BISMARCK, N.D. (KXNET) — Although many of us make the effort to keep up our health, when the layout of the entire state is considered, the truth is that a majority of states in the US have their fair share of bad habits. This isn’t something that is limited to the United States, either — many countries across the world report partaking in unhealthy practices. And in a recent study, created a list of factors that came together to determine which countries and states were the most unhealthy of all.

In order to compare countries, Medicalaid used data from the World Health Organization which showcased the rates of tobacco smoking, obesity, and physical inactivity across the world, data from the CIA Factbook regarding alcohol consumption per capita, and data from Wisevoter showing how common 5 STDs (excluding HIV) were in the countries. All of this data was then combined into a single Unhealthy Lifestyle Score — which was then used to rank each country.

In this study, it was identified that when every factor was weighed as one, the United States is the fourth most unhealthy country in the entire world, falling just under the likes of Bulgaria, Latvia, and Argentina. The main glaring reasons for this are our above-average levels of physical inactivity and the highest rate of obesity in the world at 36.2%.

RankCountryObesity RatePhysical Inactivity RateLiters of Alcohol Consumed Per CapitaSmoking RateSTD Prevalence Per CapitaUnhealthy Lifestyle Score
4United States36.2%40.0%8.916.6%19,9006.84
10South Africa28.3%38.0%7.216.6%37,2736.14
List of the 10 Unhealthiest countries in the world (Data Citation:

In terms of states, however, there were a few changes that needed to be made to the survey. Here, information was taken from the United States Centers for Disease Control (CDC) — with factors ranging from those shared by countries (particularly obesity and physical inactivity scores) to some specific aspects for the states, including the percentage of residents who use cigarettes and the percentage of individuals who engage in binge drinking. When STDs were considered, the data was split between two sets (one for cases of chlamydia, gonorrhea, and syphilis, and one for new HIV diagnoses). Like the countries, these numbers were then pooled and scored to determine the unhealthiest states in the union.

RankStateCigarette UseBinge Drinking PrevalenceObesity RatePhysical Inactivity RateSTD Prevalence Per CapitaUnhealthy Lifestyle Score
2South Dakota19.0%21.1%38.4%25.3%1,0138.01
9South Carolina18.0%16.2%36.1%27.6%1,0657.12
10North Dakota19.1%21.7%35.2%25.6%7547.01

According to the study results, North Dakota is one of the unhealthiest states in the US, placing tenth on the list of those with the highest Unhealthy Lifestyle Scores. Although ND does not possess any of the highest levels of any issue in the nation, a majority of these levels tend to be on the larger side, averaging out to a level above states with one or two higher scores. Of particular note was our percentage of binge drinking prevalence, which was greater than any other entry in the top ten.

To view the full study, including infographics, visit this page on MedicalAid’s website.