Home

 › 

Featured

 › 

Health

 › 

The Healthiest County in Every State

The Healthiest County in Every State

The Roman poet Virgil said “The greatest wealth is health” more than 2,000 years ago and that still holds true. America is a wealthy country but that doesn’t necessarily mean it’s a healthy one. In fact, affluence may result in a less healthy population, as people use more labor-saving devices, exercise less, and have ready access to calorie-laden food. That said, some parts of the country are healthier than others overall.

To identify the healthiest county in every state, 24/7 Tempo reviewed data tracking rates of smoking, obesity, and physical activity from County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Counties were ranked within their state for health outcomes and health factors, which were then averaged to find the healthiest county in the state. County median household income comes from the American Community Survey 2020 five-year estimates.

The results are startling. For example, Douglas County, the healthiest county in Colorado, has an obesity rate of 21.4%. That’s the lowest rate on our list, but it still means that more than one in five people in the state is obese. (These are America’s most obese counties.) 

Smoking has been described as the single most preventable cause of death, yet people across the country still smoke. Ironically, Virginia, a state strongly associated with tobacco, has a relatively low statewide smoking rate of 14.2% and has the county with the lowest rate on our list: Falls Church City (an independent city with county-level governance status), where only 8.8% of the population light up. However, neighboring West Virginia has a statewide smoking rate of 26.1% and its healthiest county, Monongalia, has a smoking rate of 20.3%. (For a number of reasons, these are the worst counties to live in.)

Physical activity is another factor strongly linked to health outcomes, and exercise rates also vary dramatically from state to state and within states. Colorado also scores well by this metric. Only a relatively low 18.7% of adults do not exercise regularly in the state and in Douglas County the figure is only 12.9%. 

Source: Jacqueline Nix / iStock Editorial via Getty Images

1. Alabama: Shelby
> Smoking rate: 15.3% (state: 21.1%)
> Obesity rate: 30.2% (state: 36.3%)
> Adults who do not exercise regularly: 23.6% (state: 30.8%)
> Median household income: $78,889

Source: urbanglimpses / iStock via Getty Images

2. Alaska: Juneau
> Smoking rate: 15.1% (state: 17.3%)
> Obesity rate: 27.5% (state: 30.7%)
> Adults who do not exercise regularly: 16.7% (state: 21.6%)
> Median household income: $88,077

Source: Sean Pavone / iStock via Getty Images

3. Arizona: Maricopa
> Smoking rate: 14.3% (state: 15.6%)
> Obesity rate: 31.0% (state: 31.9%)
> Adults who do not exercise regularly: 24.8% (state: 23.6%)
> Median household income: $67,799

Source: raksyBH / iStock Editorial via Getty Images

4. Arkansas: Benton
> Smoking rate: 16.4% (state: 21.1%)
> Obesity rate: 29.8% (state: 38.0%)
> Adults who do not exercise regularly: 26.5% (state: 30.4%)
> Median household income: $71,556

Source: tiburonstudios / E+ via Getty Images

5. California: Marin
> Smoking rate: 9.5% (state: 10.1%)
> Obesity rate: 22.5% (state: 26.2%)
> Adults who do not exercise regularly: 17.3% (state: 22.3%)
> Median household income: $121,671

Source: SWKrullImaging / iStock via Getty Images

6. Colorado: Douglas
> Smoking rate: 9.8% (state: 13.6%)
> Obesity rate: 21.4% (state: 23.6%)
> Adults who do not exercise regularly: 12.9% (state: 18.7%)
> Median household income: $121,393

Source: Joe Mabel / Wikimedia Commons

7. Connecticut: Middlesex
> Smoking rate: 13.2% (state: 12.6%)
> Obesity rate: 27.9% (state: 29.1%)
> Adults who do not exercise regularly: 21.3% (state: 23.3%)
> Median household income: $84,907

Source: aimintang / iStock Unreleased via Getty Images

8. Delaware: New Castle
> Smoking rate: 15.4% (state: 16.4%)
> Obesity rate: 33.0% (state: 34.2%)
> Adults who do not exercise regularly: 26.8% (state: 25.3%)
> Median household income: $75,275

Source: SeanPavonePhoto / iStock via Getty Images

9. Florida: St. Johns
> Smoking rate: 16.4% (state: 15.3%)
> Obesity rate: 26.7% (state: 26.3%)
> Adults who do not exercise regularly: 22.2% (state: 25.9%)
> Median household income: $83,803

Source: BOB WESTON / iStock via Getty Images

10. Georgia: Oconee
> Smoking rate: 13.6% (state: 16.5%)
> Obesity rate: 28.0% (state: 33.4%)
> Adults who do not exercise regularly: 21.8% (state: 27.4%)
> Median household income: $95,064

Source: okimo / iStock via Getty Images

11. Hawaii: Honolulu
> Smoking rate: 13.6% (state: 12.9%)
> Obesity rate: 25.4% (state: 25.5%)
> Adults who do not exercise regularly: 25.1% (state: 23.9%)
> Median household income: $87,722

Source: mtcurado / Getty Images

12. Idaho: Ada
> Smoking rate: 13.2% (state: 15.9%)
> Obesity rate: 28.4% (state: 29.5%)
> Adults who do not exercise regularly: 21.1% (state: 23.3%)
> Median household income: $69,952

Source: DenisTangneyJr / iStock via Getty Images

13. Illinois: DuPage
> Smoking rate: 11.2% (state: 14.8%)
> Obesity rate: 26.8% (state: 31.5%)
> Adults who do not exercise regularly: 22.7% (state: 25.1%)
> Median household income: $94,930

Source: Jose A Perez / Getty Images

14. Indiana: Hamilton
> Smoking rate: 12.5% (state: 19.9%)
> Obesity rate: 26.3% (state: 35.4%)
> Adults who do not exercise regularly: 20.8% (state: 30.6%)
> Median household income: $98,880

Source: iip-photo-archive / Flickr

15. Iowa: Dallas
> Smoking rate: 12.8% (state: 17.4%)
> Obesity rate: 29.9% (state: 34.3%)
> Adults who do not exercise regularly: 21.7% (state: 26.1%)
> Median household income: $88,368

Source: BOB WESTON / iStock via Getty Images

16. Kansas: Johnson
> Smoking rate: 11.9% (state: 16.8%)
> Obesity rate: 31.1% (state: 35.6%)
> Adults who do not exercise regularly: 19.3% (state: 26.7%)
> Median household income: $91,650

Source: W.marsh / Wikimedia Commons

17. Kentucky: Oldham
> Smoking rate: 17.0% (state: 24.5%)
> Obesity rate: 33.1% (state: 36.4%)
> Adults who do not exercise regularly: 25.3% (state: 31.6%)
> Median household income: $103,761

Source: Judy Darby / iStock via Getty Images

18. Louisiana: St. Tammany Parish
> Smoking rate: 19.1% (state: 22.6%)
> Obesity rate: 30.7% (state: 36.2%)
> Adults who do not exercise regularly: 25.7% (state: 31.5%)
> Median household income: $70,730

Source: Faina Gurevich / iStock via Getty Images

19. Maine: Cumberland
> Smoking rate: 14.1% (state: 19.1%)
> Obesity rate: 25.3% (state: 31.4%)
> Adults who do not exercise regularly: 24.0% (state: 29.5%)
> Median household income: $76,014

Source: AppalachianViews / iStock via Getty Images

20. Maryland: Howard
> Smoking rate: 9.6% (state: 12.8%)
> Obesity rate: 25.5% (state: 32.0%)
> Adults who do not exercise regularly: 19.4% (state: 23.0%)
> Median household income: $124,042

Source: DenisTangneyJr / E+ via Getty Images

21. Massachusetts: Middlesex
> Smoking rate: 11.6% (state: 12.2%)
> Obesity rate: 22.6% (state: 25.4%)
> Adults who do not exercise regularly: 22.4% (state: 26.0%)
> Median household income: $106,202

Source: BobPalosaari / Getty Images

22. Michigan: Ottawa
> Smoking rate: 16.2% (state: 19.6%)
> Obesity rate: 31.9% (state: 35.8%)
> Adults who do not exercise regularly: 22.0% (state: 24.6%)
> Median household income: $72,418

Source: storkalex / iStock Editorial via Getty Images

23. Minnesota: Carver
> Smoking rate: 12.9% (state: 15.0%)
> Obesity rate: 28.7% (state: 30.0%)
> Adults who do not exercise regularly: 17.9% (state: 19.7%)
> Median household income: $104,011

Source: shawnzlea / Flickr

24. Mississippi: Madison
> Smoking rate: 13.6% (state: 21.1%)
> Obesity rate: 32.7% (state: 41.2%)
> Adults who do not exercise regularly: 28.3% (state: 36.9%)
> Median household income: $71,621

Source: TriggerPhoto / iStock via Getty Images

25. Missouri: Platte
> Smoking rate: 15.4% (state: 20.4%)
> Obesity rate: 32.2% (state: 34.6%)
> Adults who do not exercise regularly: 26.1% (state: 29.6%)
> Median household income: $82,448

Source: jsjgeology / Flickr

26. Montana: Gallatin
> Smoking rate: 12.4% (state: 17.7%)
> Obesity rate: 22.9% (state: 28.0%)
> Adults who do not exercise regularly: 15.7% (state: 18.6%)
> Median household income: $70,124

Source: Bkell / Public Domain / Wikimedia Commons

27. Nebraska: Hamilton
> Smoking rate: 15.4% (state: 15.1%)
> Obesity rate: 36.1% (state: 34.3%)
> Adults who do not exercise regularly: 26.5% (state: 26.6%)
> Median household income: $68,649

Source: johnrandallalves / iStock via Getty Images

28. Nevada: Douglas
> Smoking rate: 16.2% (state: 15.3%)
> Obesity rate: 31.3% (state: 30.5%)
> Adults who do not exercise regularly: 22.5% (state: 25.6%)
> Median household income: $71,415

Source: DenisTangneyJr / iStock via Getty Images

29. New Hampshire: Rockingham
> Smoking rate: 14.3% (state: 16.9%)
> Obesity rate: 27.4% (state: 32.1%)
> Adults who do not exercise regularly: 20.2% (state: 21.1%)
> Median household income: $93,962

Source: DenisTangneyJr / iStock via Getty Images

30. New Jersey: Morris
> Smoking rate: 12.2% (state: 13.2%)
> Obesity rate: 25.4% (state: 25.5%)
> Adults who do not exercise regularly: 20.8% (state: 27.9%)
> Median household income: $117,298

Source: benedek / iStock via Getty Images

31. New Mexico: Los Alamos
> Smoking rate: 9.2% (state: 16.5%)
> Obesity rate: 24.4% (state: 32.2%)
> Adults who do not exercise regularly: 15.1% (state: 24.8%)
> Median household income: $119,266

Source: Kirkikis / iStock Editorial via Getty Images

32. New York: Putnam
> Smoking rate: 13.5% (state: 12.9%)
> Obesity rate: 26.9% (state: 27.2%)
> Adults who do not exercise regularly: 22.8% (state: 27.0%)
> Median household income: $107,246

Source: BSPollard / iStock Editorial via Getty Images

33. North Carolina: Orange
> Smoking rate: 14.1% (state: 18.9%)
> Obesity rate: 29.8% (state: 34.0%)
> Adults who do not exercise regularly: 21.4% (state: 25.9%)
> Median household income: $74,803

Source: afiler / Flickr

34. North Dakota: Burleigh
> Smoking rate: 16.5% (state: 17.4%)
> Obesity rate: 32.3% (state: 35.8%)
> Adults who do not exercise regularly: 25.5% (state: 27.9%)
> Median household income: $72,974

Source: Mojo Hand / Wikimedia Commons

35. Ohio: Delaware
> Smoking rate: 15.0% (state: 21.8%)
> Obesity rate: 30.4% (state: 34.6%)
> Adults who do not exercise regularly: 20.9% (state: 27.6%)
> Median household income: $111,411

Source: katsrcool / Wikimedia Commons

36. Oklahoma: Canadian
> Smoking rate: 17.4% (state: 19.2%)
> Obesity rate: 33.3% (state: 37.1%)
> Adults who do not exercise regularly: 29.7% (state: 33.4%)
> Median household income: $73,591

Source: Flutter_97321 / iStock via Getty Images

37. Oregon: Benton
> Smoking rate: 13.8% (state: 14.9%)
> Obesity rate: 28.1% (state: 28.8%)
> Adults who do not exercise regularly: 22.2% (state: 23.5%)
> Median household income: $65,142

Source: DenisTangneyJr / iStock via Getty Images

38. Pennsylvania: Chester
> Smoking rate: 13.7% (state: 17.8%)
> Obesity rate: 29.3% (state: 33.1%)
> Adults who do not exercise regularly: 20.2% (state: 24.6%)
> Median household income: $104,161

Source: DenisTangneyJr / iStock via Getty Images

39. Rhode Island: Bristol
> Smoking rate: 14.5% (state: 13.8%)
> Obesity rate: 26.8% (state: 30.1%)
> Adults who do not exercise regularly: 20.1% (state: 26.0%)
> Median household income: $85,413

Source: Sean Pavone / iStock via Getty Images

40. South Carolina: Beaufort
> Smoking rate: 15.6% (state: 18.4%)
> Obesity rate: 27.8% (state: 35.5%)
> Adults who do not exercise regularly: 22.5% (state: 28.5%)
> Median household income: $71,430

Source: kkay / iStock via Getty Images

41. South Dakota: Lincoln
> Smoking rate: 15.3% (state: 19.0%)
> Obesity rate: 30.0% (state: 33.1%)
> Adults who do not exercise regularly: 25.9% (state: 28.9%)
> Median household income: $84,260

Source: mavdesign / iStock via Getty Images

42. Tennessee: Williamson
> Smoking rate: 13.3% (state: 20.7%)
> Obesity rate: 28.5% (state: 36.6%)
> Adults who do not exercise regularly: 21.5% (state: 29.0%)
> Median household income: $111,196

Source: Gary Fink / iStock via Getty Images

43. Texas: Collin
> Smoking rate: 12.4% (state: 14.7%)
> Obesity rate: 30.2% (state: 34.1%)
> Adults who do not exercise regularly: 22.5% (state: 26.9%)
> Median household income: $100,541

Source: (c) Salil Bhatt / iStock via Getty Images

44. Utah: Morgan
> Smoking rate: 8.9% (state: 7.9%)
> Obesity rate: 29.3% (state: 29.9%)
> Adults who do not exercise regularly: 18.0% (state: 18.7%)
> Median household income: $100,408

Source: DenisTangneyJr / E+ via Getty Images

45. Vermont: Chittenden
> Smoking rate: 12.9% (state: 16.2%)
> Obesity rate: 23.1% (state: 27.1%)
> Adults who do not exercise regularly: 17.4% (state: 19.3%)
> Median household income: $76,316

Source: krblokhin / iStock Editorial via Getty Images

46. Virginia: Falls Church City
> Smoking rate: 8.8% (state: 14.2%)
> Obesity rate: 27.5% (state: 31.8%)
> Adults who do not exercise regularly: 17.4% (state: 24.8%)
> Median household income: $146,922

Source: aiisha5 / iStock via Getty Images

47. Washington: King
> Smoking rate: 10.0% (state: 12.8%)
> Obesity rate: 22.3% (state: 28.2%)
> Adults who do not exercise regularly: 16.4% (state: 18.9%)
> Median household income: $99,158

Source: andrewbain / Flickr

48. West Virginia: Monongalia
> Smoking rate: 20.3% (state: 26.1%)
> Obesity rate: 39.9% (state: 39.7%)
> Adults who do not exercise regularly: 26.2% (state: 29.5%)
> Median household income: $54,198

Source: nathanhalephotography / Flickr

49. Wisconsin: Ozaukee
> Smoking rate: 13.1% (state: 16.2%)
> Obesity rate: 31.6% (state: 34.3%)
> Adults who do not exercise regularly: 18.3% (state: 22.3%)
> Median household income: $84,394

Source: Zachary Joing / iStock via Getty Images

50. Wyoming: Teton
> Smoking rate: 11.3% (state: 18.4%)
> Obesity rate: 22.2% (state: 29.6%)
> Adults who do not exercise regularly: 18.5% (state: 24.0%)
> Median household income: $87,053

To top