For much of the U.S., it's the season for winter chill, slippery streets and snow days — which also means flu season. But even if, and maybe especially if, you live in a warm weather climate, you know flu season can hit you just as hard.
Flu season is no joke. Between October 2018 and February 2019, nearly 45 million Americans came down with the virus. But from Maine to California, what are the historically worst states for the flu, and how is that a predictor of what might happen this year?
We took a look at flu season numbers over the past six years from the U.S. Centers for Disease Control during February — generally considered to be peak flu season — and assigned weighted scores for minimal, low, moderate and high flu outbreak weeks in every state and added up the numbers to determine the 10 worst states for the flu ahead of the 2019/2020 flu season.
Additionally, we analyzed two of the most important flu-related cost of living factors in each of the 10 worst states for the flu, the average cost of a visit to the doctor and the average price of a bottle of prescription Ibuprofen at a local pharmacy to get a bigger picture of where the flu hits hardest both your wallet and your immune system.
Here are the 10 worst states for the flu.
Desert air, dry heat, lots of warm and sunny days. While that doesn't sound like a recipe for a flu outbreak, the comfortable and dry weather of New Mexico allows plenty of people to gather outside for concerts and games and gatherings where the flu virus, thriving in the gentle climate, can spread from face to face contact with a plethora of people.
Last flu season, New Mexico was one of the first states to be hardest hit, and it's possible for that to occur again. In fact, New Mexico has seen more “high" peak flu level weeks since 2013 than all but five other states, and has rated “high" for 17 of the past 18 peak flu season weeks — more than any other state.
In the desert Southwest, the cost of a visit to the doctor to check on your flu-related symptoms is higher than both the top 10 worst states' mean and median, at an average of $118.10. And if that doctor prescribes a few Ibuprofen to bring your symptoms under control, a bottle of the medicine will run an average of $8.37. And in individual population centers, prices only go up.
An entry-level one-bedroom apartment in New Mexico averages $847 a month.
From real life medical facilities like the Robert Wood Johnson University Hospitals to the fictional Princeton-Plainsboro Teaching Hospital from the television show “House," New Jersey has always had a reputation as a center for health services and medical care. But it's also the top state in the Mid-Atlantic for the flu, so it's a good thing there are a few doctors in the house.
While in past years, the flu had spread sporadically throughout the Garden State, levels this season seem to be affecting all regions of the state. So, whether you say “pork roll" or “Taylor ham" or you root for the Giants or the Eagles, it's likely that the flu has or will infiltrate your part of Jersey. A spike in flu symptom-related emergency room visits and admissions is proving the theory.
Considering how much population New Jersey has surrounding the metropolises of New York and Philadelphia, you'd expect cost of living statistics like doctor visits to be through the roof. But across the state as a whole, the cost of an appointment with your doctor remains moderate at $98.26.
Likewise, the price of a bottle of Ibuprofen runs $8.74 on average. Looking deeper at some of Jersey's metro areas, Middlesex/Monmouth, not too far from several RWJ hospital campuses, has the lowest cost for a doctor's visit in the state at $93.75, while Bergen/Passaic, one of the wealthier regions of the state and closer to New York City, tops out at $102.47.
Rent prices in New Jersey vary greatly from the New York suburbs to the southern part of the state. A one-bedroom unit starts for an average of $1,828 a month.
In the movies, flu-sufferers are often depicted as bed-ridden and covered in used tissues as snow falls outside and those of sound health are jauntily building snowmen and tobogganing and the like. But in the real world, most of the worst flu states in the country are in the southeast, far away from cold winters and whiteout conditions.
And this season seems to be no exception. “We are already at really high levels nationwide and especially in the South," says the Children's Medical Group's Darren Scoggin on this season so far.
The rule stays true down in Alabama. Last year, flu patients filled more than 90 percent of hospital beds in seven of Alabama's eight public health districts. This year is starting out early and could be severe, as well. As of October, every county in north Alabama showed an uptick in flu-related illness, and cases are expanding down to the Gulf.
Fortunately, some of the lowest costs to see a doctor in Alabama are in the regions in the north end of the state. The average charge for a visit in Florence is just about $70 and comes in at about $75 in Anniston.
Meanwhile, down on the southern Gulf Coast, the most expensive metro area to see the doctor in Alabama is Mobile at about $120.50 on average. Statewide, the average cost to be seen by a doctor is $93 and a bottle of Ibuprofen to fight your symptoms will set you back $9.18. But if you happen to be in Dothan, you'll pay a lot more, as the average cost for Ibuprofen is the priciest of any city among the 10 worst flu states at $11.23.
You can find a one-bedroom apartment in Alabama for $870 a month on average.
Between 2013 and 2016, the flu danger level in Louisiana was rated at minimal, low or moderate 11 out of 12 weeks. But boy, times have changed. Since then, flu levels have jumped up to “high" 15 of the last 16 peak flu season weeks. Down in the bayou, it may be a sign of a bad flu season.
This fall, Louisiana was already ranked with the highest level of flu cases in the U.S. and the season is barely underway. In fact, in mid-October, Louisiana was already in the red for number of people seeing a doctor with flu-like symptoms, while every other state was low or minimal for flu activity.
“We seem to be really at the forefront of the flu season this year," says Dr. Alex Billioux of the Louisiana Department of Health.
And if you need to go see the doctor to diagnose your fever and chills, you're going to pay up if you happen to be in New Orleans. At $144.17, a visit will cost you more than just about anywhere in the U.S. and the most of any city in the top 10 worst states. (And to add insult to injury, the cost of a bottle of Ibuprofen in the Crescent City is the second-most expensive of any city at a pricey $11.06.) Compare that to the southern Louisiana Acadiana town of Houma, where the cost of a doctor visit is well over half that of NOLA at just $65.75 on average.
An average one-bedroom apartment in Louisiana starts at around $970 a month.
With its heel jutting out into the Gulf of Mexico and a big, dirty, mighty eponymous river running aside the length of the state, Mississippi has historically been a state where viruses and diseases have traveled over long distances to infect a swath of the population. In fact, the historic flu pandemic of 1918 killed more than 50 million around the world at the end of World War I, and took the lives of 6,200 in Mississippi alone.
Last year, the peak of the flu season hit around the end of February, much later than in previous years in Mississippi. The year prior, peak struck around Christmas, a much more usual time for the state. That makes this season vulnerable for a late peak, early peak or any time in between.
Around the state, a doctor's visit to check on those flu symptoms will cost you nearly $90 on average. And if your doctor tells you to take two Ibuprofen and call him in the morning, $8.58 will snag you a bottle at the store.
The most expensive spot in the state to make that doctor's appointment is down on the Gulf Coast in Gulfport or Biloxi where it will run you an average of $99. But fear not, if you're self-medicating and happen to live in the state capital of Jackson, the average cost for Ibuprofen is just $6.86, one of the lowest in the nation and the cheapest of any city in the top 10 worst flu states.
One-bedroom rent in Mississippi is among some of the most affordable in our top 10 list. An average entry-level unit starts for just over $800.
Ask any Kansan. When the wind rolls down the Rockies out west and across the plains country towards the Flint Hills, there's no stopping whatever is in the air. And dead in the center of the nation, Kansas experiences hot summer, cold winters and, you know, tornadoes and straightline winds throughout storm season. That wind and those conditions come flu season aren't ideal for keeping the flu virus from spreading. In fact, in 2018, Kansas was the second-most “flu-ridden" state in the nation.
Since 2013, Kansas has experienced 20 “high" condition flu season weeks, the fourth most of any state in the union. As well, the Wheat State has rated “high" every single peak week since the start of the 2016 season, one of only three states that can make that unwanted claim. Statewide, a stop at the doctor's office will cost an average of $102.71, while picking up a bottle of Ibuprofen on the way home will knock you back $8.42.
The highest prices in Kansas for a doctor's visit are at the junction of I-135 and I-70 in Salina, at an average of $117.75. But way out in Western Kansas, you don't have to get out of Dodge to see the medicine man on the cheap, with an average of $86.88 in Dodge City for a doctor's visit. Wichita, the biggest city in the state, comes in around midway in pricing for the state. It will run an average of just more than $105 for a visit to the doctor in the Air Capital, with the price of medication running $8.23.
You can get into a one-bedroom apartment in Kansas for about $900 per month for an average entry-level unit.
Last flu season in 2018-2019, flu-related deaths in the state of Arkansas were the highest in nearly two decades and hit the state hard. And the state had an issue with false positives, sending infected people back to home and school thinking they were in the clear. Clinicians fought back by treating everyone that came in with symptoms regardless of their test during the worst flu season weeks.
"A lot of clinicians don't even test in the middle of a heavy flu season because if they test positive, they're going to treat that patient for the flu, if they test negative, they're still going to treat that patient for the flu," said Jennifer Dillaha of the Arkansas Department of Health.
Across the state, the average cost of a doctor's visit ran $101 and Ibuprofen listed for just more than eight bucks. The Little Rock and North Little Rock areas were the most expensive in the state for doctor's visits at nearly $120, and Hot Springs had the most expensive medication, averaging $8.23. Fayetteville, and all its college students, had the lowest doctor's visit prices and the lowest cost for Ibuprofen, at $84.10 and $7.97 respectively.
Arkansas also has the lowest average rent prices for one-bedroom units at just over $750 a month.
Bitter cold, brutal winters and drifting snow. For centuries, the hard New England winter and red noses and sore throats are the stuff of turn-of-the-century novels. Flu outbreaks have been severe and deadly since the Mayflower days.
But there's only one New England state in the top 10, and it's probably not one of those one would first think. In Connecticut, the flu season has come in hard like the cold weather, with the first flu-related deaths in early November, one in Litchfield and one in Fairfield.
As an affluent state, one of the factors that makes the flu bad at times in Connecticut is the number of people that travel abroad and bring back the flu virus from places where the flu shot and other flu preventative measures are less common than in the U.S. Statewide, an average doctor visit runs over $124, unsurprisingly the highest figure among the 10 worst states, and $8.76 will get you an average bottle of Ibuprofen.
The Stamford area is among the highest in the nation for doctor visits, and the highest of any city among the top 10 states, with an average of $133.20, with a bottle of Ibuprofen retailing for an average of $8.57. Hartford County is where the most cases of the flu occurred last season, and the city of Hartford, despite being the lowest metro area price in the state, still averages $108.77 for a doctor's visit, and has a slightly higher price for Ibuprofen, at an even nine bucks.
New England living comes at a price. A one-bedroom apartment in Connecticut will start at an average of $1,520 a month.
If you've already sneaked a peek at the No. 1 state below, it's not hard to extrapolate why Oklahoma is No. 2 on this list. While Oklahoma is less urban and less spread out than its top ranked neighbor, it's still a warm flu season in the southern Plains, and people are outside spreading the virus whether it be in the crowd at an OU game or a crowd at the mall. Since 2013, 22 weeks of peak flu season have been rated as “high."
The flu season in OK is nothing to take lightly. Last season, more than 60 Oklahomans died from the flu, with another 2,500 hospitalized in what was the longest flu season in a decade. Officials are saying that this season is going to be a severe one, as well, but the good news is a flu shot may be more effective this time around.
The price of an average doctor visit in Oklahoma is below midrange, at about $99. A dose of Ibuprofen averages $8.87. Costs around the state vary, with a high for a doctor visit of $125 in Enid and a low of $63 and change in Ponca City. In OK's capital and largest city, Oklahoma City, a doctor's visit runs just more than $100 on average and medication runs $9.61 per bottle.
Rent in Oklahoma is also second-most affordable of all states in the top 10. The average one-bedroom starts at an average of $759 a month.
While we tend to associate the flu with cold winter weather, it's warm weather Texas that takes the crown as ground zero for the worst state for flu sufferers. The CDC reported 23 widespread flu activity weeks in Texas out of the 30 peak flu season weeks tracked since 2013, with just one week rated as “low."
As the second most populated state in the Union, maybe it's not a surprise that Texas is the worst state for the flu in 2019/2020. A lot of people living in close proximity but also in a wide-open state, a lot of travel by car and plane, and warm temperatures that don't force people inside for the winter.
Texas is a diverse state, containing three of the biggest cities in the nation but also a lot of farm, ranch and open land, where the level of medical care can fluctuate pocket by pocket. Statewide, the cost for a trip to the doctor runs about $104 on average, and a bottle of Ibuprofen sells for $8.60.
Of all the large metro areas in Texas, it's the city of Temple, near Killeen's Fort Hood military base, that's the most expensive in the state for doctor visits at $189 on average, and El Paso, on the border, where Ibuprofen skyrockets to nearly $11. In the state's largest city of Houston, a visit to the doctor will cost $88.30 and a bottle of Ibuprofen sells for just more than $8.
Rent prices in Texas are slightly higher than some of the other southern states on this list, where an average entry-level one-bedroom apartment costs $1,115 a month.
Still looking for data from your state or where your loved ones will need you to send them chicken soup? Here's the full list of flu severity data for all 50 states and D.C.
|Rank||State||Weeks of High Flu Activity||Weeks of Moderate Flu Activity||Weeks of Low Flu Activity|
|48||District of Columbia||7||4||3|
Flu data comes from the U.S. Centers for Disease Control and Prevention's weekly flu reports for February since 2013. February weeks were selected because this month is generally considered peak flu season. We counted the number of weeks during this time period for high, moderate, low and minimal flu activity and weighted the totals. States with the highest overall score were determined to be the worst for flu.
Average prices for physician visits and Ibuprofen come from the Council for Community and Economic Research's Q3 2019 Cost of Living report.
The rent information included in this article is based on December 2019 entry-level multifamily rental property inventory on Apartment Guide and Rent.com and is used for illustrative purposes only. The data contained herein do not constitute financial advice or a pricing guarantee for any apartment.
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