US counties by frequent mental distress in adults, local model estimate

Kusilvak Census Area had the highest frequent mental distress in adults, local model estimate of 3068 counties in 2021, at 26%. Kalawao County had the lowest, at 9.9%. The median was 16%. Source: the Centers for Disease Control and Prevention.

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Median163068 counties

Map of counties, 2021

%, 2021. Hatched areas have no value for this period. Source: CDC, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2021

Kusilvak Census Area: 26 %Kusilvak Census Area26East Carroll Parish: 23.2 %East Carroll Parish23.2Todd County: 23.1 %Todd County23.1Oglala Lakota County: 22.8 %Oglala Lakota County22.8Radford city: 22.8 %Radford city22.8Wolfe County: 22.7 %Wolfe County22.7Bethel Census Area: 22.4 %Bethel Census Area22.4Knox County: 22 %Knox County22Apache County: 21.8 %Apache County21.8Mingo County: 21.8 %Mingo County21.8Clay County: 21.7 %Clay County21.7Harlan County: 21.7 %Harlan County21.7McCreary County: 21.7 %McCreary County21.7Madison Parish: 21.6 %Madison Parish21.6McDowell County: 21.6 %McDowell County21.6Rowan County: 21.6 %Rowan County21.6Lee County: 21.5 %Lee County21.5McKinley County: 21.5 %McKinley County21.5Jackson County: 21.4 %Jackson County21.4Lewis County: 21.4 %Lewis County21.4Logan County: 21.4 %Logan County21.4Magoffin County: 21.4 %Magoffin County21.4Adair County: 21.3 %Adair County21.3Evangeline Parish: 21.2 %Evangeline Parish21.2Bell County: 21.1 %Bell County21.1Harrisonburg city: 21.1 %Harrisonburg city21.1Knott County: 21.1 %Knott County21.1Leslie County: 21.1 %Leslie County21.1Lincoln County: 21.1 %Lincoln County21.1Perry County: 21.1 %Perry County21.1Whitman County: 21.1 %Whitman County21.1Concordia Parish: 20.9 %Concordia Parish20.9Floyd County: 20.9 %Floyd County20.9Sioux County: 20.9 %Sioux County20.9Hancock County: 20.7 %Hancock County20.7Scott County: 20.7 %Scott County20.7Boone County: 20.6 %Boone County20.6Breathitt County: 20.6 %Breathitt County20.6Lincoln Parish: 20.6 %Lincoln Parish20.6Wyoming County: 20.6 %Wyoming County20.6Kusilvak Census Area: 26 %Kusilvak Census Area26East Carroll Parish: 23.2 %East Carroll Parish23.2Todd County: 23.1 %Todd County23.1Oglala Lakota County: 22.8 %Oglala Lakota County22.8Radford city: 22.8 %Radford city22.8Wolfe County: 22.7 %Wolfe County22.7Bethel Census Area: 22.4 %Bethel Census Area22.4Knox County: 22 %Knox County22Apache County: 21.8 %Apache County21.8Mingo County: 21.8 %Mingo County21.8Clay County: 21.7 %Clay County21.7Harlan County: 21.7 %Harlan County21.7McCreary County: 21.7 %McCreary County21.7Madison Parish: 21.6 %Madison Parish21.6McDowell County: 21.6 %McDowell County21.6Rowan County: 21.6 %Rowan County21.6Lee County: 21.5 %Lee County21.5McKinley County: 21.5 %McKinley County21.5Jackson County: 21.4 %Jackson County21.4Lewis County: 21.4 %Lewis County21.4Logan County: 21.4 %Logan County21.4Magoffin County: 21.4 %Magoffin County21.4Adair County: 21.3 %Adair County21.3Evangeline Parish: 21.2 %Evangeline Parish21.2Bell County: 21.1 %Bell County21.1Harrisonburg city: 21.1 %Harrisonburg city21.1Knott County: 21.1 %Knott County21.1Leslie County: 21.1 %Leslie County21.1Lincoln County: 21.1 %Lincoln County21.1Perry County: 21.1 %Perry County21.1Whitman County: 21.1 %Whitman County21.1Concordia Parish: 20.9 %Concordia Parish20.9Floyd County: 20.9 %Floyd County20.9Sioux County: 20.9 %Sioux County20.9Hancock County: 20.7 %Hancock County20.7Scott County: 20.7 %Scott County20.7Boone County: 20.6 %Boone County20.6Breathitt County: 20.6 %Breathitt County20.6Lincoln Parish: 20.6 %Lincoln Parish20.6Wyoming County: 20.6 %Wyoming County20.6
%. Source: CDC, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. Retrieved 2026-10-12.

Full ranking

RankCounties2021 (%)
1Kusilvak Census Area26
2East Carroll Parish23.2
3Todd County23.1
4Oglala Lakota County22.8
4Radford city22.8
6Wolfe County22.7
7Bethel Census Area22.4
8Knox County22
9Apache County21.8
9Mingo County21.8
11Clay County21.7
11Harlan County21.7
11McCreary County21.7
14Madison Parish21.6
14McDowell County21.6
14Rowan County21.6
17Lee County21.5
17McKinley County21.5
19Jackson County21.4
19Lewis County21.4
19Logan County21.4
19Magoffin County21.4
23Adair County21.3
24Evangeline Parish21.2
25Bell County21.1
25Harrisonburg city21.1
25Knott County21.1
25Leslie County21.1
25Lincoln County21.1
25Perry County21.1
25Whitman County21.1
32Concordia Parish20.9
32Floyd County20.9
32Sioux County20.9
35Hancock County20.7
35Scott County20.7
37Boone County20.6
37Breathitt County20.6
37Lincoln Parish20.6
37Wyoming County20.6
41Letcher County20.5
41Whitley County20.5
43Avoyelles Parish20.4
43Casey County20.4
43Clinch County20.4
43Macon County20.4
47Lake County20.3
47Richland Parish20.3
47Roosevelt County20.3
50Acadia Parish20.2
50Barbour County20.2
50Christian County20.2
50Franklin Parish20.2
50Isabella County20.2
50Mercer County20.2
50Morehouse Parish20.2
50Owsley County20.2
58Buffalo County20.1
58Carter County20.1
58Clay County20.1
58Estill County20.1
58Glacier County20.1
58Lauderdale County20.1
58Natchitoches Parish20.1
58Northwest Arctic Borough20.1
58Okfuskee County20.1
58St. Landry Parish20.1
58Sumter County20.1
58Webster Parish20.1
70Athens County20
70Cabell County20
70Hart County20
70Madison County20
70Payne County20
70Perry County20
70Pike County20
77Caldwell Parish19.9
77Carroll County19.9
77Cherokee County19.9
77Claiborne Parish19.9
77Clinton County19.9
77Dillon County19.9
77Fayette County19.9
77St. Bernard Parish19.9
77Tangipahoa Parish19.9
86Atkinson County19.8
86Braxton County19.8
86Calhoun County19.8
86Chattahoochee County19.8
86Columbia County19.8
86Dunklin County19.8
86Johnson County19.8
86Johnson County19.8
86Lawrence County19.8
86Menifee County19.8
86Nicholas County19.8
86Rockcastle County19.8
86Washington Parish19.8
86Wayne County19.8
86Webster County19.8
86Wilcox County19.8
102Chester County19.7
102Claiborne County19.7
102Escambia County19.7
102Grayson County19.7
102Holmes County19.7
102Seminole County19.7
102Sequoyah County19.7
102Terrebonne Parish19.7
102Vernon Parish19.7
102Weakley County19.7
112Bienville Parish19.6
112Buena Vista city19.6
112Bullock County19.6
112Campbell County19.6
112Desha County19.6
112Franklin County19.6
112Greene County19.6
112Lewis County19.6
112Martin County19.6
112Mason County19.6
112McCurtain County19.6
112Nome Census Area19.6
112Pemiscot County19.6
112Pike County19.6
112Poinsett County19.6
112Roane County19.6
128Adair County19.5
128Choctaw County19.5
128DeKalb County19.5
128Elliott County19.5
128Mississippi County19.5
128Ottawa County19.5
128Raleigh County19.5
128St. Helena Parish19.5
136Big Horn County19.4
136Butler County19.4
136Crittenden County19.4
136Green County19.4
136Henderson County19.4
136Hudspeth County19.4
136Jackson County19.4
136Lanier County19.4
136Laurel County19.4
136Le Flore County19.4
136Mississippi County19.4
136Morgan County19.4
136Putnam County19.4
136Sequatchie County19.4
136Starr County19.4
136Treutlen County19.4
136Upshur County19.4
153Assumption Parish19.3
153Barbour County19.3
153Catahoula Parish19.3
153Clark County19.3
153Dillingham Census Area19.3
153Iberia Parish19.3
153Lafourche Parish19.3
153Lewis County19.3
153Morgan County19.3
153Muskogee County19.3
153Nacogdoches County19.3
153Perry County19.3
153Phillips County19.3
153Pope County19.3
167Bath County19.2
167Calloway County19.2
167Claiborne County19.2
167Cochran County19.2
167Cumberland County19.2
167Gallatin County19.2
167Grundy County19.2
167Jenkins County19.2
167Lawrence County19.2
167Lincoln County19.2
167Monroe County19.2
167Newton County19.2
167Ripley County19.2
167St. Francis County19.2
167Wayne County19.2
167West Carroll Parish19.2
167Wirt County19.2
184Coal County19.1
184Fentress County19.1
184Fulton County19.1
184Lee County19.1
184Madison County19.1
184Marlboro County19.1
184Powell County19.1
184Prince Edward County19.1
184Sevier County19.1
184Talladega County19.1
184Todd County19.1
184Union County19.1
184Warren County19.1
197Allen Parish19
197Barren County19
197Clarke County19
197Cocke County19
197Dimmit County19
197Franklin County19
197Grant Parish19
197Hardeman County19
197Haskell County19
197Haywood County19
197Lawrence County19
197Monroe County19
197Oregon County19
197Overton County19
197Randolph County19
197Rapides Parish19
213Adair County18.9
213Brazos County18.9
213Bulloch County18.9
213Chicot County18.9
213Clay County18.9
213Dallam County18.9
213Dallas County18.9
213Edmonson County18.9
213Emporia city18.9
213Fleming County18.9
213Geary County18.9
213Geneva County18.9
213Hale County18.9
213Hopewell city18.9
213Liberty County18.9
213Macon County18.9
213McNairy County18.9
213Obion County18.9
213Okmulgee County18.9
213Pulaski County18.9
213Rhea County18.9
213Russell County18.9
213San Juan County18.9
213Summers County18.9
213Tensas Parish18.9
213Union County18.9
213Van Buren County18.9
213Vinton County18.9
213Walker County18.9
213White County18.9
213Yukon-Koyukuk Census Area18.9
213Ziebach County18.9
245Ashley County18.8
245Chattooga County18.8
245Cross County18.8
245De Soto Parish18.8
245DeKalb County18.8
245Falls County18.8

Showing the top 250 of 3068. The Excel download has every row.

Other periods

About this ranking

Percentage of adults who say their mental health was not good on 14 or more of the past 30 days. Model-based estimate for adults aged 18 and over from CDC PLACES. Crude prevalence, not age-adjusted.

US counties and cities (incorporated places of 10,000 or more). CDC PLACES combines Behavioral Risk Factor Surveillance System (BRFSS) answers with local population data through multilevel regression and poststratification, so a county or city value is a model estimate, not a survey count. The year is the BRFSS survey year, not the release year. CDC says the method does not support tracking change in a place over time, and each annual release can change the model, so values for different years are not strictly comparable. A state is missing in a year when its BRFSS data did not meet standards (Kentucky and Pennsylvania in 2023, Florida in 2021). Connecticut counties appear as its nine planning regions from 2022; its eight former counties are not served. City values for 2021 come from the 2023 release, built on 2010 Census place boundaries; later years use 2020 boundaries.

Every value in the ranking comes from the same publisher and the same period, so the counties are compared on one definition. 76 counties with data in other periods have no value for 2021 and are left out rather than filled from another source. Equal values share a rank.

How to cite

Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.

Citation styles

The publisher is the author. Invokely is named only as the place the figures were read, where a style asks for it.

APA 7

Centers for Disease Control and Prevention. (2025). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence (US counties by frequent mental distress in adults, local model estimate, 2021) [Data set]. Retrieved October 12, 2026, from https://www.cdc.gov/places/

MLA 9

PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence, US counties by frequent mental distress in adults, local model estimate, 2021. Centers for Disease Control and Prevention, 4 Dec. 2025, https://www.cdc.gov/places/. Invokely, https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021. Accessed 12 Oct. 2026.

Chicago (author-date)

Centers for Disease Control and Prevention. 2025. PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. US counties by frequent mental distress in adults, local model estimate, 2021. Dataset. Accessed October 12, 2026. https://www.cdc.gov/places/. Also distributed by Invokely, https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021.

Harvard

Centers for Disease Control and Prevention (2025) PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence, US counties by frequent mental distress in adults, local model estimate, 2021 [Dataset]. Available at: https://www.cdc.gov/places/, via Invokely: https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{centers_us_counties_by_frequent_2021,
  author = {{Centers for Disease Control and Prevention}},
  title = {{PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence: US counties by frequent mental distress in adults, local model estimate, 2021}},
  year = {2025},
  howpublished = {Data set},
  url = {https://www.cdc.gov/places/},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021. Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.},
}
RIS
TY  - DATA
AU  - Centers for Disease Control and Prevention
TI  - PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence: US counties by frequent mental distress in adults, local model estimate, 2021
PY  - 2025
DA  - 2025/12/04
PB  - Centers for Disease Control and Prevention
DB  - Invokely
UR  - https://www.cdc.gov/places/
L2  - https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-frequent-mental-distress-rate-county-estimate/us-counties?period=2021.
N1  - Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.
ER  - 
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Questions

Which county has the highest frequent mental distress in adults, local model estimate?

Kusilvak Census Area, with 26% in 2021, according to the Centers for Disease Control and Prevention.

Which county has the lowest frequent mental distress in adults, local model estimate?

Kalawao County, with 9.9% in 2021.

Where does this ranking come from?

Every value comes from one source and one period, so the places are comparable: Centers for Disease Control and Prevention, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), frequent mental distress in adults, crude prevalence. Retrieved 2026-10-12. 76 counties have no value for 2021 and are not ranked.

Frequent mental distress in adults, local model estimate: other rankings

US counties: more rankings