It seems that almost everywhere you turn, someone is advising you on how to live a long and healthy life. From the multitude of diets to choose from and the myriad exercise programs, there is plenty to choose from to get your health in the right direction. There are many lifestyle factors that we can control, such as keeping active, not smoking, and eating a balanced diet, but there are other factors that are not.
Many of these factors beyond our control include genetics, environment, socioeconomic status, access to health care, and even social determinants such as race and gender. As some of these factors – especially socioeconomic conditions, healthcare infrastructure, and environmental quality – are common to many U.S. cities, variations in them contribute to disparities in health outcomes across different urban areas.
24/7 Tempo reviewed county-level data from the 2023 County Health Rankings & Roadmaps program of the University of Wisconsin Population Health Institute to determine the healthiest cities in America. Metropolitan areas were ranked based on an index consisting of eight health measures, such as potential life lost, smoking rate, and percentage reporting fair or poor health, all using data from the CHR. In all, 384 metro areas were considered.
The adult smoking rate is one component of the index. This is lower than the national rate of 16% in all of the 25 healthiest metro areas. No. 6 on the list, Provo-Orem, Utah, has the lowest smoking rate nationwide at 6.8%. Similarly, 24 of the 25 healthiest cities have lower adult obesity rates than the national average of 32%, including eight cities that have among the 10 lowest obesity rates of all 384 metros considered. Boulder, Colorado, the city with the lowest obesity rate nationwide, at 17.6%, ranks No. 2 on the list. (In contrast, here’s a list of the most obese city in every state.)
Median household income is not an index component, although nine of the 25 healthiest cities are also among the 10 wealthiest nationwide. Still, five of the 25 cities on the list have lower median household incomes than the national median of $69,717. The city with the highest income on the list, at $139,892, also has the highest income nationwide – and ranks as the healthiest of all 384 U.S. metro areas.
Here is the list of the healthiest cities in America:
25. Iowa City, Iowa
- Adults in fair or poor health, 2020: 11.1% (#340 of 384 MSAs)
- Adult smoking rate, 2020: 14.0% (#339 of 384 MSAs)
- Adult obesity rate, 2020: 30.6% (#308 of 384 MSAs)
- Median household income, 2021: $66,216 (#141 of 384 MSAs)
24. Madison, Wisconsin
- Adults in fair or poor health, 2020: 9.3% (#380 of 384 MSAs)
- Adult smoking rate, 2020: 13.3% (#349 of 384 MSAs)
- Adult obesity rate, 2020: 26.4% (#368 of 384 MSAs)
- Median household income, 2021: $76,731 (#62 of 384 MSAs)
23. Rochester, Minnesota
- Adults in fair or poor health, 2020: 9.7% (#376 of 384 MSAs)
- Adult smoking rate, 2020: 15.2% (#305 of 384 MSAs)
- Adult obesity rate, 2020: 32.5% (#262 of 384 MSAs)
- Median household income, 2021: $80,434 (#44 of 384 MSAs)
22. Logan, Utah-Idaho
- Adults in fair or poor health, 2020: 12.7% (#273 of 384 MSAs)
- Adult smoking rate, 2020: 9.9% (#378 of 384 MSAs)
- Adult obesity rate, 2020: 30.1% (#316 of 384 MSAs)
- Median household income, 2021: $67,022 (#126 of 384 MSAs)
21. Ames, Iowa
- Adults in fair or poor health, 2020: 10.8% (#354 of 384 MSAs)
- Adult smoking rate, 2020: 15.0% (#316 of 384 MSAs)
- Adult obesity rate, 2020: 33.7% (#229 of 384 MSAs)
- Median household income, 2021: $64,569 (#161 of 384 MSAs)
20. San Diego-Chula Vista-Carlsbad, California
- Adults in fair or poor health, 2020: 13.4% (#246 of 384 MSAs)
- Adult smoking rate, 2020: 10.9% (#375 of 384 MSAs)
- Adult obesity rate, 2020: 28.4% (#345 of 384 MSAs)
- Median household income, 2021: $91,003 (#13 of 384 MSAs)
19. Oxnard-Thousand Oaks-Ventura, California
- Adults in fair or poor health, 2020: 13.5% (#239 of 384 MSAs)
- Adult smoking rate, 2020: 11.1% (#372 of 384 MSAs)
- Adult obesity rate, 2020: 28.9% (#339 of 384 MSAs)
- Median household income, 2021: $96,454 (#9 of 384 MSAs)
18. Boston-Cambridge-Newton, Massachusetts-New Hampshire
- Adults in fair or poor health, 2020: 9.9% (#374 of 384 MSAs)
- Adult smoking rate, 2020: 11.9% (#365 of 384 MSAs)
- Adult obesity rate, 2020: 23.9% (#379 of 384 MSAs)
- Median household income, 2021: $100,750 (#7 of 384 MSAs)
17. Washington-Arlington-Alexandria, DC-Virginia-Maryland-West Virginia
- Adults in fair or poor health, 2020: 10.8% (#356 of 384 MSAs)
- Adult smoking rate, 2020: 11.1% (#374 of 384 MSAs)
- Adult obesity rate, 2020: 28.5% (#342 of 384 MSAs)
- Median household income, 2021: $110,355 (#3 of 384 MSAs)
16. Fort Collins, Colorado
- Adults in fair or poor health, 2020: 9.3% (#381 of 384 MSAs)
- Adult smoking rate, 2020: 13.0% (#353 of 384 MSAs)
- Adult obesity rate, 2020: 23.9% (#377 of 384 MSAs)
- Median household income, 2021: $78,109 (#57 of 384 MSAs)
15. San Luis Obispo-Paso Robles, California
- Adults in fair or poor health, 2020: 12.3% (#291 of 384 MSAs)
- Adult smoking rate, 2020: 11.6% (#369 of 384 MSAs)
- Adult obesity rate, 2020: 27.9% (#353 of 384 MSAs)
- Median household income, 2021: $80,615 (#42 of 384 MSAs)
14. Santa Cruz-Watsonville, California
- Adults in fair or poor health, 2020: 13.2% (#255 of 384 MSAs)
- Adult smoking rate, 2020: 11.4% (#370 of 384 MSAs)
- Adult obesity rate, 2020: 27.5% (#357 of 384 MSAs)
- Median household income, 2021: $93,933 (#11 of 384 MSAs)
13. Seattle-Tacoma-Bellevue, Washington
- Adults in fair or poor health, 2020: 11.0% (#349 of 384 MSAs)
- Adult smoking rate, 2020: 11.6% (#368 of 384 MSAs)
- Adult obesity rate, 2020: 25.6% (#370 of 384 MSAs)
- Median household income, 2021: $101,721 (#5 of 384 MSAs)
12. Kahului-Wailuku-Lahaina, Hawaii
- Adults in fair or poor health, 2020: 11.0% (#344 of 384 MSAs)
- Adult smoking rate, 2020: 14.0% (#340 of 384 MSAs)
- Adult obesity rate, 2020: 23.9% (#377 of 384 MSAs)
- Median household income, 2021: $76,273 (#63 of 384 MSAs)
11. Burlington-South Burlington, Vermont
- Adults in fair or poor health, 2020: 9.1% (#383 of 384 MSAs)
- Adult smoking rate, 2020: 13.0% (#352 of 384 MSAs)
- Adult obesity rate, 2020: 24.5% (#374 of 384 MSAs)
- Median household income, 2021: $81,852 (#37 of 384 MSAs)
10. Urban Honolulu, HI
- Adults in fair or poor health, 2020: 11.4% (#326 of 384 MSAs)
- Adult smoking rate, 2020: 12.0% (#363 of 384 MSAs)
- Adult obesity rate, 2020: 24.3% (#375 of 384 MSAs)
- Median household income, 2021: $90,704 (#15 of 384 MSAs)
9. Santa Rosa-Petaluma, California
- Adults in fair or poor health, 2020: 12.3% (#291 of 384 MSAs)
- Adult smoking rate, 2020: 11.8% (#366 of 384 MSAs)
- Adult obesity rate, 2020: 25.2% (#372 of 384 MSAs)
- Median household income, 2021: $94,295 (#10 of 384 MSAs)
8. Ithaca, New York
- Adults in fair or poor health, 2020: 9.9% (#372 of 384 MSAs)
- Adult smoking rate, 2020: 14.7% (#327 of 384 MSAs)
- Adult obesity rate, 2020: 26.9% (#364 of 384 MSAs)
- Median household income, 2021: $66,441 (#137 of 384 MSAs)
7. Napa, California
- Adults in fair or poor health, 2020: 12.7% (#274 of 384 MSAs)
- Adult smoking rate, 2020: 11.1% (#372 of 384 MSAs)
- Adult obesity rate, 2020: 26.9% (#364 of 384 MSAs)
- Median household income, 2021: $97,213 (#8 of 384 MSAs)
6. Provo-Orem, Utah
- Adults in fair or poor health, 2020: 10.8% (#355 of 384 MSAs)
- Adult smoking rate, 2020: 6.8% (#384 of 384 MSAs)
- Adult obesity rate, 2020: 30.1% (#322 of 384 MSAs)
- Median household income, 2021: $86,629 (#22 of 384 MSAs)
5. Bridgeport-Stamford-Norwalk, Connecticut
- Adults in fair or poor health, 2020: 9.9% (#372 of 384 MSAs)
- Adult smoking rate, 2020: 10.5% (#376 of 384 MSAs)
- Adult obesity rate, 2020: 23.5% (#381 of 384 MSAs)
- Median household income, 2021: $100,810 (#6 of 384 MSAs)
4. Corvallis, Oregon
- Adults in fair or poor health, 2020: 11.1% (#341 of 384 MSAs)
- Adult smoking rate, 2020: 12.7% (#357 of 384 MSAs)
- Adult obesity rate, 2020: 28.5% (#343 of 384 MSAs)
- Median household income, 2021: $64,163 (#167 of 384 MSAs)
3. San Francisco-Oakland-Berkeley, California
- Adults in fair or poor health, 2020: 11.2% (#334 of 384 MSAs)
- Adult smoking rate, 2020: 9.5% (#379 of 384 MSAs)
- Adult obesity rate, 2020: 23.8% (#380 of 384 MSAs)
- Median household income, 2021: $116,005 (#2 of 384 MSAs)
2. Boulder, Colorado
- Adults in fair or poor health, 2020: 8.5% (#384 of 384 MSAs)
- Adult smoking rate, 2020: 11.3% (#371 of 384 MSAs)
- Adult obesity rate, 2020: 17.6% (#384 of 384 MSAs)
- Median household income, 2021: $90,168 (#16 of 384 MSAs)
1. San Jose-Sunnyvale-Santa Clara, California
- Adults in fair or poor health, 2020: 10.7% (#360 of 384 MSAs)
- Adult smoking rate, 2020: 8.5% (#383 of 384 MSAs)
- Adult obesity rate, 2020: 20.9% (#383 of 384 MSAs)
- Median household income, 2021: $139,892 (#1 of 384 MSAs)