MISCELLANEOUS

Health & Hygiene Confessions:

America’s Filthiest Cities Revealed
July 2nd, 202010 Minute Read

Cities are often judged by how they look on the outside. However, personal
hygiene might be a better barometer of cleanliness than litter-free
sidewalks or manicured landscaping. The truth is: American cities are not
equal in terms of how often residents shower, brush their teeth, and
put on fresh underwear. That kind of cleanliness is a high priority in some
places, while bad breath, germy hands, and body odor are par for the
course in others.

This can seriously affect an individual’s well-being and the overall health of
a certain location. For instance, according to the CDC, washing hands with
soap and water could prevent 23-40% of all episodes of diarrhea and 16-
21% of colds and respiratory illnesses. Frequent handwashing is also
beneficial to stop the spread of serious diseases and viruses like influenza,
Ebola, or the coronavirus. When you put it all together, a person’s private
hygiene behaviors directly affect the health and well-being of all residents
and contribute to the overall cleanliness of their city.

Since Quality Logo Products sells about 800,000 hand sanitizers each

year, we were curious to know whether they are put to good use! We’ve all
seen sanitizing stations at busy malls and restaurants, but are they just for
show? Are cities as clean as they strive to be? The only way to figure out
which cities have the best hygiene habits — and which are more lax when
it comes to personal care — was to choose 25 of America’s largest
metropolises and partner with an independent research firm to survey at
least 100 people in each. When all was said and done, we had in-depth
surveys of 2,732 individuals and some fascinating insights into
America’s personal hygiene behaviors. (See the methodology here.)

Curious to see which cities have the least hygienic residents and how your
own personal behaviors stack up? Read on for the results of our study.

Personal Hygiene in the U.S.

Overall, the 25 locations we surveyed had varying levels of attention to
personal hygiene. The results below are an aggregated set of data about
the behaviors for all the residents we surveyed in the following states:
 Arizona
 California
 Colorado
 Florida
 Georgia
 Illinois

 Nevada
 New York
 North Carolina
 Ohio
 Pennnsylvania
 Indiana

 Louisiana
 Maryland
 Massachusetts
 Michigan
 Minnesota
 Missouri

 Tennessee
 Texas
 Virginia
 Washington

Most Americans in the surveyed metropolises shower almost every day

(averaging 6.2 showers per week), brush their teeth twice on most days
(11.7 times per week), and change their bed sheets every 2.5 weeks.

As many as a quarter of Americans go 3 days between showers and let

their teeth get a little grimy before taking action. One in 10 Americans
haven’t changed their bed sheets in two months or longer. Finally, a little
over 4% of Americans have been wearing the same underwear for 4 days
or longer. Maybe it’s time to do some laundry?

There is a case to be made that daily showering might not be necessary.

However, microbial analysis of the fungi, bacteria, dead skin cells, pollen,
pet dander, and bodily fluids that accumulate on bed sheets is enough to
make anyone lose sleep. Meanwhile, skipping laundry day and recycling
underwear can lead to itchiness, rashes, yeast infections, UTIs, and
questionable odors. Let’s not forget about all that could happen when you
don’t brush your teeth for a couple of days. These behaviors can lead to
bad health down the road, and in turn, contribute to the overall cleanliness
and health of a person’s entire city. It’s enough to make anyone want to
grab the soap.

Hygiene Report Cards for 25 Cities

Let’s break that aggregated data down even further. We spoke with
residents in 25 major metropolises across those listed states and found that
behavior changed from location to location, resulting in some cities being
more hygienic than others.

To judge a city’s overall hygiene, we crunched the data and generated

scores based on six equally weighted criteria:

1. How often residents shower or bathe

2. How often they brush their teeth
3. How often they change their bedsheets
4. How often they change their shirts and underwear
5. How often they clean their homes (specifically, scrubbing toilets and
mopping floors)
6. How often they wash their hands after using the toilet

Miami-Ft. Lauderdale residents got top marks, making their location

the most hygienic metro area in the U.S. Also earning high scores for
overall cleanliness: New Orleans, Charlotte, Detroit, and New York. Be
sure to pack your hand sanitizer if you’re headed to the places at the
bottom of the list. Seattle residents are the nation’s grungiest followed
by Denver, Washington, DC, the San Francisco-Oakland-San Jose
corridor, and Pittsburgh.

Hygiene Highs and Lows Across

the U.S.
Here is a closer look at how cities compare on key behaviors. As
mentioned, these personal behaviors all contribute to the overall
cleanliness of a particular city.
With an average annual temperature of 77ºF and persistent humidity, it
makes sense that residents of Miami and Ft. Lauderdale might shower
more often than people in cooler climates. Still, weather alone doesn’t
explain the big discrepancy in bathing habits across the country.
Boston can get brutally cold, yet it has the second-highest percentage of
residents who shower more than once a day.

Las Vegas has an average annual temperature of 80ºF with highs typically

in the triple digits over the summer, but almost 9% of residents routinely go
4 to 5 days or longer between showers. Residents in San Francisco and
Washington, DC are also more likely to go long stretches without bathing,
probably making for some pretty smelly bus rides.

New York City has no shortage of iconic spots for a first kiss, but before
you pucker up, you might want to make sure your mate isn’t among the
13.7% of foul-mouthed Big Apple residents who haven’t brushed their teeth
in several days. New Yorkers were most likely to skip brushing their
teeth, followed by residents of Washington, DC, and Dallas-Ft. Worth. To
find the freshest breath in the country, head to Miami, Nashville, or
Philadelphia.

While New Yorkers are less likely to brush their teeth, their sheets are the
most likely to be freshly laundered. Our survey found that New York,
Houston, and Miami residents were most likely to change their linens once
a week or more, while Los Angeles residents were worst at washing
their bedsheets on a regular basis — 1 in 6 L.A. residents sleep in the
same set of sheets for two months or longer. San Francisco and
Indianapolis residents weren’t far behind when it comes to bedding.

Washington, DC might be where the nation’s health policies are debated

and approved, but it turns out that residents of the Beltway are less
conscientious about their own hygiene. Almost 1 in 5 Washington, DC
residents wear the same underwear for four days or longer, and 1 in 4
often skip washing their hands after using the toilet — both rates were
significantly greater than other cities.

Measuring Concern About Germs

All of this data might be surprising, but it makes sense to see why the cities
have these behaviors. After all, a germaphobe is going to wash their hands
way more often than someone who isn’t fazed by those pesky particles. We
looked into which cities in the United States are the most germophobic.
If you cringe a little at the thought of using a gas station toilet, touching the
rubber handrail on an escalator, or shaking a stranger’s hand… you’re not
alone. Most Americans are aware of the germs and microorganisms that
are all around us, but the degree to which we worry about it varies greatly.

We asked people: “On a scale of 1-5, how concerned are you about

coming into contact with germs in public places?”  1 was “not
concerned at all” and 5 was “extremely concerned”. The average score
nationally was 3.3.

Perhaps taking a “what doesn’t kill you makes you stronger” approach,
nearly a third of Denver residents answered “1” or “2.” This isn’t necessarily
a bad approach considering hygiene hypothesis that says excessive
cleanliness prevents children from developing strong immune systems and
makes it more likely that they’ll have allergies later in life. Chicago and
Pittsburgh residents were also comparatively unconcerned about germs.

At the other end of the spectrum, Miami-Ft. Lauderdale residents were

most likely to reply with a “4” or “5,” followed by San Francisco, New York
City, New Orleans, and Washington, DC residents. More than half of those
cities’ populations were very concerned about germs. Of course, they might
have reason to be. New York and Washington, DC residents were also
among the most likely to get sick with a cold or flu multiple times each year.

Odds of Getting Sick

A city may or may not be concerned with germs, but how is that affecting
their health? We took a look at how often residents get a cold or the flu in
the surveyed cities and found some surprising stats.

Can where you live influence how likely you are to catch a cold or flu?

Maybe. We asked people how often they get sick with a cold or flu in a
typical year. The average response was 2-3 times a year, but it varied by
location.

Washington, DC and New York City scored poorly on several measures of

hygiene and cleanliness — particularly hand washing after using the toilet –
and they had comparatively higher percentages of residents reporting
getting sick 4 to 5 times a year or more.

On the other hand, Atlanta and Charlotte residents were most likely to
wash their hands and were among the least likely to get sick.

It’s not a perfect correlation. Factors including population density,

percentage of people taking public transportation, and weather patterns
can also influence the spread of disease. In any given year, different cities
and states can be particularly active on the CDC’s influenza map.

The Problem of ‘Presenteeism’

Do you know that person who refuses to take a sick day? Well, they could
be bringing a crazy amount of germs to the workplace. Some cities are
more likely to have “presenteeism” problems than others.

Depending on who you ask, people who show up to work with red noses
and boxes of tissues are either hardworking troupers or pariahs putting the
whole office at risk. We asked people how often they go to work while ill
with a cold or flu.  Overall, 12.7% said “never,” 65.9% said “sometimes,”
and 21.4% said they “often” go to work sick.

It’s frustrating for managers when employees call in sick. However, the
alternative — having contagious workers spread germs through the office
— can be a lot worse. The economic cost of “presenteeism” has been
estimated at $150 billion a year in terms of lost productivity and spread of
disease.

We found geographic differences in how willing people were to take a sick

day. More than 1 in 4 workers in Denver, Las Vegas, Pittsburgh, New York,
and Seattle said they “often” go to work while sick with a cold or flu. By
contrast, residents of St. Louis and Washington, DC, were least likely to
drag themselves into work while sick. Dallas, Charlotte, and Philadelphia
residents were also comparatively more willing to take a sick day as
needed.

Presenteeism by Profession
It isn’t just a particular city that houses folks who are willing to go to work
even when they’re sick. It turns out your occupation may also determine
whether or you’re willing to bring germs with you to work.

We analyzed the responses by profession to learn more about

presenteeism. In the process, we discovered that teachers and retail
salespeople are most likely to report for work sick. Nearly 3 in 10
teachers said they “often” go to work while suffering from a cold or
flu. Recent research found that high job demands, stress, and economic
insecurity were key factors in whether people report for work sick.

‘Employees Must Wash Hands

Before Returning to Work’ … But
Do They?
People in the workplace should, in theory, wash their hands after using the
bathroom. However, this isn’t always the case, especially in certain
industries. The numbers just might surprise you!

Have you ever wondered if those signs in bathrooms reminding employees

to wash their hands before returning to work are really necessary? It turns
out, they are but they might not be taken to heart. Overall, 39.3% of
Americans sometimes skip washing our hands after using the
toilet. Bankers are most likely to skip washing their hands, but
healthcare workers also cut corners pretty regularly. Teachers are the
most diligent about handwashing.

This attention to handwashing is extremely important, especially as

epidemics like coronavirus (COVID-19) or other respiratory diseases
spread across the nation. No matter what industry you are part of, take
some time to wash your hands for at least 20 seconds with warm water and
soap.

Conclusion
The consequences of poor hygiene can be minor — romantic moments lost
to bad breath or an unpleasant commute to work because of someone’s
body odor — or they can be more serious like getting the flu or contracting
a disease. Although good hygiene can’t fully protect you from getting sick,
other people’s bad habits can expose you to viruses and germs
unnecessarily, which can have a social and economic impact in your
respective city.

Cultural norms are a significant factor in hygiene practices around the

world, but our survey results suggest they might be a factor between cities
as well. Different cities have different vibes and personalities, and it turns
out they have slightly different hygiene norms as well.

Whatever the reason for the variation in behavior, the differences are
interesting. If you’re concerned about germs, taking some hand sanitizer
out in public might not be a bad idea no matter where you live.

Methodology
We surveyed a total of 2,732 people, polling at least 100 residents in each
of 25 major cities across the United States. The cities were chosen based
on population, media market size, and geographic location. Surveys were
conducted online.

Respondents ranged in age from 18 to 82, with a median age of 33. There
were 46% men and 54% women. In terms of relationship status:

 40.9% were married

 29.8% were single
 15% were in a relationship, living together
 8% were in a relationship, living separately
 The remaining 6.3% were divorced, separated, or widowed

The median household income was $50,001–$75,000 a year with 31.4% of

respondents earning more and 44.1% earning less. Our survey
respondents included:

 207 people who work in healthcare, medicine, or pharmacy

 177 people who work in finance, insurance, or banking
 149 people who work in retail sales
 141 educators (Pre-K through 12th grade)
 131 people who work in arts, entertainment, or photography
 119 people who work in construction, roofing, or building trades
  103 people who work in hotel, hospitality, restaurant, or food services
 87 people who work in government or public administration

Fair Use
If you’re a journalist or blogger interested in covering this project, feel free
to use any of the images or graphics above. All we ask is that you kindly
credit Quality Logo Products® and link back to this page so your readers
can learn more about our study and its methodology.

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