Large gaps in health persist not just across the country, but within every state. County Health Rankings & Roadmaps, in its 2019 annual report released March 19, demonstrates how health outcomes such as life span and behaviors such as smoking, obesity, and exercise vary widely across the country.
Positive health outcomes are often the result of healthy behaviors. Maintaining a healthy weight through a balanced diet and regular exercise, abstaining from smoking and excessive drinking, and regular doctor visits — while by no means a guarantee — will greatly increase one’s chances for a long and healthy life.
These and other such features of well-being are closely linked to indirect factors. Proximity to quality schools and good job opportunities provide education and the financial means that often contribute to better health by allowing people to make better choices and providing the means to live a healthy lifestyle. Eating a healthy diet is much easier for people living in communities with access to grocery stores with affordable nutritious food. And access to parks and other places of exercise means staying active can be made a part of everyday routines.
To identify the healthiest county in each state, 24/7 Wall St. reviewed county-level health data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. In almost every state, even in those characterized by unhealthy habits and poor health outcomes, there is at least one county where residents are much more likely to be in good health than is typical nationwide.
1. Alabama: Shelby
> Smoking rate: 16.9% (state: 21.5%)
> Obesity rate: 32.9% (state: 35.1%)
> Adults who do not exercise regularly: 22.3% (state: 28.2%)
> Median household income: $74,063
2. Alaska: Juneau
> Smoking rate: 18.0% (state: 19.0%)
> Obesity rate: 28.8% (state: 30.4%)
> Adults who do not exercise regularly: 14.7% (state: 18.8%)
> Median household income: $90,749
3. Arizona: Greenlee
> Smoking rate: 15.3% (state: 14.7%)
> Obesity rate: 29.7% (state: 27.2%)
> Adults who do not exercise regularly: 21.1% (state: 20.2%)
> Median household income: $56,298
4. Arkansas: Benton
> Smoking rate: 17.6% (state: 23.6%)
> Obesity rate: 31.9% (state: 35.2%)
> Adults who do not exercise regularly: 25.0% (state: 31.2%)
> Median household income: $61,271
5. California: Marin
> Smoking rate: 9.7% (state: 11.0%)
> Obesity rate: 18.2% (state: 22.7%)
> Adults who do not exercise regularly: 12.0% (state: 17.4%)
> Median household income: $104,703
6. Colorado: Douglas
> Smoking rate: 9.5% (state: 15.6%)
> Obesity rate: 18.6% (state: 21.0%)
> Adults who do not exercise regularly: 9.6% (state: 14.0%)
> Median household income: $111,154
7. Connecticut: Tolland
> Smoking rate: 12.3% (state: 13.3%)
> Obesity rate: 24.4% (state: 25.5%)
> Adults who do not exercise regularly: 18.0% (state: 19.3%)
> Median household income: $81,312
8. Delaware: New Castle
> Smoking rate: 16.8% (state: 17.7%)
> Obesity rate: 28.8% (state: 30.6%)
> Adults who do not exercise regularly: 23.2% (state: 25.4%)
> Median household income: $68,336
9. Florida: St. Johns
> Smoking rate: 13.4% (state: 15.5%)
> Obesity rate: 22.8% (state: 26.5%)
> Adults who do not exercise regularly: 19.5% (state: 24.7%)
> Median household income: $73,640
10. Georgia: Oconee
> Smoking rate: 14.4% (state: 17.9%)
> Obesity rate: 28.2% (state: 30.3%)
> Adults who do not exercise regularly: 23.4% (state: 24.3%)
> Median household income: $77,388
11. Hawaii: Honolulu
> Smoking rate: 11.2% (state: 13.1%)
> Obesity rate: 23.0% (state: 23.1%)
> Adults who do not exercise regularly: 20.2% (state: 19.8%)
> Median household income: $80,078
12. Idaho: Ada
> Smoking rate: 11.8% (state: 14.5%)
> Obesity rate: 24.9% (state: 28.3%)
> Adults who do not exercise regularly: 14.4% (state: 19.0%)
> Median household income: $60,151
13. Illinois: DuPage
> Smoking rate: 12.5% (state: 15.8%)
> Obesity rate: 25.2% (state: 28.7%)
> Adults who do not exercise regularly: 17.4% (state: 21.5%)
> Median household income: $84,442
14. Indiana: Hamilton
> Smoking rate: 12.8% (state: 21.1%)
> Obesity rate: 26.1% (state: 32.8%)
> Adults who do not exercise regularly: 14.0% (state: 25.1%)
> Median household income: $90,582
15. Iowa: Dallas
> Smoking rate: 12.8% (state: 16.7%)
> Obesity rate: 27.7% (state: 32.2%)
> Adults who do not exercise regularly: 19.3% (state: 23.0%)
> Median household income: $82,719
16. Kansas: Johnson
> Smoking rate: 12.0% (state: 17.2%)
> Obesity rate: 27.2% (state: 33.2%)
> Adults who do not exercise regularly: 16.1% (state: 23.5%)
> Median household income: $81,121
17. Kentucky: Oldham
> Smoking rate: 15.9% (state: 24.5%)
> Obesity rate: 24.7% (state: 34.2%)
> Adults who do not exercise regularly: 20.8% (state: 27.4%)
> Median household income: $92,237
18. Louisiana: Cameron
> Smoking rate: 16.4% (state: 22.8%)
> Obesity rate: 36.0% (state: 35.3%)
> Adults who do not exercise regularly: 32.3% (state: 28.5%)
> Median household income: $60,194
19. Maine: Cumberland
> Smoking rate: 12.8% (state: 19.8%)
> Obesity rate: 24.3% (state: 29.4%)
> Adults who do not exercise regularly: 15.3% (state: 20.2%)
> Median household income: $65,702
20. Maryland: Howard
> Smoking rate: 9.7% (state: 13.7%)
> Obesity rate: 24.4% (state: 30.3%)
> Adults who do not exercise regularly: 15.6% (state: 21.0%)
> Median household income: $115,576
21. Massachusetts: Middlesex
> Smoking rate: 11.3% (state: 13.6%)
> Obesity rate: 22.5% (state: 24.4%)
> Adults who do not exercise regularly: 18.0% (state: 19.9%)
> Median household income: $92,878
22. Michigan: Livingston
> Smoking rate: 15.3% (state: 20.4%)
> Obesity rate: 26.8% (state: 31.7%)
> Adults who do not exercise regularly: 18.3% (state: 22.3%)
> Median household income: $78,430
23. Minnesota: Carver
> Smoking rate: 11.6% (state: 15.2%)
> Obesity rate: 23.5% (state: 27.6%)
> Adults who do not exercise regularly: 14.3% (state: 18.5%)
> Median household income: $93,095
24. Mississippi: Madison
> Smoking rate: 15.1% (state: 22.7%)
> Obesity rate: 30.8% (state: 36.5%)
> Adults who do not exercise regularly: 23.6% (state: 31.3%)
> Median household income: $68,600
25. Missouri: St. Charles
> Smoking rate: 16.8% (state: 22.1%)
> Obesity rate: 28.3% (state: 32.2%)
> Adults who do not exercise regularly: 23.7% (state: 25.0%)
> Median household income: $78,380
26. Montana: Gallatin
> Smoking rate: 14.6% (state: 18.5%)
> Obesity rate: 16.1% (state: 25.4%)
> Adults who do not exercise regularly: 11.6% (state: 19.6%)
> Median household income: $59,397
27. Nebraska: Cedar
> Smoking rate: 12.6% (state: 17.0%)
> Obesity rate: 33.7% (state: 31.2%)
> Adults who do not exercise regularly: 25.8% (state: 22.0%)
> Median household income: $57,208
28. Nevada: Douglas
> Smoking rate: 13.6% (state: 16.5%)
> Obesity rate: 25.3% (state: 26.5%)
> Adults who do not exercise regularly: 20.0% (state: 21.7%)
> Median household income: $61,176
29. New Hampshire: Grafton
> Smoking rate: 14.4% (state: 18.0%)
> Obesity rate: 23.2% (state: 28.0%)
> Adults who do not exercise regularly: 19.4% (state: 20.0%)
> Median household income: $61,036
30. New Jersey: Hunterdon
> Smoking rate: 13.1% (state: 14.0%)
> Obesity rate: 20.8% (state: 26.2%)
> Adults who do not exercise regularly: 17.9% (state: 23.6%)
> Median household income: $110,969
31. New Mexico: Los Alamos
> Smoking rate: 10.0% (state: 16.6%)
> Obesity rate: 21.3% (state: 25.6%)
> Adults who do not exercise regularly: 12.6% (state: 18.2%)
> Median household income: $110,190
32. New York: Nassau
> Smoking rate: 10.7% (state: 14.2%)
> Obesity rate: 23.2% (state: 25.7%)
> Adults who do not exercise regularly: 22.8% (state: 24.5%)
> Median household income: $105,744
33. North Carolina: Orange
> Smoking rate: 14.2% (state: 17.9%)
> Obesity rate: 24.8% (state: 30.2%)
> Adults who do not exercise regularly: 19.5% (state: 23.0%)
> Median household income: $65,522
34. North Dakota: Wells
> Smoking rate: 14.5% (state: 19.8%)
> Obesity rate: 31.5% (state: 32.2%)
> Adults who do not exercise regularly: 28.1% (state: 21.6%)
> Median household income: $54,464
35. Ohio: Delaware
> Smoking rate: 13.6% (state: 22.5%)
> Obesity rate: 26.8% (state: 31.8%)
> Adults who do not exercise regularly: 17.4% (state: 24.6%)
> Median household income: $100,229
36. Oklahoma: Canadian
> Smoking rate: 14.4% (state: 19.6%)
> Obesity rate: 33.8% (state: 33.3%)
> Adults who do not exercise regularly: 26.6% (state: 28.4%)
> Median household income: $69,220
37. Oregon: Benton
> Smoking rate: 14.0% (state: 16.2%)
> Obesity rate: 26.5% (state: 28.3%)
> Adults who do not exercise regularly: 11.5% (state: 15.2%)
> Median household income: $54,682
38. Pennsylvania: Montgomery
> Smoking rate: 13.4% (state: 18.0%)
> Obesity rate: 25.8% (state: 29.9%)
> Adults who do not exercise regularly: 17.1% (state: 22.4%)
> Median household income: $84,791
39. Rhode Island: Bristol
> Smoking rate: 12.5% (state: 14.4%)
> Obesity rate: 23.5% (state: 27.0%)
> Adults who do not exercise regularly: 18.6% (state: 23.4%)
> Median household income: $74,630
40. South Carolina: Beaufort
> Smoking rate: 12.5% (state: 20.0%)
> Obesity rate: 23.1% (state: 32.4%)
> Adults who do not exercise regularly: 16.1% (state: 24.7%)
> Median household income: $60,603
41. South Dakota: Lincoln
> Smoking rate: 13.7% (state: 18.1%)
> Obesity rate: 29.6% (state: 31.1%)
> Adults who do not exercise regularly: 18.4% (state: 19.9%)
> Median household income: $81,849
42. Tennessee: Williamson
> Smoking rate: 15.2% (state: 22.1%)
> Obesity rate: 25.2% (state: 33.0%)
> Adults who do not exercise regularly: 19.7% (state: 26.7%)
> Median household income: $103,543
43. Texas: Collin
> Smoking rate: 12.1% (state: 14.3%)
> Obesity rate: 26.9% (state: 29.0%)
> Adults who do not exercise regularly: 18.9% (state: 22.8%)
> Median household income: $90,124
44. Utah: Morgan
> Smoking rate: 8.5% (state: 8.8%)
> Obesity rate: 21.0% (state: 25.9%)
> Adults who do not exercise regularly: 13.2% (state: 16.1%)
> Median household income: $86,071
45. Vermont: Addison
> Smoking rate: 13.3% (state: 17.0%)
> Obesity rate: 24.2% (state: 25.5%)
> Adults who do not exercise regularly: 18.4% (state: 18.6%)
> Median household income: $61,875
46. Virginia: Arlington
> Smoking rate: 12.3% (state: 15.3%)
> Obesity rate: 19.6% (state: 28.8%)
> Adults who do not exercise regularly: 15.1% (state: 21.6%)
> Median household income: $112,138
47. Washington: King
> Smoking rate: 9.4% (state: 13.9%)
> Obesity rate: 22.3% (state: 27.6%)
> Adults who do not exercise regularly: 13.0% (state: 16.4%)
> Median household income: $83,571
48. West Virginia: Jefferson
> Smoking rate: 18.8% (state: 24.8%)
> Obesity rate: 34.5% (state: 36.3%)
> Adults who do not exercise regularly: 21.9% (state: 27.8%)
> Median household income: $72,526
49. Wisconsin: Ozaukee
> Smoking rate: 12.4% (state: 17.1%)
> Obesity rate: 23.9% (state: 31.1%)
> Adults who do not exercise regularly: 15.8% (state: 19.5%)
> Median household income: $80,526
50. Wyoming: Teton
> Smoking rate: 14.1% (state: 18.9%)
> Obesity rate: 13.6% (state: 28.5%)
> Adults who do not exercise regularly: 12.0% (state: 23.1%)
> Median household income: $80,049