In some states, many people think they're ailing. About 16.4% of the working-age Americans in a typical state reported in 2023 that they were in fair or poor health.

The median was up from 15.6 % in 2018, before the COVID-19 pandemic appeared, according to new data from the U.S. Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System survey program.

Related: Americans report slightly higher vitality for first time since 2022, Cigna study finds

One factor could be patients' failure to get the normal level of preventive care during the peak years of the COVID-19 pandemic.

Overall health varies widely from state to state. The percentage of people who said their health was less than good ranged from 12.8%, in Vermont, up to more than 20%, in one state. For a look at the five states with the highest rates of working-age adults who reported being in just fair or poor health, see the gallery above. For data for all 50 states, the District of Columbia and Puerto Rico, see the table below. (If we had included Puerto Rico in the gallery, it would have ranked first.) Methods: The CDC breaks down data on self-reported health for people under 18, people ages 65 and older, and four age groups from 18 through 64. We came up with a prevalence rate for working-age people being in fair or poor health by averaging the data for the age groups in that age range. One benefit of using that approach is that it filters out the effects of the aging of the population, or other population trends, in a given state. At press time, the CDC had not included data from Kentucky and Pennsylvania in the 2023 BRFSS results. The impact: Finding data on the impact of fair and poor health on employers is difficult, but it certainly affects the wellbeing of employees. About 31% of adults with employer-sponsored health coverage and household income under 200% of the federal poverty level report being in poor or fair health, compared with about 17% of the adults with employer-sponsored health coverage and income over 200% of the federal poverty level, according to a 2023 KFF analysis. The authors of a 1999 study found that people who reported being in excellent health in 1974 had 74% more wealth than respondents in fair or poor health.

Adults Ages 18-64 in Fair or Poor Health
	2018	2023	Change, in percentage points
Alabama	19.54%	19.68%	+0.14
Alaska	14.94%	16.96%	+2.02
Arizona	18.10%	17.96%	-0.14
Arkansas	21.84%	23.94%	+2.10
California	16.70%	19.44%	+2.74
Colorado	12.94%	14.48%	+1.54
Connecticut	11.66%	13.24%	+1.58
Delaware	15.00%	17.58%	+2.58
District of Columbia	14.65%	12.98%	-1.68
Florida	18.44%	16.92%	-1.52
Georgia	16.62%	16.44%	-0.18
Hawaii	14.84%	13.78%	-1.06
Idaho	14.00%	14.42%	+0.42
Illinois	14.70%	16.36%	+1.66
Indiana	17.38%	18.40%	+1.02
Iowa	12.28%	16.06%	+3.78
Kansas	15.34%	15.76%	+0.42
Kentucky	19.80%	NA	-
Louisiana	19.64%	20.16%	+0.52
Maine	16.20%	17.24%	+1.04
Maryland	13.78%	14.32%	+0.54
Massachusetts	12.14%	13.72%	+1.58
Michigan	17.70%	17.06%	-0.64
Minnesota	11.72%	14.34%	+2.62
Mississippi	19.40%	20.32%	+0.92
Missouri	18.34%	17.58%	-0.76
Montana	13.02%	16.32%	+3.30
Nebraska	12.88%	14.08%	+1.20
Nevada	18.26%	20.64%	+2.38
New Hampshire	12.26%	13.62%	+1.36
New Jersey	15.70%	14.74%	-0.96
New Mexico	19.08%	20.72%	+1.64
New York	14.52%	14.90%	+0.38
North Carolina	16.12%	16.90%	+0.78
North Dakota	11.48%	13.04%	+1.56
Ohio	16.22%	18.14%	+1.92
Oklahoma	19.48%	18.56%	-0.92
Oregon	17.66%	17.52%	-0.14
Pennsylvania	16.24%	NA	-
Puerto Rico	28.26%	25.84%	-2.42
Rhode Island	15.48%	16.30%	+0.82
South Carolina	16.68%	17.60%	+0.92
South Dakota	12.18%	15.46%	+3.28
Tennessee	19.58%	19.38%	-0.20
Texas	17.12%	19.54%	+2.42
Utah	13.84%	13.42%	-0.42
Vermont	11.72%	12.76%	+1.04
Virginia	15.12%	15.72%	+0.60
Washington	14.52%	15.28%	+0.76
West Virginia	21.66%	23.30%	+1.64
Wisconsin	13.52%	15.98%	+2.46
Wyoming	14.12%	15.52%	+1.40
MEDIAN	15.59%	16.40%	+0.81