<P> Nine Southern states have obesity rates exceeding thirty percent of the population, the highest in the country: Mississippi, Louisiana, West Virginia, Alabama, Oklahoma, Arkansas, South Carolina, Kentucky, and Texas . Rates for hypertension and diabetes for these states are also the highest in the nation . A study reported that six Southern states have the worst incidence of sleep disturbances in the nation, attributing the disturbances to high rates of obesity and smoking . The South has a higher percentage of obese people and diabetics . It has the largest number of people dying from stroke . and the highest rates of cognitive decline . Life expectancy is lower and death rates are higher in the South than in other regions of the United States for all racial groups . This disparity reflects substantial divergence between the South and other regions since the middle of the 20th century . </P> <P> The East South Central Census Division of the United States (made up of Kentucky, Tennessee, Mississippi, and Alabama) had the highest rate of inpatient hospital stays in 2012 . The other divisions, West South Central (Texas, Oklahoma, Arkansas, and Louisiana) and South Atlantic (West Virginia, Delaware, Maryland, Virginia, North Carolina, South Carolina, Georgia, and Florida) ranked seventh and fifth, respectively . The South had a significantly higher rate of hospital discharges in 2005 than other regions of the United States, but the rate had declined to be closer to the overall national rate by 2011 . </P> <P> For cancer in a region, the South, particularly an axis from West Virginia through Texas, leads the nation in adult obesity, adult smoking, low exercise, low fruit consumption, low vegetable consumption, all known cancer risk factors, which matches a similar high risk axis in "All Cancers Combined, Death Rates by State, 2011" from the Centers for Disease Control and Prevention . </P> <P> In the first decades after Reconstruction, when white Democrats regained power in the state legislatures, they began to make voter registration more complicated, to reduce black voting . With a combination of intimidation, fraud and violence by paramilitary groups, they suppressed black voting and turned Republicans out of office . From 1890 to 1908, ten of eleven states ratified new constitutions or amendments that effectively disenfranchised most black voters and many poor white voters . This disfranchisement persisted for six decades into the 20th century, depriving blacks and poor whites of all political representation . Because they could not vote, they could not sit on juries . They had no one to represent their interests, resulting in state legislatures consistently underfunding programs and services, such as schools, for blacks and poor whites . </P>

Which states in the us are considered southern