41. South Dakota: Sioux Falls
> Premature death rate (per 100,000): 302.3 (state: 339.7)
> Adult obesity rate: 31.3% (state: 31.1%)
> Rate of uninsured people under 65: 8.7% (state: 10.4%)
> Median household income: $64,882 (state: $56,521)
Of the two metro areas in South Dakota — Sioux Falls and Rapid City — Sioux Falls is the healthiest. Unlike in Rapid City, adults in Sioux City report fewer than three physically unhealthy days and fewer than three mentally unhealthy days per month on average.
Americans with health insurance are more likely to make regular doctor visits, and in Sioux Falls, 8.7% of the population lacks health insurance compared to 10.4% of Rapid City residents.
42. Tennessee: Nashville-Davidson–Murfreesboro–Franklin
> Premature death rate (per 100,000): 397.6 (state: 445.6)
> Adult obesity rate: 31.7% (state: 33.0%)
> Rate of uninsured people under 65: 10.0% (state: 10.6%)
> Median household income: $63,939 (state: $51,340)
The typical household in the Nashville metro area earns $63,939 a year, approximately $13,000 more than the median household income across Tennessee as a whole and the most of any city in the state. People with higher incomes tend to have greater access to quality health care and better health outcomes overall.
In Nashville, 16.4% of adults report being in fair or poor health, the smallest share in Tennessee and far below the 19.1% state rate. Some 398 in every 100,000 residents in Nashville die before the age of 75 annually, far less than the state premature death rate of 446 per 100,000 and the least of any city in the state.
43. Texas: Austin-Round Rock
> Premature death rate (per 100,000): 258.0 (state: 339.5)
> Adult obesity rate: 25.2% (state: 29.0%)
> Rate of uninsured people under 65: 14.5% (state: 18.6%)
> Median household income: $73,800 (state: $59,206)
Of the 25 metro areas in Texas, Austin is by far the healthiest. Only about 25% of adults in the metro area are obese, the smallest share of any city in the state and well below the 29.0% obesity rate across Texas as a whole. Regular physical activity can help in maintaining a healthy weight, and in Austin, only 16.8% of adults do not exercise, well below the 22.8% inactivity rate across the state as a whole.
Wealthier individuals tend to have better access to health care and can better afford a greater range of healthy options related to diet and lifestyle, and incomes tend to be higher than average in Austin. The typical metro area household earns $73,800 a year, well above the median income of $59,206 across Texas.
44. Utah: Provo-Orem
> Premature death rate (per 100,000): 258.7 (state: 291.5)
> Adult obesity rate: 25.4% (state: 25.9%)
> Rate of uninsured people under 65: 7.9% (state: 9.7%)
> Median household income: $70,196 (state: $68,358)
Provo-Orem has one of the lowest premature death rates in the United States. There are 259 deaths before age 75 for every 100,000 people annually in the metro area. Across the state, there are 292 premature deaths for every 100,000 people and 340 per 100,000 nationwide.
The low premature death rate is partially attributable to health habits. For example, Provo is the only metro area in the United States where fewer than one in every 10 adults drink excessively. Additionally, just 6.8% of area adults smoke, the lowest smoking rate in the country and well below the 8.8% rate statewide, and 17.0% rate nationwide.
45. Vermont: Burlington-South Burlington
> Premature death rate (per 100,000): 283.6 (state: 300.0)
> Adult obesity rate: 22.6% (state: 25.5%)
> Rate of uninsured people under 65: 4.2% (state: 4.7%)
> Median household income: $63,160 (state: $57,513)
Burlington is the only metro area in Vermont, and as a result, it ranks as the healthiest city in the state by default. Still, by several measures, city residents are more likely to lead healthier lifestyles and have better health outcomes than the average Vermont resident. For example, just 13.0% of adults in Burlington smoke, compared to the 17.0% state smoking rate. Adults in Burlington are also more likely to regularly exercise and are less likely to be obese than the typical adult in the state.
Healthy behaviors can lead to healthy outcomes, and in Burlington, adult residents report an average of just 3.6 mentally unhealthy days per month, compared to an average of about four days across the state.