Forbes compiled a comprehensive ranking of U.S. states based on health criteria, utilizing 21 metrics from the Kaiser Family Foundation and the Centers for Disease Control and Prevention (CDC).
These metrics were categorized and weighted: lifestyle habits and health outlook (15 points), substance abuse (25 points), and disease prevalence and mortality rate (60 points).
Each category received a score from 0 to 100, with a lower number indicating a healthier state, and all data was based on a rate per 100,000 residents.
Generally, Americans live shorter lives and face more health issues than those in high-income countries.
Here are the states ranked by healthiness:
The Most Healthy States
1: Hawaii
Hawaii is officially the healthiest state, earning a coveted 0 out of 100 score. This is largely due to Hawaiians having the longest lifespan (80.87 years) and the second-lowest obesity rate (24.83%).
Residents also have America’s lowest alcohol-induced fatalities and the seventh lowest illicit drug dependence among adults.
2: Utah
Utah ranks as the second healthiest state with an excellent health score of 0.6 out of 100. Utahans reported the highest number of people who exercised in the past month.
This active lifestyle, combined with residents having the lowest rates of disease mortality and chronic illness, significantly contributed to their impressive health standing.
3: Minnesota
Minnesota is the third healthiest state in America, with a health score of 1.11 out of 100. Only 2.5% of its residents report opioid misuse, ranking it fifth lowest nationally.
Minnesotans also demonstrate strong health outcomes with the seventh lowest percentage of diabetes diagnoses, reflecting positive overall health trends within the state.
4: California
California claims the title of the fourth healthiest state in the US with a score of 3.2. The Golden State achieved excellent rankings for its lifestyle habits & health outlook category.
Californians also benefit from having the second longest life expectancy nationally at 80.23 years, contributing significantly to their high overall health ranking.
5: Massachusetts
Massachusetts secured an impressive health score of 4.52. The state benefits from a low obesity rate of 25.67% compared to the national average.
Additionally, only 11.27% of Bay Staters currently smoke, which is the fifth lowest in America, showcasing strong public health indicators and positive lifestyle habits.
6: Colorado
Colorado received a health score of 5.62 out of 100. It performed exceptionally well in the lifestyle habits and health outlook category, scoring a low 1.12.
However, Coloradans face significant challenges in the substance abuse area, evidenced by a high score of 88.27 out of 100, which heavily impacted its overall ranking.
7: Washington
Forbes assigned Washington state a health score of 6.04. Similar to Colorado, residents of the Evergreen State struggle with substance abuse, receiving a score of 81.48 in this category.
On a more positive note, Washington landed a strong lifestyle habits and health outlook score of 3.37, balancing its health profile.
8: Connecticut
Connecticut received a health score of 8.23. Like many states in the top ten, it performed well in the lifestyle habits & health outlook department.
However, its moderate scores in substance abuse and disease prevalence & mortality rate prevented Connecticut from achieving a higher overall position among the healthiest states in America.
9: New York
New York earned a healthiness score of 9.0. The state exhibited fewer significant fluctuations between categories compared to many others.
New York consistently ranked well, scoring in the low 20s for both substance abuse and lifestyle habits & health outlook, indicating a relatively balanced approach to public health across key metrics.
10: New Jersey
New Jersey proudly made the top ten healthiest states, though it’s the first on this list to surpass double digits with a total healthiness score of 14.44.
The high 60-point weight assigned to disease prevalence and mortality rate in this study was identified as the primary reason preventing the Garden State from ranking higher.
11: Idaho
Idaho’s healthiness score was close to New Jersey’s, at 15.04. Substance abuse emerged as the highest category for the Gem State, with a score of 44.44.
Positively, Idahoans demonstrate excellent health in another critical area, reflected by a low 15.65 score for disease prevalence & mortality rate.
12: Oregon
Oregon’s total healthiness score is 23.05, a notable increase from Idaho. The state received a distressing 100 out of 100 score for substance abuse.
This high score is consistent with news reports stating Oregon has the second-highest alcohol and drug addiction rate in the US, highlighting a significant public health challenge.
13: Vermont
Vermont’s healthiness score is 23.37, just slightly above Oregon’s. The Green Mountain State also ranks terribly for substance abuse, with a score of 89.51.
Its prevalence & mortality rate score of 43.13 is concerningly high. However, a low 11.8 habits & health outlook score serves as its primary positive factor.
14: Virginia
Virginia holds a health score less than 0.2 worse than Vermont’s, with a significantly different distribution across categories.
The state boasts a low substance abuse score of 12.35. However, both its prevalence & mortality rate and lifestyle habits & health outlook categories rank in the low 30s, indicating areas for improvement.
15: New Hampshire
New Hampshire has a total healthiness score of 24.91. Like several other states, its residents face challenges with substance abuse, receiving a high Forbes score of 85.19.
The Granite State’s strongest performance was in lifestyle habits & health outlook, with a score of 20.79, indicating relatively healthy everyday behaviors.
16: Rhode Island
Forbes gave Rhode Island a health score of 26.19. The state’s most challenging category was substance abuse, with a high score of 83.33.
Additionally, the disease prevalence & mortality rate category was unfavorable for Rhode Islanders, scoring 41.98, contributing to its overall health ranking.
17: Wisconsin
Despite Wisconsin’s score of 27.04, it presents a better health profile than many states in the top 20. The Badger State has a substance abuse score of 53.7 out of 100, which is comparatively moderate.
However, it ranks just above 40.0 for the disease prevalence & mortality rate category, indicating room for improvement.
18: Nebraska
Nebraska is the last state on this list to have a healthiness score in the 20s, at 28.82. This score appears relatively low compared to those that follow in the rankings.
The Cornhusker State ranked in the 40s for all categories except for substance abuse, which had a score of 39.51, indicating a more moderate challenge.
19: Texas
Texas received an overall health score of 33.11. A significant contributing factor to this ranking is its 35.8% obesity rate.
This high rate plays a role in Texas’s poor score of 51.69 for lifestyle habits & health outlook, indicating a need for improvement in residents’ daily health practices.
20: Maryland
Maryland’s overall health ranking is worse than Texas’s. While it performs almost 50% better than Texas in the lifestyle habits & health outlook category, Maryland’s scores are significantly higher in other areas.
Specifically, it has more than 33 points higher in substance abuse and a 6.3 higher score for disease prevalence & mortality rate.
21: North Dakota
North Dakota has a health score of 25.72. The state ranks moderately to poorly across all health categories.
Its lifestyle habits & health outlook category received the worst score at 56.18, indicating significant areas for improvement in residents’ daily health practices and overall well-being.
22: Illinois
Illinois has a health score of 37.17. The Prairie State experiences its most significant challenges in the disease prevalence & mortality rate category, scoring 45.23 out of 100.
In contrast, its substance abuse score of 38.89 appears relatively low when compared to many states discussed earlier in the rankings.
23: Iowa
Forbes assigned Iowa a health score of 38.52. The Hawkeye State showed consistent results across the board, scoring in the 50s for all three health categories.
Unfortunately, these consistent moderate-to-high scores are not promising numbers for the overall health and well-being of its residents.
24: Alaska
Alaska presents a mixed health profile, with a total health score of 40.87. Despite a very low disease prevalence & mortality rate score of 4.58, suggesting positive outcomes in that area, Alaskans face challenges.
They have a high lifestyle habits & health outlook score of 45.51 and a notably high substance abuse score of 95.06.
25: Montana
Montana’s total health score clocked in at 41.11, placing it in the middle for state healthiness. The Treasure State achieved a relatively respectable 29.21 score for lifestyle habits & health outlook.
However, a high 79.63 score in another category (not specified in this snippet but implied to be a negative factor) prevented it from ranking healthier.
26: Florida
Florida’s health score came in at 42.85. Its relatively low ranking for healthiness is partly attributed to the large number of seniors who move there for retirement.
This demographic trend could contribute to Florida’s high 63.55 disease prevalence & mortality rate score, influencing its overall health profile.
27: South Dakota
With a health score of 43.96, South Dakota residents need to improve their health. The Mount Rushmore State performed worst in the lifestyle habits & health outlook category, with a 58.43 score.
Even a comparatively low substance abuse score of 40.74 was insufficient to significantly boost its overall ranking.
28: Arizona
Arizona has a health score of 46.42. Its residents face considerable struggles with substance abuse, scoring 87.04 out of 100.
While its lifestyle habits & health outlook score of 35.39 appears smaller in comparison, it is still far from the healthy numbers achieved by the top ten states in Forbes’ ranking.
29: Georgia
Georgia’s health ranking of 49.27 includes a zero substance abuse score, indicating very low reported illicit drug use and alcohol addictions.
Unfortunately, the Peach State scores moderately to high in other critical areas. These include a disease prevalence & mortality rate of 35.5 and a lifestyle habits & health outlook score of 59.55.
30: Maine
Maine received a health score of 49.65. The state ranked among the highest for disease prevalence & mortality rate, with a score of 68.89.
The significant weight Forbes placed on this category, combined with a high substance abuse score (not specified here, but implied as a negative factor), contributed to the Pine Tree State’s lower ranking.
The Least Healthy States
31: Kansas
Kansas breaks into the top 20 unhealthiest states in America and is the first state to exceed a health score of 50, reaching 51.97.
The Sunflower State exhibited quite even scoring across all three categories, with its results ranging in the 50s out of 100, indicating consistent challenges across health metrics.
32: Wyoming
Forbes gave Wyoming a total health score of 52.4. Wyomingites are most affected by health issues related to the substance abuse category.
As a positive aspect, they demonstrate a lower-than-average prevalence & mortality rate score of 35.5, indicating better outcomes in disease and death rates compared to their substance abuse challenges.
33: Nevada
Nevada’s health score clocked in at 53.29. The state registered an exceedingly high substance abuse score of 88.27, indicating significant challenges in this area.
Additionally, the outlook for Nevadans in the lifestyle & health outlook category is not promising, with a score of 46.63, highlighting multiple health concerns.
34: Delaware
Delaware had a total health score of 53.54. The First State’s most significant challenge was the lifestyle habits & health outlook category, scoring 59.55.
Delawareans are not performing much better in the disease prevalence & mortality category, scoring less than four points below that, indicating multiple areas for health improvement.
35: Pennsylvania
Pennsylvania scored just slightly higher than Delaware regarding its unhealthiness ranking.
The poor disease prevalence & mortality rate score of 62.02 is the biggest contributor to the Keystone State’s unfavorable ranking when compared to most other states. This highlights a significant area for health improvement in Pennsylvania.
36: North Carolina
North Carolina’s total health score of 59.14 places it as the 15th most unhealthy state in America.
The state’s poor scores in the disease prevalence & mortality rate (56.11) and lifestyle habits & health outlook (57.87) categories were very close, indicating widespread health challenges across multiple key areas for its residents.
37: New Mexico
New Mexico’s total health score takes a significant leap from North Carolina’s, landing at 66.28. A high substance abuse score of 82.10 is one of the primary reasons for this.
Additionally, a 52.81 score in lifestyle habits & health outlook further exacerbates its health situation, indicating multiple challenges.
38: Michigan
Michigan is less than 0.5 points above New Mexico for unhealthiness. The state ranks highly across the board for all categories, indicating widespread health challenges.
Both disease prevalence & mortality rate (69.08) and substance abuse (70.99 out of 100) scores are nearly identical and quite high, reflecting significant issues in these areas.
39: Indiana
The outlook for Indiana’s health department is not promising unless its residents take proactive measures to improve their well-being.
Its 82.58 score in the lifestyle habits & health outlook category is identified as one of the worst in the country, indicating significant challenges in daily health practices and overall wellness within the state.
40: Missouri
Missouri managed to stay out of the top ten unhealthiest states, but its total health score of 71.98 is still concerning.
The state scored moderately to high in all categories, with lifestyle habits & health outlook being the biggest challenge, scoring 78.65, indicating a need for significant improvement in residents’ daily health practices.
41: Ohio
Ohio is the tenth most unhealthy state in the US, with a total health score of 73.38. While it ranks poorly across all categories, its 80.34 score for lifestyle habits & health outlook is the worst, highlighting significant challenges in residents’ daily choices and overall wellness.
42: South Carolina
Southern cooking traditions appear to be negatively impacting the health of South Carolinians.
The Palmetto State faces challenges with a disease prevalence & mortality rate score of nearly 70. Additionally, its lifestyle habits & health outlook score is nearing 80 out of 100, indicating significant issues in daily health practices.
43: Oklahoma
According to Forbes’ study, Oklahomans face serious health issues. The Sooner State has a highly unfavorable lifestyle habits & health outlook score of 87.64.
In comparison, its substance abuse score of 50.62 appears relatively smaller, yet still represents a considerable challenge for the state’s residents.
44: Louisiana
Louisiana’s total health score jumps into the 80s, reaching 82.47. Similar to preceding states, the Pelican State ranks poorly for habits & health outlook (91.57).
It also holds the second-highest substance abuse score among the top ten unhealthiest states, at 70.99, indicating significant challenges in these areas.
45: Tennessee
Even though Tennessee narrowly avoided being listed among the top five most unhealthy states, its total health score of 82.81 is not commendable.
Among the three categories, Tennesseans performed worst for disease prevalence & mortality rate (76.15) and lifestyle habits & health outlook (86.52), highlighting significant health challenges.
46: Arkansas
Arkansas is the fifth most unhealthy state in the US, with a total health score of 85.35 out of 100.
Contributing factors include Arkansans having the second-highest heart disease fatalities and third-highest diabetes mortalities. Furthermore, over 20% of its population smokes, ranking third highest nationally.
47: Alabama
Obesity is a major factor contributing to Alabama’s 85.69 total health score. Over 38% of Alabamians aged 18 and older are obese, partly due to ranking third-highest in America for residents not exercising in the past month. The state also has the second-highest rate of stroke and Alzheimer’s disease fatalities.
48: Kentucky
Kentucky is the third-most unhealthy state in the US, with a Forbes health score of 86.96 out of 100.
The Bluegrass State has the fourth-highest cancer incidence rate, with over 643 diagnoses per 100,000 residents. Its 21.53% smoking percentage makes it the second-highest state for current smokers.
49: Mississippi
Mississippi narrowly avoided the title of unhealthiest state, but with a health score of 96.55, its residents face significant challenges.
The Magnolia State has the highest obesity rate in America (39.87%) and the lowest life expectancy at birth.
Residents also suffer from the worst mortality rates for hypertension, Alzheimer’s, and influenza & pneumonia.
50: West Virginia
West Virginia’s health score of 100 out of 100 makes it the number one unhealthiest state in the US.
Factors include having the highest rate of drug overdose fatalities (57.13 per 100,000 residents) and the highest prevalence of illness and mortality from chronic diseases. This includes the worst rankings for diabetes, heart, kidney disease, and cancer mortality.
Alicia Richards