Many bad habits can have a detrimental effect on our health, but some are far more damaging than others. Whether you’re guilty of excessive snacking, avoiding exercise, or staying up late way past your bedtime, the behaviours we build up over time can have a mounting impact on our long-term health.
As habits constitute learned behaviour, they can also be unlearned or replaced with new habits that will provide better health outcomes. That’s not to say that the occasional slip-up or indulgence will seriously damage your health, rather it’s the repetition of these behaviours over time that allow health problems to manifest.
Human behaviour around health is a result of many different factors, from your individual preferences to the environment you grew up in and the culture to which you belong. With this in mind, we at Medical Aid wanted to find out which countries have the most bad habits when it comes to staying healthy.
To get to the bottom of this, we’ve conducted a study looking at 5 separate habits that are detrimental to human health across 🌎50 countries. These factors are combined into an overall “Unhealthy Lifestyle Score”, revealing the countries with the healthiest and least healthy lifestyles overall.
We will then reveal the countries that fall into these bad habits the most, as well as the places that manage to best keep clear of them, before repeating the study with a focus on US states.
Unhealthy Lifestyle Score: 7.94
Bulgaria is the country with the most bad health habits, with an overall Unhealthy Lifestyle Score of 7.94. As of 2020, the large Balkan country has the highest smoking rate in our study, with as much as 35.5% of the population consuming tobacco products, making it the only country where this rate is higher than one-third. Bulgaria also has the 7th highest average annual alcohol consumption at 11.2 litres per capita, as well as relatively high scores for most other factors.
Unhealthy Lifestyle Score: 7.16
Latvia has the second-highest Unhealthy Lifestyle Score at 7.16 and also scores quite highly in most factors. This Baltic country recorded the highest annual alcohol consumption in our study at 12.9 litres per capita, as well as recording the fourth highest rate of smoking at 31.1% and the 9th highest rate of STD prevalence, indicating that unprotected sex is a greater problem in the country than elsewhere in the world.
Unhealthy Lifestyle Score: 6.88
Argentina has the third-highest Unhealthy Lifestyle Score of 6.88, which is just a fraction higher than fourth-placed United States’ 6.84. While Argentina didn’t have the highest score in any one category, the country did have the 9th highest obesity rate at 28.3%, as well as the 10th highest rates for both physical inactivity and STD prevalence.
Unhealthy Lifestyle Score: 1.31
India recorded the lowest Unhealthy Lifestyle Score of any country in our study at just 1.31, meaning people in the country have the fewest unhealthy habits on average. India has the lowest rate of smoking at 5.2% of the population as well as the lowest rate of obesity at 3.9%. Additionally, the country has the second lowest rate of STD prevalence, with 10,763 diagnoses per 100,000 people.
Unhealthy Lifestyle Score: 2.30
Iceland is the country that performed the second best with an Unhealthy Lifestyle Score of 2.30. This Nordic island nation has the 4th lowest smoking rate in our study at 9.3%, while also recording a low level of alcohol consumption of 7.7 litres and the 11th lowest rate of STD prevalence with 11,921 diagnoses per 100,000 people. Data for physical inactivity was not available for Iceland, so the country’s score was calculated from the four remaining factors.
Unhealthy Lifestyle Score: 2.54
The country with the third healthiest lifestyle is Sweden, which finished with a score of 2.54. Sweden is one of the most active countries in our study, with the 4th lowest rate of physical inactivity amongst adults at 23.5%. The country also has a very low rate of smoking at 11.1%, the joint 6th lowest tied with Australia, and also has a lower than average rate of obesity at 20.6%.
Obesity rate – 36.2%
The United States has the highest obesity rate of all countries in our study at 36.20% of the population, which is 828% higher than the rate in India, which has the lowest obesity rate of 3.9%. Diet in the two countries is incredibly different, as Hinduism forbids the consumption of beef and vegetarianism is a very common lifestyle choice in the country. In contrast, the United States is home to the modern phenomenon of fast food, which is known for its very high calorific value.
Rate of physical inactivity – 55%
Saudi Arabia has the highest rate of physical inactivity in our study at a huge 55%, whereas China has the lowest rate at 14%. The hot Middle Eastern climate in Saudi Arabia could contribute to the low levels of physical inactivity, while the prevalence of physical work in China could in part explain why the Chinese population is so active. Rates of physical inactivity in Saudi Arabia are 294% higher than in low-scoring China.
Smoking rate – 35.5%
Smoking tobacco is an extremely addictive and unhealthy habit to pick up, and can lead to many health conditions including multiple forms of cancer. While smoking used to be considered good for your health, this has long since been debunked and global smoking rates have fallen in recent decades as a result. Bulgaria has the highest rate of smoking at 35.5% of the country’s population, which is 583% higher than India, which recorded the lowest smoking rate of 5.2%.
STD cases per 100,000 people – 37,273
Engaging in unprotected sexual activity can be very risky, especially if you are not in a committed monogamous relationship. Having unprotected sex with multiple partners exponentially increases the risk of contracting an STD, which can be unpleasant for those infected and can have lasting health implications. By looking at which countries have the highest levels of STD prevalence, we can infer that rates of unprotected sex are also high in those locations. South Africa has the highest rate of STD prevalence at 37,273 people per 100,000, which is 294% higher than in Israel, where the lowest rate of 9,455 cases per 100,000 people was recorded.
Unhealthy Lifestyle Score: 8.81
Louisiana is the state with the most bad health habits, earning an overall Unhealthy Lifestyle Score of 8.81. Louisiana has the second highest rate of STD prevalence with 1,176 diagnoses per 100,000 people, meaning that many people in the state are putting their health at risk by having unprotected sex. Louisiana also has a very high rate of physical inactivity at 30.8%, the fourth highest in the country, while also being in the top ten for both cigarette use and obesity.
Unhealthy Lifestyle Score: 8.01
South Dakota has the second highest Unhealthy Lifestyle Score of 8.01, indicating a range of bad health habits in the state. South Dakota has the 5th highest rate of binge drinking in the country at 21.1%, just behind North Dakota where the rate is 21.7%. The state also has the 5th highest rate of STD diagnoses at 1,013 per 100,000 people, revealing that unprotected sex is also a big problem in this midwestern state.
Unhealthy Lifestyle Score: 7.69
The state with the third most unhealthy habits is Missouri, which earned an Unhealthy Lifestyle Score of 7.69. While Missouri didn’t have the highest score in any one factor, all of the bad habits we looked at were more common here than in the majority of other states. Missouri had the 10th highest rates of cigarette smoking and obesity, while also having the 11th highest rate of physical inactivity.
Unhealthy Lifestyle Score: 0.79
The state with the fewest bad health habits is Utah, which received an overall Unhealthy Lifestyle Score of 0.79. Utah has the lowest rate of cigarette smoking in the country at just 9%, while also having the lowest rate of binge drinking at 11.7%.
Unhealthy Lifestyle Score: 1.69
Washington is the state with the second lowest Unhealthy Lifestyle Score in the country at just 1.69. This large state in the Pacific Northwest has the third lowest prevalence of cigarette use, with a smoking rate of just 12%, while also having the third lowest rate of physical inactivity at 18.4%.
Unhealthy Lifestyle Score: 1.75
People in New Jersey have the third-fewest unhealthy habits, having received a low overall score of 1.75. Rates of obesity in the state are the 5th lowest in the country at 28.2%, while scores for the prevalence of cigarette use and STDs are both among the 10 lowest.
Cigarette use – 25.2%
Smoking cigarettes is an extremely unhealthy habit to pick up and can impact not just your own health but the health of those around you via second-hand smoking. Smoking rates across the United States vary dramatically, with West Virginia recording the highest rate of 25.2%. This is 180% higher than the state with the lowest smoking rate, Utah, where only 9% of adults smoke cigarettes.
Binge drinking prevalence – 23.5%
Binge drinking is defined by the CDC as consuming 5 drinks or more on one occasion for men, and 4 drinks or more for women. The CDC states that excessive drinking, of which binge drinking is one example, is associated with an increased risk of injuries, chronic diseases such as liver disease and heart disease, several cancers, and poor pregnancy outcomes. The state where binge drinking is the most common is Wisconsin, where 23.5% of adults engage in binge drinking. This is 101% higher than in Utah, where the lowest rate of 11.7% was recorded.
Obesity rate – 40.6%
According to the CDC, if your body mass index (BMI) is 30.0 or higher, then you classify as clinically obese. Being obese puts you at a heightened risk of a variety of different conditions and ailments such as heart disease, strokes, type 2 diabetes, and some cancers, while also being shown to negatively impact mental health. West Virginia has the highest rate of self-reported obesity in the United States at 40.6% of the population, which is 62% higher than Hawaii, where the lowest rate of 25% was reported.
Physical inactivity rate – 33.2%
Physical activity is an important part of maintaining a healthy lifestyle and preventing a range of conditions that can begin to affect your health as you get older. Obesity, arthritis and low lung capacity are just three examples of the potential consequences of low physical activity. The state where physical inactivity is most prevalent is Mississippi, where 33.2% of adults reported engaging in no physical activity outside of their daily jobs. The state with the lowest rate of physical inactivity is Colorado, where it stood at 17.7%.
STD prevalence – 1,280 cases per 100,000 people
A high STD rate can be an indicator of a high rate of unprotected sex, which leaves you vulnerable to contracting venereal diseases. By looking at data for cases of chlamydia, gonorrhoea, syphilis and new HIV diagnoses, we have created a combined rate of STD prevalence for each state. The state with the highest STD prevalence is Mississippi, with 1,280 cases per 100,000 people, while the lowest rate was found in Vermont, where there were just 167 cases per 100,000 people.
We wanted to find out which countries and US states had the most bad health habits. To do this, we used separate data for the international section and the section focusing on US states.
When comparing countries, we used data from the World Health Organization showing rates of tobacco smoking, obesity and physical inactivity across different countries. We also used data from the CIA Factbook showing the rate of alcohol consumption per capita in each country, as well as data from Wisevoter showing the prevalence of 5 common STDs in each country (excluding HIV). Data for all of these factors were combined into a single Unhealthy Lifestyle Score which was used to rank the countries from those with the most unhealthy habits to those with the fewest.
We then carried out a similar analysis of unhealthy habits in which we compared their prevalence in different US states. All data for this section was taken from the United States Centers for Disease Control (CDC), with factors including smoking rates, binge drinking, obesity, physical inactivity and STD rates. The data for STD rates were compiled from two separate data sets, one for chlamydia, gonorrhoea and syphilis, and another for new HIV diagnoses. All of these factors, with STD data combined into a single figure, were then translated into a single Unhealthy Lifestyle Score which was used to rank the states from those with the most unhealthy habits to those with the fewest.