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Most and least healthy states in America

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Most and least healthy states in America

Recently Americans have witnessed new changes to health care in the United States—most notably, the individual health care mandate is no longer omnipresent. Although most citizens can now freely ditch health care premiums, perhaps it's best to hold off for a bit. The state where you live can play a bigger role in your overall health than you might think.

Stacker analyzed data from America's Health Rankings' 2018 Annual Report. This included 76 individual metrics of health for all 50 states, including the prevalence of major diseases, drug and alcohol misuse, immunization rates, health care availability, and more. Each state was then compared to the overall U.S. average and given a corresponding score. Stacker also pulled the most and least healthy trait from each state—these are the major of those 76 categories (metrics concerning at least 10 in 100,000 Americans) that had the greatest positive and negative difference compared to national averages. Where does your home state fall in the rankings?

Read on to find out the most and least healthy states in America. 
 

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Chris Graythen // Getty Images

#50. Louisiana

- Overall score: -1.021
- Most healthy trait: HPV immunization for females (64.3% of females aged 13 to 17; Rank: #6; 21.1% above national average)
- Least healthy trait: Salmonella (29.1 cases per 100,000 people; Rank: #47; 74.3% above national average)
- Cancer deaths: 215.3 per 100,000 people (Rank: #44; 13.4% below national average)
- Excessive drinking: 19.6% of adults (Rank: #32; 3.2% below national average)
- Drug deaths: 18.9 per 100,000 people (Rank: #30; 11.8% below national average)
- Infant mortality: 7.8 deaths per 1,000 live births (Rank: #46; 32.2% below national average)
- Public health funding: $85 per person (Rank: #27; 1.2% below national average)

Although Louisiana's uninsured population decreased and the amount of primary care providers increased over the last five years, the state still suffers from unchanging poverty rates and a rise in heart concerns. Central Louisiana is particularly affected by poor health. Louisiana residents can find positives from the ample amount of mental health professionals and high immunization rates in the state.

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#49. Mississippi

- Overall score: -1.01
- Most healthy trait: Disparity in health status (19.6% point difference; Rank: #3; 34.4% below national average)
- Least healthy trait: Salmonella (39.8 cases per 100,000 people; Rank: #50; 138.3% above national average)
- Cancer deaths: 226.6 per 100,000 people (Rank: #48; 19.4% below national average)
- Excessive drinking: 13.6% of adults (Rank: #3; 28.4% above national average)
- Drug deaths: 11.9 per 100,000 people (Rank: #8; 29.6% above national average)
- Infant mortality: 8.9 deaths per 1,000 live births (Rank: #50; 50.8% below national average)
- Public health funding: $80 per person (Rank: #31; 7% below national average)

Mississippi residents tend to rein in the excess, with less than average rates of excessive drinking and drug abuse. But the state is on the lower end of public health funds, which is not good news for an area with high levels of cardiovascular deaths and obesity. In addition, the salmonella rate in Mississippi is so high—more than twice the national average—that medical researchers focus studies solely on the Magnolia State to model infections.

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Rob Hainer // Shutterstock

#48. Alabama

- Overall score: -0.838
- Most healthy trait: Public health funding ($112 per person; Rank: #12; 30.2% above national average)
- Least healthy trait: Mental health providers (92.6 per 100,000 people; Rank: #50; 60.5% below national average)
- Cancer deaths: 210.5 per 100,000 people (Rank: #42; 10.9% below national average)
- Excessive drinking: 13.9% of adults (Rank: #4; 26.8% above national average)
- Drug deaths: 15.4 per 100,000 people (Rank: #20; 8.9% above national average)
- Infant mortality: 8.7 deaths per 1,000 live births (Rank: #49; 47.5% below national average)
- Public health funding: $112 per person (Rank: #12; 30.2% above national average)

Obesity, heart problems, and mental health care are all challenges in Alabama. However, the air quality is increasing—the American Lung Association reported fewer bad ozone days in its 2018 report—and a comprehensive public health program offers free and low-cost health insurance to more families than most other states.

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Sean Pavone // Shutterstock

#47. Oklahoma

- Overall score: -0.744
- Most healthy trait: Mental health providers (395.2 per 100,000 people; Rank: #6; 68.4% above national average)
- Least healthy trait: Uninsured (14% of people; Rank: #49; 60.9% above national average)
- Cancer deaths: 216.8 per 100,000 people (Rank: #45; 14.2% below national average)
- Excessive drinking: 14.1% of adults (Rank: #5; 25.8% above national average)
- Drug deaths: 20.4 per 100,000 people (Rank: #34; 20.7% below national average)
- Infant mortality: 7.4 deaths per 1,000 live births (Rank: #43; 25.4% below national average)
- Public health funding: $87 per person (Rank: #26; 1.2% above national average)

One of Oklahoma's biggest challenges is a low rate of physical activity, which likely contributes to the rise in obesity—an increase of 17% in adults over the last six years. The state also has one of the largest counts of uninsured residents and a low tally of primary care physicians.

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Photolitherland // Wikimedia Commons

#46. Arkansas

- Overall score: -0.672
- Most healthy trait: Disparity in health status (21.2% point difference; Rank: #5; 29.1% below national average)
- Least healthy trait: Salmonella (27.3 cases per 100,000 people; Rank: #46; 63.5% above national average)
- Cancer deaths: 218.6 per 100,000 people (Rank: #47; 15.2% below national average)
- Excessive drinking: 15.8% of adults (Rank: #8; 16.8% above national average)
- Drug deaths: 13.2 per 100,000 people (Rank: #14; 21.9% above national average)
- Infant mortality: 7.8 deaths per 1,000 live births (Rank: #46; 32.2% below national average)
- Public health funding: $108 per person (Rank: #16; 25.6% above national average)

A high rate of adolescent immunizations keep Arkansas from the very bottom of this list, along with decreasing excessive drinking and poverty rates. Those in the state without access to quality health care can benefit from specific programs for women and children, prevention and healthy living programs, and addiction and disease management programs. But obesity is a growing concern in Arkansas, with 35% of the adult population overweight, with increases in high school obesity levels every year since 2007.

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#45. Kentucky

- Overall score: -0.62
- Most healthy trait: Violent crime (226 offenses per 100,000 people; Rank: #5; 42.6% below national average)
- Least healthy trait: Drug deaths (28.6 deaths per 100,000 people; Rank: #47; 69.2% above national average)
- Cancer deaths: 234.9 per 100,000 people (Rank: #50; 23.8% below national average)
- Excessive drinking: 17.3% of adults (Rank: #17; 8.9% above national average)
- Drug deaths: 28.6 per 100,000 people (Rank: #47; 69.2% below national average)
- Infant mortality: 6.7 deaths per 1,000 live births (Rank: #36; 13.6% below national average)
- Public health funding: $85 per person (Rank: #27; 1.2% below national average)

Diabetes, mental distress, and excessive drinking are all increasing at a relatively rapid rate in Kentucky. Luckily for residents, the Department of Health offers almost 150 public programs for those without access to health care, broken into three main categories: prevention, promotion, and protection.

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Jerry Pennington // Shutterstock

#44. West Virginia

- Overall score: -0.603
- Most healthy trait: Public health funding ($215 per person; Rank: #3; 150% above national average)
- Least healthy trait: Drug deaths (41.4 deaths per 100,000 people; Rank: #50; 145% above national average)
- Cancer deaths: 227.4 per 100,000 people (Rank: #49; 19.8% below national average)
- Excessive drinking: 12.3% of adults (Rank: #2; 35.3% above national average)
- Drug deaths: 41.4 per 100,000 people (Rank: #50; 145% below national average)
- Infant mortality: 7.2 deaths per 1,000 live births (Rank: #39; 22% below national average)
- Public health funding: $215 per person (Rank: #3; 150% above national average)

West Virginians receive a large amount of public health funding, covering services like a rural hospital flex program, a transition plan for older youth, and cancer screenings. However, drug usage, obesity, and mental distress remain big challenges. As of 2014, about 55% of adolescents facing mental health concerns went untreated.

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f11photo // Shutterstock

#43. South Carolina

- Overall score: -0.567
- Most healthy trait: Air pollution (7.4 micrograms of fine particles per cubic -meter; Rank: #22; 11.9% below national average)
- Least healthy trait: Salmonella (33.4 cases per 100,000 people; Rank: #48; 100% above national average)
- Cancer deaths: 202 per 100,000 people (Rank: #37; 6.4% below national average)
- Excessive drinking: 17.4% of adults (Rank: #18; 8.4% above national average)
- Drug deaths: 16.1 per 100,000 people (Rank: #21; 4.7% above national average)
- Infant mortality: 7 deaths per 1,000 live births (Rank: #38; 18.6% below national average)
- Public health funding: $76 per person (Rank: #33; 11.6% below national average)

Diabetes, premature death, and low immunizations plague South Carolinians. On-the-job fatalities are another issue, having increased nearly 40% over the past three years. A lack of air pollution is the state's most healthy trait, but air quality is also worsening here, according to data from the American Lung Association.

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#42. Tennessee

- Overall score: -0.566
- Most healthy trait: Excessive drinking (14.3% of adults; Rank: #6; 24.7% below national average)
- Least healthy trait: Violent crime (652 offenses per 100,000 people; Rank: #48; 65.5% above national average)
- Cancer deaths: 217.7 per 100,000 people (Rank: #46; 14.7% below national average)
- Excessive drinking: 14.3% of adults (Rank: #6; 24.7% above national average)
- Drug deaths: 22 per 100,000 people (Rank: #38; 30.2% below national average)
- Infant mortality: 7.2 deaths per 1,000 live births (Rank: #39; 22% below national average)
- Public health funding: $97 per person (Rank: #21; 12.8% above national average)

Although not the country's best in public health funding, Tennessee offers a wide variety of programs, from prescription drug overdose workshops to information about the human health impact of environmental pollution. But those likely won't solve violent crime, one of the biggest afflictions in the state, which according to FBI data, surpassed the national average in both 2016 and 2017.

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Jonathan Weiss // Shutterstock

#41. Indiana

- Overall score: -0.432
- Most healthy trait: Salmonella (12 cases per 100,000 people; Rank: #14; 28.1% below national average)
- Least healthy trait: Public health funding ($51 per person; Rank: #48; 40.7% below national average)
- Cancer deaths: 210.5 per 100,000 people (Rank: #42; 10.9% below national average)
- Excessive drinking: 17.6% of adults (Rank: #21; 7.4% above national average)
- Drug deaths: 20.2 per 100,000 people (Rank: #33; 19.5% below national average)
- Infant mortality: 7.4 deaths per 1,000 live births (Rank: #43; 25.4% below national average)
- Public health funding: $51 per person (Rank: #48; 40.7% below national average)

Indiana sits near the bottom of this list, but has had some major successes—poverty levels for children are decreasing and immunization rates are on the rise. Unfortunately though, the state provides very little public health funding outside of preventing infant mortality, increasing immunizations, and reducing obesity and smoking rates.

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f11photo // Shutterstock

#40. Ohio

- Overall score: -0.424
- Most healthy trait: Uninsured (5.8% of people; Rank: #14; 33.3% below national average)
- Least healthy trait: Drug deaths (30.4 deaths per 100,000 people; Rank: #48; 79.9% above national average)
- Cancer deaths: 210.3 per 100,000 people (Rank: #41; 10.8% below national average)
- Excessive drinking: 20.2% of adults (Rank: #37; 6.3% below national average)
- Drug deaths: 30.4 per 100,000 people (Rank: #48; 79.9% below national average)
- Infant mortality: 7.3 deaths per 1,000 live births (Rank: #41; 23.7% below national average)
- Public health funding: $53 per person (Rank: #46; 38.4% below national average)

Ohio faces a serious drug problem—in the last three years, the rate of drug deaths has increased 61%. In response, the state has developed a Community Overdose Action Team focused on reducing drug deaths and tackling opiate addiction.

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#39. Georgia

- Overall score: -0.394
- Most healthy trait: Drug deaths (12.7 deaths per 100,000 people; Rank: #13; 24.9% below national average)
- Least healthy trait: Uninsured (13.2% of people; Rank: #47; 51.7% above national average)
- Cancer deaths: 195.5 per 100,000 people (Rank: #31; 3% below national average)
- Excessive drinking: 14.4% of adults (Rank: #7; 24.2% above national average)
- Drug deaths: 12.7 per 100,000 people (Rank: #13; 24.9% above national average)
- Infant mortality: 7.6 deaths per 1,000 live births (Rank: #45; 28.8% below national average)
- Public health funding: $73 per person (Rank: #35; 15.1% below national average)

Low immunization rates and a high level of uninsured residents are continuing challenges for Georgia. The state offers a large amount of programs for those struggling with insurance, ranging from tuberculosis control to emergency medical services. Although Georgia's most healthy trait is a low level of drug deaths, methamphetamine overdoses have increased every year since 2010.

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Kenny Tong // Shutterstock

#38. Missouri

- Overall score: -0.345
- Most healthy trait: Disparity in health status (22.3% point difference; Rank: #8; 25.4% below national average)
- Least healthy trait: Public health funding ($55 per person; Rank: #44; 36% below national average)
- Cancer deaths: 207.2 per 100,000 people (Rank: #40; 9.2% below national average)
- Excessive drinking: 19.8% of adults (Rank: #35; 4.2% below national average)
- Drug deaths: 19.5 per 100,000 people (Rank: #31; 15.4% below national average)
- Infant mortality: 6.5 deaths per 1,000 live births (Rank: #33; 10.2% below national average)
- Public health funding: $55 per person (Rank: #44; 36% below national average)

Missouri continually struggles with a high rate of violent crime and increasing cancer deaths, excessive drinking, and low birthweight. Sexually transmitted diseases are increasing, as well. The state offers little in the way of public health funding, but programs available provide aid to seniors, women, and children.

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f11photo // Shutterstock

#37. Texas

- Overall score: -0.286
- Most healthy trait: Drug deaths (10 deaths per 100,000 people; Rank: #5; 40.8% below national average)
- Least healthy trait: Uninsured (17% of people; Rank: #50; 95.4% above national average)
- Cancer deaths: 180.5 per 100,000 people (Rank: #11; 4.9% above national average)
- Excessive drinking: 19.5% of adults (Rank: #30; 2.6% below national average)
- Drug deaths: 10 per 100,000 people (Rank: #5; 40.8% above national average)
- Infant mortality: 5.7 deaths per 1,000 live births (Rank: #19; 3.4% above national average)
- Public health funding: $65 per person (Rank: #38; 24.4% below national average)

Although Texas enjoys low rates of drug and cancer deaths, plus a decreasing rate of smokers, the state still suffers from a large uninsured population and decreasing immunization rates. In addition, both heart-related deaths and mental distress have risen in the past three years, 4% and 28%, respectively.

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Lucky-photographer // Shutterstock

#36. Nevada

- Overall score: -0.267
- Most healthy trait: Salmonella (6.8 cases per 100,000 people; Rank: #1; 59.3% below national average)
- Least healthy trait: Public health funding ($43 per person; Rank: #50; 50% below national average)
- Cancer deaths: 190.1 per 100,000 people (Rank: #22; 0.2% below national average)
- Excessive drinking: 19.3% of adults (Rank: #29; 1.6% below national average)
- Drug deaths: 21 per 100,000 people (Rank: #36; 24.3% below national average)
- Infant mortality: 5.5 deaths per 1,000 live births (Rank: #17; 6.8% above national average)
- Public health funding: $43 per person (Rank: #50; 50% below national average)

For all of the glitz and glamour found on the Las Vegas strip, Nevada has the lowest level of per capita public health funding. The state is also facing a low tally of primary care physicians and an increase in premature deaths.

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turtix // Shutterstock

#35. New Mexico

- Overall score: -0.204
- Most healthy trait: Mental health providers (381.5 per 100,000 people; Rank: #8; 62.5% above national average)
- Least healthy trait: Violent crime (784 offenses per 100,000 people; Rank: #49; 99% above national average)
- Cancer deaths: 168.9 per 100,000 people (Rank: #6; 11% above national average)
- Excessive drinking: 16.2% of adults (Rank: #9; 14.7% above national average)
- Drug deaths: 25.6 per 100,000 people (Rank: #44; 51.5% below national average)
- Infant mortality: 5.6 deaths per 1,000 live births (Rank: #18; 5.1% above national average)
- Public health funding: $124 per person (Rank: #9; 44.2% above national average)

Violent crime, New Mexico's least healthy trait, is on the rise, growing 40% over the past four years. In 2017, FBI reports showed that even though the national violent crime average is decreasing, it continues to rise in New Mexico. The state does provide a comprehensive and well-funded public health system, including access to medical marijuana.

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Andrey Bayda // Shutterstock

#34. Michigan

- Overall score: -0.194
- Most healthy trait: Uninsured (5.3% of people; Rank: #8; 39.1% below national average)
- Least healthy trait: Public health funding ($58 per person; Rank: #41; 32.6% below national average)
- Cancer deaths: 203 per 100,000 people (Rank: #38; 7% below national average)
- Excessive drinking: 19.6% of adults (Rank: #32; 3.2% below national average)
- Drug deaths: 20.8 per 100,000 people (Rank: #35; 23.1% below national average)
- Infant mortality: 6.5 deaths per 1,000 live births (Rank: #33; 10.2% below national average)
- Public health funding: $58 per person (Rank: #41; 32.6% below national average)

Over the past five years, the smoking rate in Michigan has reduced by about 17%, although in 2017, the rate of high school-age smokers was almost 2% higher than the national average. Premature deaths, however, have increased 7% over the past four years.

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James Willamor // Flickr

#33. North Carolina

- Overall score: -0.191
- Most healthy trait: HPV immunization for males (53.7% of males aged 13 to 17; Rank: #10; 21.2% above national average)
- Least healthy trait: Public health funding ($57 per person; Rank: #42; 33.7% below national average)
- Cancer deaths: 197.9 per 100,000 people (Rank: #33; 4.3% below national average)
- Excessive drinking: 16.9% of adults (Rank: #14; 11.1% above national average)
- Drug deaths: 16.2 per 100,000 people (Rank: #22; 4.1% above national average)
- Infant mortality: 7.3 deaths per 1,000 live births (Rank: #41; 23.7% below national average)
- Public health funding: $57 per person (Rank: #42; 33.7% below national average)

Although North Carolina doesn't offer much in the way of public health funding compared to the rest of the U.S., what is available is relatively comprehensive. Meanwhile, the state continues to battle with increasing drug use, premature death rates, and high obesity levels.

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Rocky Grimes // Shutterstock

#32. Alaska

- Overall score: -0.115
- Most healthy trait: Public health funding ($281 per person; Rank: #1; 226.7% above national average)
- Least healthy trait: Air pollution (7.4 micrograms of fine particles per cubic meter; Rank: #22; 640% above national average)
- Cancer deaths: 192.1 per 100,000 people (Rank: #26; 1.2% below national average)
- Excessive drinking: 21.3% of adults (Rank: #43; 12.1% below national average)
- Drug deaths: 16.5 per 100,000 people (Rank: #25; 2.4% above national average)
- Infant mortality: 6.1 deaths per 1,000 live births (Rank: #27; 3.4% below national average)
- Public health funding: $281 per person (Rank: #1; 226.7% above national average)

Alaska tops the country with high public health funding, providing resources for both new settlers and longtime residents. But the state struggles with rapidly increasing cases of physical distress, occupational fatalities, violent crime (which is already at the highest rate in the U.S.), and drug-related deaths.

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Paul Brady Photography // Shutterstock

#31. Delaware

- Overall score: -0.109
- Most healthy trait: Uninsured (5.6% of people; Rank: #11; 35.6% below national average)
- Least healthy trait: Infant mortality (8.4 deaths per 1,000 live births; Rank: #48; 42.4% above national average)
- Cancer deaths: 200.8 per 100,000 people (Rank: #36; 5.8% below national average)
- Excessive drinking: 16.8% of adults (Rank: #13; 11.6% above national average)
- Drug deaths: 24 per 100,000 people (Rank: #42; 42% below national average)
- Infant mortality: 8.4 deaths per 1,000 live births (Rank: #48; 42.4% below national average)
- Public health funding: $107 per person (Rank: #18; 24.4% above national average)

Delaware has made healthy strides over the past decade, seeing a decrease in excessive drinking, air pollution, and cancer deaths, plus a rise in mental health professionals. Unfortunately, low rates of available dentists, high infant mortality, and a lot of physical inactivity bring the state's ranking down. Delaware is one of the few states that requires a dental residency; early in 2018, the government considered dropping the mandate to encourage more dentists to move there.

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Mark Skalny // Shutterstock

#30. Arizona

- Overall score: -0.105
- Most healthy trait: Preventable hospitalizations (36.1 discharges per 1,000 Medicare enrollees; Rank: #8; 26.9% below national average)
- Least healthy trait: Mental health providers (129.3 per 100,000 people; Rank: #47; 44.9% below national average)
- Cancer deaths: 168.4 per 100,000 people (Rank: #4; 11.3% above national average)
- Excessive drinking: 16.7% of adults (Rank: #12; 12.1% above national average)
- Drug deaths: 19.5 per 100,000 people (Rank: #31; 15.4% below national average)
- Infant mortality: 5.4 deaths per 1,000 live births (Rank: #15; 8.5% above national average)
- Public health funding: $50 per person (Rank: #49; 41.9% below national average)

Arizona's public health offerings are sparse outside of a series of programs designed to prevent disease and spread awareness about potential medical issues. The state does have one of the lowest cancer death rates in the country, and child poverty is decreasing.

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littlenySTOCK // Shutterstock

#29. Florida

- Overall score: -0.087
- Most healthy trait: Disparity in health status (24.8% point difference; Rank: #13; 17.1% below national average)
- Least healthy trait: Salmonella (27.2 cases per 100,000 people; Rank: #45; 62.9% above national average)
- Cancer deaths: 181.4 per 100,000 people (Rank: #12; 4.4% above national average)
- Excessive drinking: 17.1% of adults (Rank: #15; 10% above national average)
- Drug deaths: 17.7 per 100,000 people (Rank: #29; 4.7% below national average)
- Infant mortality: 6.2 deaths per 1,000 live births (Rank: #30; 5.1% below national average)
- Public health funding: $62 per person (Rank: #40; 27.9% below national average)

Obesity and uninsured residents continually cause headaches in Florida's health care scene. Luckily, violent crime is decreasing (down 44% over the last decade), and the cancer death rate remains low and is getting lower. Still, the American Cancer Society estimates 45,000 Floridians will die from cancer in 2019.

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Asamudra // Wikimedia Commons

#28. Pennsylvania

- Overall score: -0.014
- Most healthy trait: Uninsured (5.6% of people; Rank: #11; 35.6% below national average)
- Least healthy trait: Drug deaths (28.1 deaths per 100,000 people; Rank: #46; 66.3% above national average)
- Cancer deaths: 200.3 per 100,000 people (Rank: #35; 5.5% below national average)
- Excessive drinking: 19.2% of adults (Rank: #27; 1.1% below national average)
- Drug deaths: 28.1 per 100,000 people (Rank: #46; 66.3% below national average)
- Infant mortality: 6.1 deaths per 1,000 live births (Rank: #27; 3.4% below national average)
- Public health funding: $55 per person (Rank: #44; 36% below national average)

Pennsylvania faces hefty challenges with air pollution and frequent physical distress among residents, plus an increasing rate of drug deaths. The state recently introduced a referral program for people struggling through addiction. Pennsylvania does rank fairly high in the U.S. for the rate of residents with health insurance.

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Sean Pavone // Shutterstock

#27. Kansas

- Overall score: 0.036
- Most healthy trait: Drug deaths (11.6 deaths per 100,000 people; Rank: #7; 31.4% below national average)
- Least healthy trait: Public health funding ($56 per person; Rank: #43; 34.9% below national average)
- Cancer deaths: 195.5 per 100,000 people (Rank: #31; 3% below national average)
- Excessive drinking: 18.7% of adults (Rank: #24; 1.6% above national average)
- Drug deaths: 11.6 per 100,000 people (Rank: #7; 31.4% above national average)
- Infant mortality: 5.9 deaths per 1,000 live births (Rank: #21; 0% below national average)
- Public health funding: $56 per person (Rank: #43; 34.9% below national average)

At its height in 1991, Kansas ranked as the eighth healthiest state in the country. But an increase in excessive drinking, chlamydia cases, cancer deaths, mental distress, and physical inactivity combined with low public health funding and low immunization rates, have caused Kansas to fall in the rankings nearly every year since.

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Alex Zyuzikov // Shutterstock

#26. Illinois

- Overall score: 0.06
- Most healthy trait: Uninsured (6.7% of people; Rank: #20; 23% below national average)
- Least healthy trait: Public health funding ($68 per person; Rank: #37; 20.9% below national average)
- Cancer deaths: 199.9 per 100,000 people (Rank: #34; 5.3% below national average)
- Excessive drinking: 21.4% of adults (Rank: #45; 12.6% below national average)
- Drug deaths: 15.3 per 100,000 people (Rank: #19; 9.5% above national average)
- Infant mortality: 6.2 deaths per 1,000 live births (Rank: #30; 5.1% below national average)
- Public health funding: $68 per person (Rank: #37; 20.9% below national average)

Thanks to high levels of immunizations—helped along by the state actively making it difficult for children to skip vaccines—low mental distress, and an ample amount of primary care doctors, Illinois has been climbing the rankings recently. The state does face challenges with high air pollution, excessive drinking, and increasing obesity.

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Jacob Boomsma // Shutterstock

#25. South Dakota

- Overall score: 0.067
- Most healthy trait: Drug deaths (8 deaths per 100,000 people; Rank: #2; 52.7% below national average)
- Least healthy trait: Salmonella (35.4 cases per 100,000 people; Rank: #49; 112% above national average)
- Cancer deaths: 188 per 100,000 people (Rank: #20; 0.9% above national average)
- Excessive drinking: 19% of adults (Rank: #26; 0% below national average)
- Drug deaths: 8 per 100,000 people (Rank: #2; 52.7% above national average)
- Infant mortality: 6.1 deaths per 1,000 live births (Rank: #27; 3.4% below national average)
- Public health funding: $111 per person (Rank: #14; 29.1% above national average)

For people in South Dakota struggling with a lack of health insurance, the state offers an array of programs, including a special office specifically for residents in rural areas. Smoking, obesity, and cardiovascular deaths remain issues statewide.

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Michel Rathwell // Flickr

#24. Wyoming

- Overall score: 0.21
- Most healthy trait: Mental health providers (331.6 per 100,000 people; Rank: #13; 41.3% above national average)
- Least healthy trait: Uninsured (11.9% of people; Rank: #44; 36.8% above national average)
- Cancer deaths: 168.8 per 100,000 people (Rank: #5; 11.1% above national average)
- Excessive drinking: 19.8% of adults (Rank: #35; 4.2% below national average)
- Drug deaths: 17.6 per 100,000 people (Rank: #27; 4.1% below national average)
- Infant mortality: 5 deaths per 1,000 live births (Rank: #10; 15.3% above national average)
- Public health funding: $109 per person (Rank: #15; 26.7% above national average)

Wyoming has one of the highest populations of uninsured people in the country. For those residents, the state offers programs related to aging, behavioral health, financing, and general public health initiatives. Unfortunately, diabetes, occupational death rates, and obesity are all rapidly increasing throughout the state.

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Max Pixel

#23. Wisconsin

- Overall score: 0.22
- Most healthy trait: Uninsured (5.4% of people; Rank: #10; 37.9% below national average)
- Least healthy trait: Public health funding ($52 per person; Rank: #47; 39.5% below national average)
- Cancer deaths: 191.1 per 100,000 people (Rank: #25; 0.7% below national average)
- Excessive drinking: 24.2% of adults (Rank: #50; 27.4% below national average)
- Drug deaths: 16.4 per 100,000 people (Rank: #24; 3% above national average)
- Infant mortality: 6 deaths per 1,000 live births (Rank: #24; 1.7% below national average)
- Public health funding: $52 per person (Rank: #47; 39.5% below national average)

Wisconsin's low public health funding includes strict limits on what counties patients can visit doctors in, which does not help a state facing increasing rates of obesity, premature death, and high levels of excessive drinking—a 2017 study showed that Wisconsinites drink more than any other state. In some good news, air pollution and poverty are decreasing, both down more than 20% from three years ago.

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Pruhter // Wikimedia Commons

#21. Montana

- Overall score: 0.295
- Most healthy trait: Mental health providers (492.3 per 100,000 people; Rank: #2; 109.8% above national average)
- Least healthy trait: Frequent mental distress (15% of adults; Rank: #43; 25% above national average)
- Cancer deaths: 190.4 per 100,000 people (Rank: #23; 0.3% below national average)
- Excessive drinking: 18.6% of adults (Rank: #23; 2.1% above national average)
- Drug deaths: 12.6 per 100,000 people (Rank: #11; 25.4% above national average)
- Infant mortality: 4.9 deaths per 1,000 live births (Rank: #9; 16.9% above national average)
- Public health funding: $81 per person (Rank: #29; 5.8% below national average)

Montana enjoys a few above-average healthy traits, like a low death rate from drugs, low obesity, and a decrease in smoking. The state has its challenges though, including low immunization rates, a lack of primary care physicians, and a high rate of excessive drinking.

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M.O. Stevens // Wikipedia

#21. Oregon

- Overall score: 0.295
- Most healthy trait: Public health funding ($115 per person; Rank: #11; 33.7% above national average)
- Least healthy trait: Primary care physicians (115.2 number per 100,000 people; Rank: #44; 26.5% below national average)
- Cancer deaths: 183.3 per 100,000 people (Rank: #17; 3.4% above national average)
- Excessive drinking: 20.9% of adults (Rank: #41; 10% below national average)
- Drug deaths: 12.6 per 100,000 people (Rank: #11; 25.4% above national average)
- Infant mortality: 5.9 deaths per 1,000 live births (Rank: #21; 0% below national average)
- Public health funding: $115 per person (Rank: #11; 33.7% above national average)

Oregon has a stout public health program that includes everything from laboratory services and vaccines to medical marijuana and food stamps. Smoking and poverty have both decreased over the past five years, and immunization rates increased more than 20% in the last year. Marijuana usage in the state may end up being a bit of a concern at some point though, as in the first year it was legalized, drivers under the influence more than doubled.

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Ron Cogswell // Wikimedia Commons

#20. Virginia

- Overall score: 0.305
- Most healthy trait: Violent crime (208 offenses per 100,000 people; Rank: #4; 47.2% below national average)
- Least healthy trait: Mental health providers (162.4 per 100,000 people; Rank: #40; 30.8% below national average)
- Cancer deaths: 190.7 per 100,000 people (Rank: #24; 0.5% below national average)
- Excessive drinking: 17.4% of adults (Rank: #18; 8.4% above national average)
- Drug deaths: 13.4 per 100,000 people (Rank: #15; 20.7% above national average)
- Infant mortality: 5.9 deaths per 1,000 live births (Rank: #21; 0% below national average)
- Public health funding: $73 per person (Rank: #35; 15.1% below national average)

Virginians enjoy healthy perks of living like low violent crime rates, low levels of excessive drinking, and high immunization rates. But the state struggles with some important factors including access to public health funding and a large uninsured population. More than 10% of Virginia's under-65 population doesn't have insurance, and the majority of those uninsured are members of working families.

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GoodFreePhotos

#19. Maryland

- Overall score: 0.306
- Most healthy trait: Children in poverty (12% of children aged 0 to 17; Rank: #6; 34.8% below national average)
- Least healthy trait: Drug deaths (23.9 deaths per 100,000 people; Rank: #41; 41.4% above national average)
- Cancer deaths: 188.1 per 100,000 people (Rank: #21; 0.9% above national average)
- Excessive drinking: 16.6% of adults (Rank: #10; 12.6% above national average)
- Drug deaths: 23.9 per 100,000 people (Rank: #41; 41.4% below national average)
- Infant mortality: 6.6 deaths per 1,000 live births (Rank: #35; 11.9% below national average)
- Public health funding: $96 per person (Rank: #24; 11.6% above national average)

Drug deaths are increasing in Maryland, rising 78% over the past three years. High violent crime and infant mortality rates challenge the state as well, though it does benefit from relatively low rates of poverty, smoking, and physical distress.

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f11photo // Shutterstock

#18. Iowa

- Overall score: 0.336
- Most healthy trait: Uninsured (4.5% of people; Rank: #5; 48.3% below national average)
- Least healthy trait: Salmonella (24.8 cases per 100,000 people; Rank: #43; 48.5% above national average)
- Cancer deaths: 195.3 per 100,000 people (Rank: #30; 2.9% below national average)
- Excessive drinking: 22.1% of adults (Rank: #48; 16.3% below national average)
- Drug deaths: 9.8 per 100,000 people (Rank: #4; 42% above national average)
- Infant mortality: 5.1 deaths per 1,000 live births (Rank: #11; 13.6% above national average)
- Public health funding: $124 per person (Rank: #9; 44.2% above national average)

Iowa's well-funded public health program includes initiatives to help people quit smoking, screenings for cervical cancer, and food poisoning prevention. Still, the state is combatting heavy drinking and high obesity rates. The obesity rate in Iowa currently stands at about 36%, accounting for more than 1 in 3 adults in the state.

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Robbymilo // Wikimedia Commons

#16. Idaho (tie)

- Overall score: 0.349
- Most healthy trait: Mental health providers (459.5 per 100,000 people; Rank: #3; 95.8% above national average)
- Least healthy trait: Drug deaths (21.6 deaths per 100,000 people; Rank: #37; 27.8% above national average)
- Cancer deaths: 205.8 per 100,000 people (Rank: #39; 8.4% below national average)
- Excessive drinking: 20.2% of adults (Rank: #37; 6.3% below national average)
- Drug deaths: 21.6 per 100,000 people (Rank: #37; 27.8% below national average)
- Infant mortality: 6.2 deaths per 1,000 live births (Rank: #30; 5.1% below national average)
- Public health funding: $97 per person (Rank: #21; 12.8% above national average)

Low rates of violent crime and diabetes help keep Idaho near the top of this year's ranking, as well as a rapid decrease in air pollution and children facing poverty. However, cancer death rates are up, as are cardiovascular death rates. Heart disease is the second biggest killer of Idaho residents, just behind cancer.

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Kenneth C. Zirkel // Wikimedia Commons

#16. Maine (tie)

- Overall score: 0.349
- Most healthy trait: Public health funding ($149 per person; Rank: #4; 73.3% above national average)
- Least healthy trait: Primary care physicians (95.7 number per 100,000 people; Rank: #50; 38.9% below national average)
- Cancer deaths: 182.1 per 100,000 people (Rank: #14; 4.1% above national average)
- Excessive drinking: 16.6% of adults (Rank: #10; 12.6% above national average)
- Drug deaths: 14.2 per 100,000 people (Rank: #16; 16% above national average)
- Infant mortality: 5.4 deaths per 1,000 live births (Rank: #15; 8.5% above national average)
- Public health funding: $149 per person (Rank: #4; 73.3% above national average)

Maine couples low violent crime and smoking rates with high levels of immunizations and an excellent public health care system. The state provides resources for every stage of life, as well as real-time data on a number of health concerns, including tick-borne diseases.

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Tony Webster // Flickr

#15. Nebraska

- Overall score: 0.379
- Most healthy trait: Drug deaths (6.8 deaths per 100,000 people; Rank: #1; 59.8% below national average)
- Least healthy trait: Disparity in health status (35.8% point difference; Rank: #49; 19.7% above national average)
- Cancer deaths: 187.4 per 100,000 people (Rank: #19; 1.3% above national average)
- Excessive drinking: 21.7% of adults (Rank: #46; 14.2% below national average)
- Drug deaths: 6.8 per 100,000 people (Rank: #1; 59.8% above national average)
- Infant mortality: 6 deaths per 1,000 live births (Rank: #24; 1.7% below national average)
- Public health funding: $97 per person (Rank: #21; 12.8% above national average)

Nebraska continually remains near the top of the rankings thanks to a low drug death rate, high immunizations, and a high percentage of high school graduates. But the state has seen its standing wobble lately as violent crime, cancer deaths, diabetes, and infant mortality have all increased. Hate crimes are rising in Nebraska as well, up nearly 77% from 2016.

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Sean Pavone // Shutterstock

#14. Rhode Island

- Overall score: 0.382
- Most healthy trait: HPV immunization for males (78.4% of males aged 13 to 17; Rank: #1; 77% above national average)
- Least healthy trait: Drug deaths (27.5 deaths per 100,000 people; Rank: #45; 62.7% above national average)
- Cancer deaths: 193.5 per 100,000 people (Rank: #28; 1.9% below national average)
- Excessive drinking: 19.6% of adults (Rank: #32; 3.2% below national average)
- Drug deaths: 27.5 per 100,000 people (Rank: #45; 62.7% below national average)
- Infant mortality: 5.7 deaths per 1,000 live births (Rank: #19; 3.4% above national average)
- Public health funding: $143 per person (Rank: #7; 66.3% above national average)

Rhode Island residents enjoy a robustly funded public health system, which offers programs designed to help people quit smoking, manage chronic conditions, register for special health care needs, and get acquainted with being a temporary caregiver. The state still has an uphill slog with drug deaths, mental distress, and obesity, though.

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Unimatic1140 // Wikimedia Commons

#13. North Dakota

- Overall score: 0.416
- Most healthy trait: Public health funding ($130 per person; Rank: #8; 51.2% above national average)
- Least healthy trait: Excessive drinking (24.1% of adults; Rank: #49; 26.8% above national average)
- Cancer deaths: 177.8 per 100,000 people (Rank: #10; 6.3% above national average)
- Excessive drinking: 24.1% of adults (Rank: #49; 26.8% below national average)
- Drug deaths: 8.3 per 100,000 people (Rank: #3; 50.9% above national average)
- Infant mortality: 6.8 deaths per 1,000 live births (Rank: #37; 15.3% below national average)
- Public health funding: $130 per person (Rank: #8; 51.2% above national average)

Although North Dakota has a low rate of drug-related deaths, that number rose 207% over the past three years. Violent crime is an issue as well, rising 98% over the past 10 years. The state still enjoys low levels of air pollution, high immunization rates, and excellent public health funding.

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Chones // Shutterstock

#12. California

- Overall score: 0.431
- Most healthy trait: Mental health providers (338 per 100,000 people; Rank: #11; 44% above national average)
- Least healthy trait: Air pollution (11.9 micrograms of fine particles per cubic meter; Rank: #50; 495% above national average)
- Cancer deaths: 169.2 per 100,000 people (Rank: #7; 10.9% above national average)
- Excessive drinking: 19.2% of adults (Rank: #27; 1.1% below national average)
- Drug deaths: 11.9 per 100,000 people (Rank: #8; 29.6% above national average)
- Infant mortality: 4.3 deaths per 1,000 live births (Rank: #4; 27.1% above national average)
- Public health funding: $108 per person (Rank: #16; 25.6% above national average)

California is notorious for its high air pollution, but does contain low obesity and low mortality rates for workers and infants. The state is steadily rising in the rankings thanks to decreasing poverty—though poverty rates are still the worst in the nation—increasing insurance coverage, and a decline in cancer deaths.

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Adithyavr // Wikimedia Commons

#11. New Jersey

- Overall score: 0.46
- Most healthy trait: Violent crime (229 offenses per 100,000 people; Rank: #8; 41.9% below national average)
- Least healthy trait: Public health funding ($64 per person; Rank: #39; 25.6% below national average)
- Cancer deaths: 182.3 per 100,000 people (Rank: #15; 4% above national average)
- Excessive drinking: 18.1% of adults (Rank: #22; 4.7% above national average)
- Drug deaths: 17.6 per 100,000 people (Rank: #27; 4.1% below national average)
- Infant mortality: 4.4 deaths per 1,000 live births (Rank: #5; 25.4% above national average)
- Public health funding: $64 per person (Rank: #39; 25.6% below national average)

Although New Jersey has low public health funding, the state continues to jump nearly every year in the healthy state rankings. Residents currently enjoy an ample amount of dentists, low infant mortality rates, decreasing air pollution—even though the majority of the state failed smog tests in 2018—and declining cancer death rates.

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pisaphotography // Shutterstock

#10. New York

- Overall score: 0.476
- Most healthy trait: Public health funding ($149 per person; Rank: #4; 73.3% above national average)
- Least healthy trait: Chlamydia (552.8 cases per 100,000 people; Rank: #39; 11.2% above national average)
- Cancer deaths: 177.7 per 100,000 people (Rank: #9; 6.4% above national average)
- Excessive drinking: 18.8% of adults (Rank: #25; 1.1% above national average)
- Drug deaths: 14.3 per 100,000 people (Rank: #17; 15.4% above national average)
- Infant mortality: 4.5 deaths per 1,000 live births (Rank: #6; 23.7% above national average)
- Public health funding: $149 per person (Rank: #4; 73.3% above national average)

After the Empire State bottomed out in the rankings at #41 in 1996, New York's growing public health system is on a mission to become the healthiest state in the country through a comprehensive prevention agenda. But there are still hurdles to jump—the state still battles with low immunization rates, increasing drug deaths, and increasing premature death rates. Fentanyl, an opioid about 100-times stronger than morphine, was involved in about 57% of New York City's overdoses in 2017.

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Joe Mabel // Wikimedia Commons

#9. Washington

- Overall score: 0.584
- Most healthy trait: Mental health providers (333.1 per 100,000 people; Rank: #12; 41.9% above national average)
- Least healthy trait: Primary care physicians (146.5 number per 100,000 people; Rank: #23; 6.5% below national average)
- Cancer deaths: 184.3 per 100,000 people (Rank: #18; 2.9% above national average)
- Excessive drinking: 17.4% of adults (Rank: #18; 8.4% above national average)
- Drug deaths: 14.6 per 100,000 people (Rank: #18; 13.6% above national average)
- Infant mortality: 4.6 deaths per 1,000 live births (Rank: #7; 22% above national average)
- Public health funding: $94 per person (Rank: #25; 9.3% above national average)

Washingtonians can bank on low premature death rates, a low rate of physical inactivity, and more normal birth weights than other states. But Washington is facing increasing worksite fatalities, jumps in chlamydia and mental distress, and decreasing immunization rates.

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chachpond // Pixabay

#8. Colorado

- Overall score: 0.588
- Most healthy trait: Mental health providers (339.1 per 100,000 people; Rank: #10; 44.5% above national average)
- Least healthy trait: Primary care physicians (141.3 number per 100,000 people; Rank: #27; 9.8% below national average)
- Cancer deaths: 162.3 per 100,000 people (Rank: #3; 14.5% above national average)
- Excessive drinking: 20.5% of adults (Rank: #39; 7.9% below national average)
- Drug deaths: 16.2 per 100,000 people (Rank: #22; 4.1% above national average)
- Infant mortality: 4.7 deaths per 1,000 live births (Rank: #8; 20.3% above national average)
- Public health funding: $98 per person (Rank: #20; 14% above national average)

Colorado has never been lower than the top 15 healthy states, thanks in part to low obesity, poverty, and cancer death rates. Smoking rates are continually decreasing as well, as are infant mortality rates. Mental health continues to be a strong focus in the state; in December an $800,000 grant supplied mental health kits to schools around Colorado.

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Scott Olson // Getty Images

#7. Minnesota

- Overall score: 0.665
- Most healthy trait: Uninsured (4.3% of people; Rank: #4; 50.6% below national average)
- Least healthy trait: Excessive drinking (21.7% of adults; Rank: #46; 14.2% above national average)
- Cancer deaths: 181.4 per 100,000 people (Rank: #12; 4.4% above national average)
- Excessive drinking: 21.7% of adults (Rank: #46; 14.2% below national average)
- Drug deaths: 10.8 per 100,000 people (Rank: #6; 36.1% above national average)
- Infant mortality: 5.1 deaths per 1,000 live births (Rank: #11; 13.6% above national average)
- Public health funding: $99 per person (Rank: #19; 15.1% above national average)

In 2018, Minnesota hit its lowest ranking yet in the tracked metrics for the healthiest state. The drop is due to increases in obesity—though only in adults, as the obesity rate in Minnesota children is decreasing—drug deaths, infant mortality rates, and low immunization rates.

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Jon Platek // Wikimedia Commons

#6. New Hampshire

- Overall score: 0.692
- Most healthy trait: Violent crime (199 offenses per 100,000 people; Rank: #3; 49.5% below national average)
- Least healthy trait: Drug deaths (31.9 deaths per 100,000 people; Rank: #49; 88.8% above national average)
- Cancer deaths: 192.8 per 100,000 people (Rank: #27; 1.6% below national average)
- Excessive drinking: 20.7% of adults (Rank: #40; 8.9% below national average)
- Drug deaths: 31.9 per 100,000 people (Rank: #49; 88.8% below national average)
- Infant mortality: 3.9 deaths per 1,000 live births (Rank: #1; 33.9% above national average)
- Public health funding: $74 per person (Rank: #34; 14% below national average)

New Hampshire doesn't have the best funded public health system, but it does offer all the traditional services a state should provide like food stamps, Medicaid, and programs for women and children. Drug deaths in the state are rising at an alarming rate though, up 120% in the past three years.

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f11photo // Shutterstock

#5. Utah

- Overall score: 0.702
- Most healthy trait: Smoking (8.9% of adults; Rank: #1; 48% below national average)
- Least healthy trait: Primary care physicians (99.2 number per 100,000 people; Rank: #49; 36.7% below national average)
- Cancer deaths: 150.4 per 100,000 people (Rank: #1; 20.8% above national average)
- Excessive drinking: 12.2% of adults (Rank: #1; 35.8% above national average)
- Drug deaths: 22.9 per 100,000 people (Rank: #40; 35.5% below national average)
- Infant mortality: 5.2 deaths per 1,000 live births (Rank: #13; 11.9% above national average)
- Public health funding: $77 per person (Rank: #32; 10.5% below national average)

Utah can attribute a number of healthy habits to keeping it in the top 10 every year—like low rates of smoking, poverty, physical distress, and diabetes. But the state still has to contend with a few challenges, like a lack of primary care doctors, low immunization rates, and an increasing amount of cancer deaths. Recently, more doctors are retiring throughout Utah.

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Bob P. B. // Flickr

#4. Vermont

- Overall score: 0.719
- Most healthy trait: Mental health providers (433.4 per 100,000 people; Rank: #4; 84.7% above national average)
- Least healthy trait: Salmonella (19.4 cases per 100,000 people; Rank: #37; 16.2% above national average)
- Cancer deaths: 193.9 per 100,000 people (Rank: #29; 2.2% below national average)
- Excessive drinking: 19.5% of adults (Rank: #30; 2.6% below national average)
- Drug deaths: 17 per 100,000 people (Rank: #26; 0.6% below national average)
- Infant mortality: 3.9 deaths per 1,000 live births (Rank: #1; 33.9% above national average)
- Public health funding: $148 per person (Rank: #6; 72.1% above national average)

Vermont's public health system doesn't just offer the basics, but also a robust schedule of healthy habit-related events and workshops. The state enjoys low infant mortality rates, high insurance coverage, and low levels of violent crime. Every year, the Vermont government releases a statewide crime report—from 1997 to 2014, crime decreased by about 24% and continues to drop.

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Richard A. McGuirk // Shutterstock

#3. Connecticut

- Overall score: 0.799
- Most healthy trait: Mental health providers (375.5 per 100,000 people; Rank: #9; 60% above national average)
- Least healthy trait: Drug deaths (22.1 deaths per 100,000 people; Rank: #39; 30.8% above national average)
- Cancer deaths: 174.7 per 100,000 people (Rank: #8; 8% above national average)
- Excessive drinking: 17.1% of adults (Rank: #15; 10% above national average)
- Drug deaths: 22.1 per 100,000 people (Rank: #39; 30.8% below national average)
- Infant mortality: 5.2 deaths per 1,000 live births (Rank: #13; 11.9% above national average)
- Public health funding: $81 per person (Rank: #29; 5.8% below national average)

Even though only 5.2% of residents are uninsured, Connecticut lacks services for those who struggle with finding affordable health insurance. This is a blemish on a state that has a low rate of excessive drinking, low premature death rates, and a steadily decreasing cancer death rate.

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None // Max Pixel

#2. Massachusetts

- Overall score: 0.866
- Most healthy trait: Mental health providers (590.9 per 100,000 people; Rank: #1; 151.8% above national average)
- Least healthy trait: Drug deaths (25.2 deaths per 100,000 people; Rank: #43; 49.1% above national average)
- Cancer deaths: 182.7 per 100,000 people (Rank: #16; 3.7% above national average)
- Excessive drinking: 21.3% of adults (Rank: #43; 12.1% below national average)
- Drug deaths: 25.2 per 100,000 people (Rank: #43; 49.1% below national average)
- Infant mortality: 4.1 deaths per 1,000 live births (Rank: #3; 30.5% above national average)
- Public health funding: $112 per person (Rank: #12; 30.2% above national average)

In 2017, Massachusetts held the top spot on the list, but was knocked down because of increasing obesity, excessive drinking, and drug deaths. Massachusetts residents still have one of the longest life expectancies of any other state at an average of 80 years and 8 months.

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MNStudio // Shutterstock

#1. Hawaii

- Overall score: 0.882
- Most healthy trait: Public health funding ($226 per person; Rank: #2; 162.8% above national average)
- Least healthy trait: Salmonella (21.4 cases per 100,000 people; Rank: #40; 28.1% above national average)
- Cancer deaths: 161.1 per 100,000 people (Rank: #2; 15.1% above national average)
- Excessive drinking: 21.1% of adults (Rank: #42; 11.1% below national average)
- Drug deaths: 12.3 per 100,000 people (Rank: #10; 27.2% above national average)
- Infant mortality: 6 deaths per 1,000 live births (Rank: #24; 1.7% below national average)
- Public health funding: $226 per person (Rank: #2; 162.8% above national average)

Since 2012, Hawaii has been the top-ranked state for all but one year (2017). The state still has to contend with heavy drinking, low immunization rates, and steadily increasing diabetes rates—13.1% of the state's adult population already has the disease, with 41.5% in prediabetes. But residents can thank the strong public health system, and low rates of obesity, air pollution, and mental distress for their unmatched state of living.

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