Health can be defined as being free from illness or injury or a person's mental or physical condition. The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. People measure health differently. Some people place more value on appearance, weight, or muscle mass, while others place more value on mental well-being, and others focus on the absence of medical conditions and disease.
The United States is one of the wealthiest countries in the world, and its healthcare spending is by far the largest in the world. Despite this, the United States still struggles with a high prevalence of chronic health conditions and preventable deaths. Like many other things, health is not uniform across all 50 states.
One major health problem in the United States is the prevalence of obesity, leading to other problems such as certain types of cancer, type 2 diabetes, heart disease, and stroke. According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity in the U.S. was 42.4% in 2017-2018. This is a significant increase from 30.5% in 1999-2000. West Virginia, Mississippi, Alabama, and Louisiana have the highest obesity rates. The estimated annual medical cost of obesity in the U.S. in 2008 U.S. dollars was $147 billion.
The prevalence of diabetes has increased in the U.S. from 9.5% in 2012 to 10.9% in 2018.
Healthy behaviors and active lifestyles are the largest contributors to good health; however, health can be affected by several factors, including but not limited to: housing, financial safety (especially household income), lifestyle/culture, employment, community safety, education, and environment. Because these factors can vary greatly between states, so do each state population's overall level of health.
Healthiest U.S. States
To determine which states are the healthiest, data can be drawn from the 2020 America's Health Rankings from the United Health Foundation. The ranking includes healthy behaviors, quality of health care, health policy, the presence of disease, and deaths from illnesses.
Vermont is considered the healthiest state in the U.S. Vermont's adult obesity rate is 26.6%, the seventh-lowest in the country, and its adult smoking rate is 15.1%, the 21st-lowest. Physical activity is common in Vermont, with just about 80% of residents reporting daily exercise, the seventh-highest. The state also has one of the highest public health funding in the U.S., spending $157 per person for programs that promote exercise, nutrition, and other healthy habits. Additionally, Vermont has 395.3 primary care physicians per 100,000 people, the second-highest among states.
Vermont's neighbor Massachusetts is the second-healthiest state in the country. Massachusetts's obesity rate, 25.2%, is the fourth-lowest among all states, and its median household income is $79,835, also the fourth-highest. Likely because of the state's relatively well-off economic status, it also has the lowest rate of residents without health insurance at just 3.0%. Massachusetts also has the highest concentration of primary care physicians in the country, at 247 physicians for every 100,000 residents.
Hawaii is known for promoting good health through policy - and it's working. Hawaii has the third-lowest obesity rate in the U.S. of 25.0% and the third-highest median household income of $80,212. Right behind Massachusetts, only 4.2% of Hawaii residents are uninsured. The state spends $205 in public health funding per person, behind only two states: Alaska and New Mexico. Physical inactivity is also uncommon in the beautiful state of Hawaii.
Connecticut has great health determinants like policy and clinical care. The adolescent immunization rate is 95.4%, the third-highest in the nation, and the child immunization rate is 75.3%, the tenth-highest. Connecticut has the fifth-highest median household income in the U.S. of $76,348. The state has the fourth-lowest rate of premature deaths of 6,091 per 100,000 residents and the fourth-lowest adult smoking rate of 12.1%, and the 13th-lowest adult obesity rate of 29.1%.
Utah has some of the lowest rates in the country for several health determinants. Utah adults have the lowest rate of excessive drinking, at just 11.3%, and the lowest smoking rate at just 7.9%. Physical inactivity is the lowest in Utah, with only 18.5% of residents not exercising regularly. Because Utah's median household income is relatively high, at $71,414, residents can afford health insurance, regular medical care, and healthier food.
New Hampshire, the fourth northeastern state on the list, is the sixth-healthiest state in the United States. New Hampshire has the second-lowest infant mortality rate at 3.9 deaths per 1,000 live births and the second-lowest prevalence of infectious diseases like whooping cough, salmonella, and chlamydia, only second to West Virginia. Additionally, the state has the highest teenage Tdap (tetanus, diphtheria, and pertussis) immunization rate in the country at 97.5%. Like the other states on this list, New Hampshire has one of the country's highest median household incomes at $74,991.
Minnesota is known to have some of the highest-quality health care in the country. Because of this, Minnesota has the second-lowest rate of premature deaths at 5,648 per 100,000 and the lowest cardiovascular deaths at 193.8 per 100,000. The state's median household income of $70,315, the 13th-highest in the U.S., allows its residents to access its great health care options. Minnesota's obesity rate does not fare as well at 30.1%, the 18th-lowest in the country. Additionally, about 22.0% of the state's adult population drinks excessively. Only 4.9% of the state's population is uninsured.
8. New Jersey
The Garden State is the eighth-healthiest state in the U.S. thanks to its low rates of several risk factors, including obesity, smoking, and excessive drinking. 25.6% of New Jersey's adult population is obese, and 13.1% are smokers, the fifth-lowest and tenth-lowest in the country, respectively. New Jersey has the fifth-lowest poverty rate in the country at 9.5% and the second-highest median household income of $81,740. This level of economic well-being allows for access to high-quality health care and components of a healthy lifestyle such as gym memberships and healthful food.
Washington residents have some of the lowest rates of risky health behaviors in the country, making it one of the healthiest states. The adult smoking rate is 12.6%, and the adult obesity rate is 28.3%. This, combined with just 19.2% of adults not getting regular exercise, allows the state to have the fifth-lowest rate of premature deaths at 6,086 per 100,000. Regular outdoor exercise is easy in a beautiful state like Washington. The state also boasts a low rate of cardiovascular deaths of just 222.4 per 100,000.
Colorado finishes the top ten list of the healthiest U.S. states, boasting the lowest adult obesity rate in the country of 23.8%. This is likely caused by the high rate of physical activity of the state's residents, with over 81% reporting regular physical exercise. The high rate of physical activity and a low rate of obesity helps keep the prevalence of type 2 diabetes and cardiovascular disease low. Only 7% of Colorado's adult population has been diagnosed with diabetes, the lowest in the country. The relatively wealthy population has a median household income of $71,953, allowing them to access components of a healthy lifestyle.
On the opposite end of these ten states are the least-healthiest states in the country. Among these are Louisiana, Mississippi, Alabama, Oklahoma, and Arkansas. These states have high obesity rates, excessive drinking rates, high cancer and heart disease rates, and low-quality health care.