Unhealthy Appalachia

Here in Northeast Tennessee, Washington County's Mortality rate is 421.7.  From Time.

The new edition of County Health Rankings from the University of Wisconsin Population Health Institute, places the county–which until very recently was called Shannon County–at the bottom of the class in the number of people who died before age 75, a common measure of public health. 
Oglala Lakota County sits inside the Pine Ridge Indian Reservation, whose residents suffer from a number of well-documented health problems. While South Dakota has a number of counties with high rates of premature deaths, the unhealthiest region in the United States is arguably the heart of Appalachia, from eastern Kentucky into southwest Virginia and southern West Virginia. Many of the counties have rates of smoking and obesity north of 30 percent of the population....
Across the country, the median value for this figure is 376 people per 100,000, meaning 0.38% of population will die before age 75 in a given year. (That’s all people, not just those who pass away.) The value for Oglala Lakota County is 983.4, while the lowest in the nation, in Pitkin, Colo., is 118.5.

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