America's Sickest States

America’s Sickest States

March 27, 2016

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We’ve all seen statistics about illnesses in America – but we wanted to dig even deeper to find out more about the state of health in our country. Beyond the numbers, what are real people saying about illness?

We looked at nearly 500,000 geotagged tweets to find out which states’ residents talk most about sickness, what they’re talking about, and which days and months see the most mentions of illness. We also compiled health data collected from the Centers for Disease Control (CDC) to get a big-picture view of specific diseases and infections across the country.

At Bay Alarm Medical, we’re dedicated to protecting your family’s health and well being. That’s why we’re so happy to provide this in-depth view of sickness across the U.S. in the form of maps, city rankings, breakdowns of common terms, and more. How does your state stack up when it comes to sickness? Keep reading to find out.

Top 10 Most Popular Illness-Related Tweet Terms/Phrases

We searched Twitter posts for a wide variety of tweets related to illness in order to determine the most common terms. The top phrase, “I’m sick,” comes up 34% more often than the next-most-frequent term “fever” – confirmation that many Twitter users are indeed discussing their own illnesses. Certain phrases (including “I’m sick of”) as well as inappropriate or unrelated usage of sickness terms were excluded from our analysis.

As for specific illnesses, “flu” is the most mentioned by far – nearly 13 times more often than specific-illness No. 2, “stomach flu.” Additionally, “stomach bug,” “malaria,” and “influenza” make appearances. The only top 10 phrase about an ill family member features the youngest: “sick baby.”

America's Top 10 Sickest States

The 10 states that most commonly mention illness in tweets are spread across the country. Based on our Twitter data, Ohio is the sickest state – with nearly 164 tweets for every 100,000 residents. When it comes to prevention of infectious disease, America’s Health Rankings put Ohio at No. 22 in the country. The state has low public health funding and struggles with a high prevalence of obesity, diabetes, and smoking.

In our second-sickest state Texas, a high percentage of uninsured residents and low immunization rates among children and adolescents may contribute to residents’ health challenges. Nevada, our third-sickest state, struggles with low per capita public health funding as well as low immunization rates and a high percentage of uninsured residents. Fourth-place Louisiana has a high prevalence of smoking and obesity, a lack of health insurance, low immunization rates, and a high percentage of children living in poverty. In No. 5 sickest state Michigan, low immunization rates and a high percentage of uninsured residents are both issues.

America's Sickest States

Tweets about illness vary dramatically across the country. The top spot for sickness tweets, Ohio, saw nearly four times as many tweets as bottom state Montana. Why do some states see so few tweets about illness compared with others?

Though our Twitter data is adjusted by state population (per 100,000 residents), it’s interesting to note that many of the states with the fewest health-related tweets also have relatively low populations. The state that tweets about sickness least, Montana ranks among the 10 best states when it comes to obesity, physical inactivity, and diabetes, though it still struggles with insurance and immunization rates. In second place for infrequent illness tweets, Alaska enjoys high per capita health funding and the lowest prevalence of low birth weight in the U.S. In third place for fewest sickness tweets, Wyoming has low levels of air pollution and the fewest children living in poverty — though it struggles with immunization rates.

Which city tweets most about sickness? New Orleans. The Big Easy sees nearly 429 sickness-related tweets per 100,000 people. One theory as to why: In the years following 2005’s Hurricane Katrina, rates of chronic sickness rose sharply and medical services decreased. In a state already plagued by poor health, a natural disaster only serves to increase rates of sickness, and it’s possible the fallout from the storm has lingered for more than a decade.

Six of the top 10 cities for illness-related tweets are located in the South, and four are in the Northeast. Miami takes second place for illness-related tweets, followed by Atlanta; Lubbock, TX; and Buffalo.

Top 5 Tweets for Women

The chart above ranks the most common tweets about sickness posted by women. The top two reference the illnesses of loved ones: Women were responsible for 84% of posts referring to a sick boyfriend and 80% mentioning a sick baby. When it comes to gastrointestinal illness posts, women posted 69% of tweets about the stomach flu and 67% of posts about a stomach bug. Finally, 72% of posts mentioning being sick at school came from women.

Top 5 Tweets for Men

What do guys tweet about in terms of illness? The sick women in their lives – and some unusual ailments. Men are responsible for nearly 81% of tweets about a sick wife and almost 57% of tweets about a sick mother. The No. 2 sickness-related tweet term for men is hepatitis: 69% of posts about the condition come from men. Male tweeters are also behind 63% of posts about malaria and 52% of posts about influenza.

Twitter User's Children

The tweets we found about sick children revealed an interesting phenomenon: When it comes to posts about a son’s illness, nearly 65% of tweets were posted by men. However, tweets about a sick daughter yielded a more even split between the genders. Gender of children aside, a 2014 study revealed that mothers are 10 times more likely than fathers to miss work to care for a sick child. While the gender breakdown is curious, the numbers overall may point to a heartening trend of increasing involvement in child care by dads.

Monthly Breakdown of Illness-Related Tweets

Breaking down illness-related tweets by month yields a telling snapshot of chatter about sickness on Twitter throughout the year. These tweets reach their height in December and January (both notoriously peak months for flu season). Sickness talk decreases as the weather warms up: April sees a sharp drop, and tweets hit rock bottom in June. September spells back-to-school time – and a significant increase in sickness tweets. Schools are a hotspot for germs and, according to the CDC, elementary-aged kids average eight to 12 cases of cold or flu per year.

Sickest Days of the Week

Looking at illness-related tweets by day of the week offers one more reason to love the weekend: Saturday sees the fewest sickness tweets, followed by Sunday. You might think Monday is the top day for calling in sick, but Twitter posts tell a different story: Although Monday sees a surge from Sunday, sickness-related tweets actually peak on Tuesday before decreasing steadily for the rest of the week. Regardless of the day, it’s not a bad idea to post about your illness if you call in sick to work: One-third of employers report having caught an employee lying about an illness by checking social media.

Chicken Pox

Characterized by itchy spots and flu-like symptoms, chickenpox (varicella) is a once-common childhood illness that saw a decrease after the introduction of a vaccine in 1995. When it comes to the prevalence of chickenpox, a few states stand out. Most notably, Maine saw a shocking 132 cases per 1 million – 109% more cases than No. 2 state Texas. Health officials in Maine noted that most cases occurred in unvaccinated or under-immunized children.

A commonality exists among many of the top states for chickenpox. Maine allows both philosophical and religious exemptions from vaccines (during the 2013-14 school year, it had the fourth-highest immunization opt-out rate in the country), as does No. 2 spot Texas, No. 3 state Pennsylvania, and No. 4 state Ohio. Fifth-place Alaska allows religious exemption though not philosophical.


Influenza – the flu – is a contagious respiratory illness that can be mild to severe. It can be more effectively prevented when patients keep their vaccinations up to date. Ever unpredictable, the flu varies in severity and affects different regions every year. Additionally, the flu vaccine varies in effectiveness each year. Oklahoma was the No. 1 spot for influenza, with nearly 24 cases reported per 1 million people. Alaska came in second, followed by Vermont, Oregon, and Tennessee.


Commonly known as “food poisoning,” salmonella causes an illness marked by fever, cramps, and other symptoms that usually lasts around four to seven days. Each year, it leads to around 1.2 million illnesses and 450 deaths, according to the CDC. Idaho was the No. 1 state for salmonella infections (with nearly 277 per 1 million residents), closely followed by Florida, Arkansas, South Carolina, and Oklahoma. Salmonella cases originate from various types of food, including beef, poultry, eggs, and fruits and vegetables. However, it can also be transmitted by animals, including reptiles and birds.

Another vaccine-preventable illness, pneumococcal disease is an infection that can cause many types of illnesses, including ear infections and meningitis. With nearly 91 cases reported per 1 million people, Alaska had the highest prevalence of pneumococcal infection in the country. In years past, the state has had one of the lowest vaccine rates in the country, but recent reports show that vaccine rates are on the rise. No. 2 spot South Dakota allows religious exemptions for vaccines, and third-place Ohio allows religious and philosophical exemptions.


As our study shows, Americans are taking to Twitter to talk about more than last night’s TV show. People tweet every day about illnesses – both their own and their loved ones’. The South and the Northeast are the two most common regions for these tweets. On a state level, Ohio, Texas, and Nevada are hotspots for illness tweets, while New Orleans, Miami, and Atlanta are the cities that see the most. Sickness-related tweets peak in December and January, and they’re particularly common on Tuesdays.

When it comes to the rate of various health illnesses across the country, it’s clear that accessibility to health care and education play a major role in enabling Americans to protect themselves and their families from preventable diseases. On an individual level, people can take important steps to maintain good health: Wash hands frequently, get enough sleep, exercise, and stay up to date on vaccines. If you want to learn even more about protecting yourself and your family, visit us at Bay Alarm Medical. Our top-rated medical alert systems let you summon medical help at the push of a button, day or night, for maximum peace of mind.


We analyzed over 500,000 Twitter posts, focusing on mentions relating to specific communicable diseases as well as general statements on being sick. We did our best to exclude any tweets that did not relate to this project and removed any duplicate tweets. We then mapped the mentions per 100,000 residents. Using CDC data, we also mapped the reported cases of communicable diseases per 1 million residents.



We grant permission to share the images found on this page freely. When doing so, please attribute the authors by providing a link back to this page so your readers can learn more about this project and the related research. If you’re a journalist hoping to learn more about our work, please contact us at


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