hawaii (41.9%) and Alabama (41.2%) are the least likely to get enough sleep at night. On the other hand, residents in Colorado (29.3%), Minnesota (30.1%) and Vermont (30.5%) are the least likely to experience sleep deprivation.
Full rankings
States with the highest/lowest percentage of residents who eat vegetables less than once a day
Rank | State | % of residents who eat vegetables less than once a day | % of residents who eat vegetables one or more times a day |
|---|---|---|---|
| 1 | Louisiana | 25.6% | 74.4% |
| 2 | Texas | 24.1% | 75.9% |
| 3 | Nevada | 24.0% | 76.0% |
| 4 | Mississippi | 23.2% | 76.8% |
| 5 | Iowa | 23.0% | 77.0% |
| 6 | North Dakota | 22.7% | 77.3% |
| 7 | California | 22.5% | 77.5% |
| 8 | New Mexico | 22.3% | 77.7% |
| 9 | Hawaii | 21.9% | 78.1% |
| 10 | Arizona | 21.6% | 78.4% |
| 11 | New Jersey | 21.3% | 78.7% |
| 12 | Indiana | 20.9% | 79.1% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
States with the highest/lowest percentage of residents who eat fruits less than once a day
Rank | State | % of residents who eat fruits less than once a day | % of residents who eat fruits one or more times a day |
|---|---|---|---|
| 1 | Oklahoma | 48.7% | 51.3% |
| 2 | Louisiana | 48.6% | 51.4% |
| 3 | Mississippi | 46.8% | 53.2% |
| 4 | Tennessee | 46.1% | 53.9% |
| 5 | West Virginia | 46.0% | 54.0% |
| 6 | Alabama | 45.8% | 54.2% |
| 7 | Arkansas | 45.4% | 54.6% |
| 8 | Kentucky | 45.0% | 55.0% |
| 9 | North Dakota | 44.0% | 56.0% |
| 10 | Kansas | 43.7% | 56.3% |
| 11 | Missouri | 43.4% | 56.6% |
| 11 | South Dakota | 43.4% | 56.6% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
States with the highest/lowest percentage of sleep-deprived residents
Rank | State | % of adults who get less than 7 hours of sleep a night | % of adults who get at least 7 hours of sleep a night |
|---|---|---|---|
| 1 | West Virginia | 42.8% | 57.2% |
| 2 | Hawaii | 41.9% | 58.1% |
| 3 | Alabama | 41.2% | 58.8% |
| 4 | Kentucky | 40.5% | 59.5% |
| 5 | Pennsylvania | 39.3% | 60.7% |
| 6 | Louisiana | 38.4% | 61.6% |
| 7 | Georgia | 38.2% | 61.8% |
| 7 | Ohio | 38.2% | 61.8% |
| 9 | Arkansas | 38.0% | 62.0% |
| 10 | Indiana | 37.9% | 62.1% |
| 11 | Mississippi | 37.5% | 62.5% |
| 12 | Nevada | 37.4% | 62.6% |
Source: ValuePenguin analysis of CDC 2020 BRFSS data.
New Hampshire residents are the most healthy
On the other end of the list, New Hampshire residents have the healthiest habits compared to other states. New Hampshire residents are the third most likely to eat vegetables and the seventh most likely to eat fruits at least once a day.
Additionally, 4 in 5 (80.0%) residents participated in physical activities in the past 30 days at the time of the CDC survey. That ranks it seventh among the states with the most physically active residents. For comparison, the top five most physically active states are:
- The District of Columbia (84.2%)
- Colorado (83.3%)
- Utah (82.7%)
- Washington (82.2%)
- Vermont (82.2%)
Income again plays a role in New Hampshire’s rankings: The median household income in New Hampshire is $83,449, which is significantly higher than the national median income of $69,021. Additionally, the poverty rate in New Hampshire is 7.2%, which is well below the national rate of 11.6%. Beyond diet, high-income residents are also more likely to live in areas conducive to physical activities than low-income residents. Low-income Americans also have higher rates of physical limitation than high-income Americans.
Education may also be a factor. New Hampshire has implemented programs and resources to promote healthy eating habits, such as the Healthy Habits for Well-Being initiative by the New Hampshire Department of Education and the Governor's Council on Physical Activity & Health.
Utah and Washington are the next states with the healthiest habits. Worth noting, Utah has the lowest percentage of current smokers (7.2%) and the second-lowest percentage of binge drinkers (11.8%). Meanwhile, Washington has the fourth-highest percentage of residents who participated in physical activities (82.2%) and the ninth-lowest percentage of sleep-deprived residents (32.2%).
Like New Hampshire, both Utah and Washington have poverty rates below the national rate, at 8.6% and 9.9%, respectively.
According to ValuePenguin health insurance expert Divya Sangameshwar, these healthy habits are critical to lowering health insurance rates — particularly as the average premium for family plans increased by 20% from 2017 to 2022, according to a study conducted by KFF.
"Companies seeking to keep costs low are offering lower-cost high-deductible health plans and pushing employees to enroll in wellness programs that encourage preventive health care and good habits," she says. "A poor diet, smoking, binge drinking or consuming drugs can lead to drastically higher health care costs."
Full rankings
States with the highest/lowest percentage of residents who participated in physical activities in the past 30 days
Rank | State | % of residents who participated | % of residents who didn't participate |
|---|---|---|---|
| 1 | Alabama | 68.5% | 31.5% |
| 2 | Mississippi | 69.1% | 30.9% |
| 3 | Arkansas | 69.4% | 30.6% |
| 4 | Kentucky | 69.5% | 30.5% |
| 4 | West Virginia | 69.5% | 30.5% |
| 6 | Louisiana | 70.6% | 29.4% |
| 7 | Tennessee | 71.3% | 28.7% |
| 8 | Oklahoma | 71.7% | 28.3% |
| 9 | Delaware | 72.8% | 27.2% |
| 9 | Illinois | 72.8% | 27.2% |
| 11 | Maine | 73.5% | 26.5% |
| 12 | Ohio | 74.0% | 26.0% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
Residents in some states may do well in some categories but poorly in others
Being healthy means balancing several good habits, but residents in some states may have some weak spots. For example, Washington, D.C., has the highest percentage of residents who exercised in the past 30 days (84.2%) but also has the highest rate of binge drinkers (22.5%).
This discrepancy may be due to its population. The district has a young population — and younger people may be more prone to both exercising and drinking, particularly as social activities.
States with the highest percentage of residents who binged on alcohol in the past 30 days
Rank | State | % of residents who binge drank | % of residents who didn't binge drink |
|---|---|---|---|
| 1 | District of Columbia | 22.5% | 77.5% |
| 2 | Wisconsin | 21.9% | 78.1% |
| 3 | North Dakota | 20.8% | 79.2% |
| 4 | Montana | 20.5% | 79.5% |
| 5 | Iowa | 20.1% | 79.9% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
Similarly, West Virginia has the lowest percentage of binge drinkers (11.6%) but the highest rate of current smokers (22.0%).
While it may be difficult to understand how these starkly contrasting habits may impact health, Sangameshwar says it’s important to consider health habits in their broader context.
"Americans’ good and bad habits can’t be viewed in a vacuum, because wealth, access to jobs, a safe place to live or go to school, stress levels, social isolation, racism, poverty and the lack of access to healthy food and other resources all play a role in all our habits," she says. "For some Americans, the system is stacked against their efforts to embrace good and healthy habits. These stats and other research can help employers, insurers and governments understand how they can make it easier for Americans to make healthier choices."
States with the highest percentage of current smokers
Rank | State | % of residents who are current smokers | % of residents who aren’t current smokers |
|---|---|---|---|
| 1 | West Virginia | 22.0% | 78.0% |
| 2 | Arkansas | 21.1% | 78.9% |
| 3 | Tennessee | 19.7% | 80.3% |
| 4 | Kentucky | 19.6% | 80.4% |
| 4 | Mississippi | 19.6% | 80.4% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
Full rankings
States with the highest/lowest percentage of residents who binged on alcohol in the past 30 days
Rank | State | % of residents who binge drank | % of residents who didn't binge drink |
|---|---|---|---|
| 1 | District of Columbia | 22.5% | 77.5% |
| 2 | Wisconsin | 21.9% | 78.1% |
| 3 | North Dakota | 20.8% | 79.2% |
| 4 | Montana | 20.5% | 79.5% |
| 5 | Iowa | 20.1% | 79.9% |
| 6 | South Dakota | 19.6% | 80.4% |
| 7 | Nebraska | 19.5% | 80.5% |
| 8 | Colorado | 18.7% | 81.3% |
| 9 | Minnesota | 17.9% | 82.1% |
| 10 | Kansas | 17.7% | 82.3% |
| 11 | Alaska | 17.5% | 82.5% |
| 12 | Rhode Island | 17.3% | 82.7% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
States with the highest/lowest percentage of current smokers
Rank | State | % of residents who are current smokers | % of residents who aren’t current smokers |
|---|---|---|---|
| 1 | West Virginia | 22.0% | 78.0% |
| 2 | Arkansas | 21.1% | 78.9% |
| 3 | Tennessee | 19.7% | 80.3% |
| 4 | Kentucky | 19.6% | 80.4% |
| 4 | Mississippi | 19.6% | 80.4% |
| 6 | Louisiana | 19.5% | 80.5% |
| 7 | Ohio | 18.0% | 82.0% |
| 8 | Indiana | 17.3% | 82.7% |
| 8 | Missouri | 17.3% | 82.7% |
| 10 | Alabama | 17.2% | 82.8% |
| 11 | Alaska | 17.1% | 82.9% |
| 12 | Michigan | 17.0% | 83.0% |
Source: ValuePenguin analysis of CDC 2021 BRFSS data.
Full rankings: States with the most bad habits
Rank | State | Alcohol ranking | Smoking ranking | Physical activity ranking | Fruits ranking | Vegetables ranking | Sleep-deprivation ranking | Score |
|---|---|---|---|---|---|---|---|---|
| 1 | Louisiana | 13 | 6 | 6 | 2 | 1 | 6 | 5.67 |
| 2 | Mississippi | 46 | 4 | 2 | 3 | 4 | 11 | 11.67 |
| 3 | Indiana | 24 | 8 | 13 | 15 | 12 | 10 | 13.67 |
| 3 | Alabama | 46 | 10 | 1 | 6 | 16 | 3 | 13.67 |
| 3 | Ohio | 15 | 7 | 12 | 14 | 27 | 7 | 13.67 |
| 6 | Arkansas | 43 | 2 | 3 | 7 | 19 | 9 | 13.83 |
| 7 | Kentucky | 45 | 4 | 4 | 8 | 24 | 4 | 14.83 |
| 8 | Tennessee | 37 | 3 | 7 | 4 | 25 | 17 | 15.50 |
| 9 | North Dakota | 3 | 20 | 15 | 9 | 6 | 41 | 15.67 |
| 10 | Missouri | 16 | 8 | 16 | 11 | 28 | 18 | 16.20 |
| 11 | West Virginia | 50 | 1 | 4 | 5 | 37 | 1 | 16.33 |
| 12 | Oklahoma | 48 | 13 | 8 | 1 | 14 | 21 | 17.50 |
Source: ValuePenguin analysis of CDC 2021 and 2020 BRFSS data. Note: Each of the categories was weighted equally.
Bad habits and health insurance: What to know
Engaging in unhealthy habits can certainly impact health insurance — and, according to Sangameshwar, that financial burden is heavy enough as it is.
"The reality for most Americans is that their salary growth isn’t keeping up with rising health care expenses, and many Americans accrue medical debt as a result of their health issues," she says. "The financial burden of health care is causing many Americans to delay or skip medical treatment, which can raise health care expenses further."
Worsening health is one of the primary reasons for rising health care costs and our struggle to manage them, Sangameswhar says. While quitting smoking is generally the only thing among our tracked bad habits that will directly impact health insurance premiums, adopting habits like getting regular preventive care checkups, quitting smoking and binge drinking, eating healthy and getting regular exercise will improve your health outcomes and lower your cost of health care in the long term.
It’s also worth noting that some employers offer cash or other incentives to employees if they adopt healthier habits. If you’re on an employer-sponsored plan and are looking to lower your health insurance premium, consider asking your employer if any health programs may be available.
Methodology
To determine which states exhibited the most unhealthy habits, ValuePenguin researchers analyzed Centers for Disease Control and Prevention (CDC) 2021 Behavioral Risk Factor Surveillance System (BRFSS) data. Specifically, researchers looked at the following factors in each state:
- The percentage of binge drinkers (defined as men having five or more drinks on one occasion and women having four or more drinks on one occasion over 30 days).
- The percentage of adults who are current smokers.
- The percentage of adults who consume fruits and vegetables less than once a day (fruits and vegetables are tracked separately as individual metrics).
- The percentage of residents who didn’t participate in physical activities in the past 30 days.
Additionally, researchers used 2020 CDC BRFSS data to determine the percentage of adults who reported getting less than seven hours of sleep a night.
Each of the six categories was weighted equally to calculate a score.
Per the CDC BRFSS, "Florida was unable to collect BRFSS data over enough months to meet the minimum requirements for inclusion in the 2021 annual aggregate data set."