Do You Live in the ‘Stroke Belt?’ These Are the 13 Unhealthiest U.S. States

The United States has become known around the world for its insanely large portions, obsession with fast food, and all-around unhealthy lifestyle. And all of these unhealthy habits lead to health problems — such as a higher stroke risk. But there are certain states in the U.S. with stroke mortality rates that are much higher than average. Dubbed the “Stroke Belt,” these states have adapted unhealthy lifestyles that have led to high rates of stroke, hypertension, diabetes, and other heart-related illnesses. The states may vary year-to-year, but as of 2016, the following 11 states had the highest stroke mortality rate per 100,000 residents. Do you live in one?

Fast food

Unhealthy habits are killing Americans. | Digital Vision./Getty Images

11. West Virginia

West Virginia

West Virginia is No. 11 | klenger/Getty Images

Death rate: 41.7 per 100,000
West Virginia saw 1,039 stroke-related deaths in 2016. While it is No. 11 in this ranking, it was found to be the most obese state in the nation based on 2017 data. It also ranks first in diabetes rate, with 15.2% of the state battling diabetes. It ranks first in hypertension (high blood pressure) as well — 43.5% of the state has it. West Virginia is projected to have more than 659,000 cases of heart disease by 2030.

Next: This state also has a high obesity rate. 

10. Oklahoma

Welcome to Oklahoma Sign along highway

Oklahoma is No. 10. | pabradyphoto/Getty Images

Death rate: 41.8 per 100,000

Oklahoma cracks the top 10 states in the country for stroke mortality rate. In 2016, the state saw 1,859 stroke-related deaths. It is the third most obese state in the country and ranks eighth in diabetes rate with 12.7%. It also ranks ninth in hypertension rate (37.7%) and is projected to have more than one million cases of heart disease by 2030. Oklahoma also has one of the highest obesity rates among high school students at 17.1%.

Next: This state didn’t used to be a part of the Stroke Belt.

9. Texas


Texas is No. 9. | Rainer Lesniewski/Getty Images

Death rate: 42.0 per 100,000

Texas wasn’t always a member of the Stroke Belt, but in recent years it has found its way into the not-so-prestigious club. As of 2016, it was ninth in the nation for stroke morality rate, but it ranks 14th in the country for obesity. It stands at No. 10 for diabetes rate and No. 23 for hypertension. Texas, whose population is much greater than most of the other states on this list, is projected to have close to six million cases of heart disease by 2030.

Next: This state has a fairly low obesity rate compared to others on this list. 

8. North Carolina

Welcome to North Carolina

North Carolina sits at No. 8. | fotoguy22/iStock/Getty Images

Death rate: 43.0 per 100,000

In 2016, North Carolina saw 4,940 stroke-related deaths. But this state is interesting in that it ranks 20th in the nation for obesity, which is much lower than most states on this list. It ranks 12th and 13th in the U.S. for diabetes and hypertension rates, respectively, and it’s projected to have around 2.5 million cases of heart disease by 2030. Between 2009 and 2014, North Carolina’s obesity rate was pretty even around 29.4%, but it has seen a steady increase over the past four years.

Next: This state has the lowest obesity rate on the list.

7. Georgia


Georgia is No. 7 | gabylya/Getty Images

Death rate: 44.3 per 100,000

Georgia’s stroke mortality rate might land at No. 7, but its obesity rate is even lower than North Carolina’s. Georgia ranks No. 24 in obesity — the middle of the pack in the U.S. It ties with North Carolina for diabetes rate and is 17th in the nation for hypertension rate. But it still has a dangerous amount of heart disease with a projected 2.3 million cases by 2030, which could explain why it has such a high stroke mortality rate.

Next: This state has a low childhood obesity rate. 

6. South Carolina

South Carolina

South Carolina ranks sixth. | Smart/Getty Images

Death rate: 45.5 per 100,000

South Carolina saw 2,627 stroke-related deaths in 2016. It ranks 10th in the nation for obesity rate, and comes in 5th and 8th for diabetes and hypertension rates, respectively. Interestingly, South Carolina has one of the lowest childhood obesity rates in the nation. That may show that the state is working hard to prevent obesity in future generations. But by 2030, South Carolina is projected to have more than 1.3 million cases of heart disease, which explains why it’s a part of the Stroke Belt.

Next: This state has a high hypertension rate. 

5. Arkansas


Arkansas is No. 5. | retrorocket/Getty Images

Death rate: 45.6 per 100,000

Arkansas has both a high stroke mortality rate and a high obesity rate. It sits at No. 7 in the nation for obesity rate and ranks third among U.S. states for hypertension. By 2030, Arkansas is expected to have more than 838,000 cases of heart disease, which contributes to its stroke mortality rate. The state is currently ninth for diabetes rate and ranks first in the nation for high school obesity.

Next: This state has a high diabetes rate. 

4. Louisiana


Louisiana ranks fourth. | fotoguy22/iStock/Getty Images

Death rate: 46.0 per 100,000

Louisiana’s stroke mortality rate puts the state at No. 3 in the nation. Its obesity rate is also high, landing at No. 6 in the country. It has one of the highest diabetes rates in the U.S., ranking fourth in that category and sixth in hypertension rate. By 2030, Louisiana is expected to have about 1.2 million cases of heart disease, a major contributing factor to stroke. It ranks eighth in the nation for childhood obesity.

Next: This state might be home to Music City — but it’s also home to a high stroke mortality rate. 

3. Tennessee


Tennessee ranks third. | gabylya/Getty Images

Death rate: 46.0 per 100,000

Tennessee saw 3,508 stroke-related deaths in 2016 and ties for third with Louisiana. Its obesity rate doesn’t reflect its high stroke rate — Tennessee is the 15th most obese state in the nation, falling far behind some other states on this list. However, it has the second-highest high-school-aged obesity rate in the nation, which shows its obesity problem could get worse among future generations. By 2030, Tennessee is expected to have nearly 1.9 million case of heart disease on its hands, which could  get worse if younger generations continue to top the charts in obesity.

Next: This state lands at No. 2. 

2. Mississippi

Mississippi State highway

Mississippi takes second place. | Tiago_Fernandez/Getty Images

Death rate: 50.6 per 100,000

Mississippi ranks second in the nation for stroke mortality rate and saw 1,705 stroke-related deaths in 2016. Mississippi is currently the second most obese state in the country, and that rate has been steadily increasing since the 1990s. It also ranks second in diabetes rate for the country, with 14.2% of residents battling diabetes. Its current adult hypertension rate (high blood pressure) ranks fourth — 40.8% of residents have hypertension. Mississippi is projected to have more than 800,000 cases of heart disease by 2020.

Next: This state has the highest stroke mortality in the nation. 

1. Alabama


Alabama has the highest stroke mortality rate of any state. | gabylya/Getty Images

Death rate: 51.6 per 100,000

Alabama takes the No. 1 spot for stroke mortality rate — last year, the state saw 2,967 stroke-related deaths. It is the fifth most obese state in the country and ranks third and second in the country for diabetes and hypertension rates, respectively. By 2030, Alabama will have close to 1.5 million cases of heart disease, which is a sharp increase from the 300,000 it has today. Alabama ranks sixth in obesity rate among children aged 10 to 17, but there is no data on the obesity rate of its high school students.

Next: Alabama has more of these than any other state. 

Alabama has the most fast food restaurants per capita

fast food

Alabama has the most fast food chains in the U.S. | Mukhina1/Getty Images

A study from June 2018 found that Alabama has more fast food restaurants per capita than any other state in the country. There are 6.3 fast food restaurants per 10,000 residents in Alabama, putting fast food easily at their disposal. Nebraska took second place with 5.4 restaurants, and West Virginia followed with 5.3. (West Virginia is also the most obese state.) Vermont, New Jersey, and New York have the lowest number of fast food restaurants in the nation.

Next: States have started to require these.

Physical education requirements have been increasing for these states

Man and woman running at the gym

Most states on this list have begun requiring physical education. | vadimguzhva/Getty Images

There are actually very few states in the nation that have strict physical education requirements for all ages. But most have requirements for at least elementary school and middle school students. And states have been trying to implement new rules about physical education among children. Today, Alabama and Mississippi, the two states with the highest stroke rate, now require that children of all ages participate in physical education. This on its own shows a potential for improved health down the road.

Next: Stroke rates are higher for this gender. 

Stroke rates are overall lower for women than men

Doctor and patient

Men have a greater stroke risk in these states than women. | Gpointstudio/iStock/Getty Images

Stroke rate in the U.S. is high, but it’s higher for men than women. In general, among the most obese states in the nation, men have higher obesity rates than women. However, there are exceptions. According to State of Obesity, in Alabama, 37.4% of adult women are obese, but only 35.1% of men. While this isn’t typically the case for most states, it could reflect on why Alabama has such a high stroke mortality rate.

Next: Obesity rates in the U.S. aren’t slowing down. 

U.S. obesity rates are only climbing

An overweight woman visits a doctor.

Weight has been an ongoing issue in the U.S. | belchonock/iStock/Getty Images

Obesity is a direct reflection of stroke rate. The unhealthier you are, the more likely you are to suffer from a heart-related illness such as a stroke. In 2017, a new study found that there are now seven states with an obesity rate above 35% — up from five states the previous year. With obesity rates climbing, we can expect that stroke rates will also climb, which is why the projected stroke rates are much higher for 2030 than they are now. The U.S. has a serious problem on its hands; we need to develop healthier habits ASAP.

Check out The Cheat Sheet on Facebook!