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Governments, individuals, and corporations spend an enormous amount of time and money to keep Americans healthy. Investments in anything from medical research, health care, insurance, nutritional programs, and exercise facilities is meant to improve residents’ health and well-being. Such investments are not uniform across the United States, and other factors, including environmental ones — such as socioeconomic factors, pollution, and geography — also play a role in the health of residents. How healthy Americans are often depends on where they live.

24/7 Wall St. reviewed county-level health rankings from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. The health of Americans varies tremendously not just between states, but within each state.

The report ranked each state’s counties based on the incidence of premature death and self-reported levels of health — that is, how long and how well residents live. Premature death rates, measured as the number of people who die before age 75 per 100,000 people annually, range from 382 per 100,000 people in Kingfisher County, Oklahoma, to 157 deaths per 100,000 in Teton County, Wyoming. These counties are each the healthiest in their respective states. By contrast, in McDowell, the least healthy county in West Virginia, there are 889 preventable deaths per 100,000 residents each year, nearly the highest of all counties.

Click here to see the healthiest county in every state.

The quality of life, measured by several self-reported levels of well-being, also varies considerably. Of all counties reviewed, residents of Brooks County, Texas, report nearly the lowest quality of life, with 40% reporting fair or poor health. This is in stark contrast with Douglas, Colorado, where just 7% of adults report such low levels of health.

How long and how well people live are a consequence of health factors, which include behavioral indicators such as exercise habits, smoking rates, obesity, and alcohol consumption; and socioeconomic indicators such as violent crime rates, unemployment, teen birth rates, the ratio of residents to physicians, and child poverty rates. In an interview with 24/7 Wall St., Bridget Catlin, co-director of the County Health Rankings & Roadmaps program at the University of Wisconsin, explained that these are factors that community leaders and county residents can improve.

No single factor can explain health outcomes in an area, and the circumstances leading to healthy lifestyles are often extremely complicated. However, a few indicators stand out. High incomes and financial stability, for example, are very common in these healthy areas. The median household income is higher than the state income level in all but one of the 50 counties on this list.

“When you are struggling, trying to make ends meet, it’s difficult to focus on being sure that you have healthy food on the table,” Catlin said. Not only are wealthier families more able to meet these basic needs, but also medical care, exercise opportunities, and access to other products and services that support better health are often quite expensive.

Premature death rates are lower in suburban and urban areas, and in large cities in particular, preventable deaths have declined in recent years. Premature death rates in rural areas, by contrast, have increased over the past several years.

Health care services are also more concentrated in relatively urban areas. In 33 states, the ratio of primary care physicians to residents in the healthiest county is better than the national ratio of 1 primary care physician to every 1,320 Americans.

Catlin noted that access to health care is only one reason for the strong health outcomes in the healthiest counties. These counties also tend to have more job opportunities, and with larger tax bases, the funding for health and other institutions and services is often greater. In 48 of the 50 states, the unemployment rate in the healthiest county is lower than the national rate.

Residents of these healthy counties are also more likely to have health insurance, which not only helps provide medical care when needed, but also offers individuals peace of mind and preventive care. Nationwide, 17% of Americans under 65 years old do not have health insurance. This percentage is lower in all but nine of these counties.

To identify the healthiest county in every state, 24/7 Wall St. reviewed county-level data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. Rankings are based on overall health outcomes — a weighted composite of length of life, quality of life, and maternal health — and overall health factors. The health factors component is itself a weighted composite of healthy behaviors, clinical care, social and economic factors, and physical environment measures. Data were compiled from more than 20 different sources and is for the most recent year available. A total of 3,140 counties were considered.

These are the healthiest counties in each state.

1. Alabama
> Healthiest county: Shelby
> Pct. without health insurance: 12.1%
> Pct. food insecure: 10.7%
> Obesity rate: 31.3%
> 2014 unemployment rate: 4.5%

Alabama is one of the least healthy states in the country. Across the state, 21.1% of adults report being in fair or poor health, nearly the largest share of all states. The average resident reports feeling physically unhealthy for 4.6 days each month, the second most of any state population. In Shelby County, the healthiest county in Alabama, residents are about as healthy as the average American. Just 13.8% of adults report being in fair or poor health, and they feel in poor physical health for 3.6 days each month on average — compared to the corresponding national figures of 14.0% and 3.5 days per month. High incomes in Shelby County likely contributed to the relatively good health outcomes. County households earn $69,432 a year, the highest median household income of any Alabama county.

2. Alaska
> Healthiest county: Juneau
> Pct. without health insurance: 17.3%
> Pct. food insecure: 11.1%
> Obesity rate: 27.0%
> 2014 unemployment rate: 5.1%

Alaska is by far the largest and most sparsely populated state in the country. Rural dwellers, who make up more than one in three Alaskans, often report more unhealthy habits and poor health outcomes. The opposite is true in more urban areas, which may explain the relatively better health of Alaskans living in Juneau, the state’s capital and healthiest county. Fewer than one in 10 Juneau residents report fair or poor health, lower than both the state and national proportions of people reporting such low levels of health.

Relatively high incomes may also help county residents stay healthy. Juneau’s median annual household income of $80,835 is higher than the state median of $70,898, itself nearly the highest of all states in the country.

3. Arizona
> Healthiest county: Maricopa
> Pct. without health insurance: 19.8%
> Pct. food insecure: 15.9%
> Obesity rate: 22.2%
> 2014 unemployment rate: 5.9%

By many measures of well-being, the rural parts of Arizona are much less healthy than the state’s urban areas. In Maricopa County, a part of the Phoenix-Mesa-Scottsdale metropolitan area, 97.6% of the population lives in an urban environment. It is also the healthiest county in the state.

In Maricopa County, 15.1% of adults smoke and 22.2% are obese, shares slightly better than the statewide 15.7% smoking and 23.5% obesity rates. For every 100,000 county residents, 295 die before the age of 75, a lower incidence of premature death than the state.

4. Arkansas
> Healthiest county: Benton
> Pct. without health insurance: 18.0%
> Pct. food insecure: 13.9%
> Obesity rate: 28.4%
> 2014 unemployment rate: 4.6%

Arkansas residents as a whole have some of the nation’s worst health outcomes and least healthy behaviors. As in many other relatively unhealthy states, residents of Arkansas’ healthiest county, Benton, do not fare particularly well compared to the nation. The percentages of Benton adults who are obese and who smoke, while lower than the statewide rates, are higher than the national obesity and smoking rates of 17% and 27%. Similarly, the 17.1% of area adults who report being in fair or poor health is better than the statewide percentage, but still far worse than the 14.0% of adults nationwide who report such low health levels.

Benton residents are financially well-off. The child poverty rate, for example, of 16.2% is well below the state and national rates of 26.3% and 22.0%.

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5. California
> Healthiest county: Marin
> Pct. without health insurance: 11.9%
> Pct. food insecure: 11.9%
> Obesity rate: 18.1%
> 2014 unemployment rate: 4.3%

The factors and behaviors that contribute to good health — including access to medical care and healthy foods, frequent exercise, and so on — can often be expensive. As a result, the healthiest areas in every state are often home to some of the nation’s wealthiest individuals. Marin, California is one such county. The typical area household earns $94,549 annually, far higher than both the state and national medians. Only 11.9% of adults do not have health insurance, and 2% report limited access to food, each well below the comparable state and national rates. Also, while 16.7% of Californians report no physical activity whatsoever, only 10.8% of Marin adults report such sedentary lifestyles — a lower rate than the nation.

6. Colorado
> Healthiest county: Douglas
> Pct. without health insurance: 7.8%
> Pct. food insecure: 10.2%
> Obesity rate: 16.9%
> 2014 unemployment rate: 4.0%

Wealth is often a primary factor in the health of a population, as higher incomes can provide for healthier food, more opportunities for exercise, and other benefits. In Douglas County, the typical household earns $107,250 a year, the most in Colorado and the fifth most in the United States. Douglas County residents also have the best health outcomes in Colorado and among the best nationwide. Just 7.2% of county adults report fair or poor health, a much smaller share than the 12.1% of adults who do statewide and close to half the 14.0% national share. Similarly, 166.0 residents out every 100,000 die before the age of 75, a much lower incidence than the state rate of 279.4 premature deaths per 100,000 people and the national rate of 330.0 premature deaths per 100,000 people.

7. Connecticut
> Healthiest county: Middlesex
> Pct. without health insurance: 8.2%
> Pct. food insecure: 11.1%
> Obesity rate: 23.6%
> 2014 unemployment rate: 5.6%

A longer life is frequently the consequence of good health. In Connecticut, home to some of the nation’s healthiest Americans, 266 lives are lost per 100,000 state residents to preventable deaths each year, the second lowest premature mortality rate of all states. In Middlesex, the annual premature death rate of 256 per 100,000 area residents is even lower.

Like Connecticut, Middlesex residents are financially well-off, which in turn has contributed to a more prosperous, safe, and — perhaps as a consequence — healthier community. The child poverty rate of 9.1% is considerably lower than the state and national child poverty rates. Also, the violent crime rate in Middlesex of 119 incidents per 100,000 people is far lower than the state and national figures.

8. Delaware
> Healthiest county: New Castle
> Pct. without health insurance: 10.0%
> Pct. food insecure: 12.0%
> Obesity rate: 26.8%
> 2014 unemployment rate: 5.5%

As is the case in most of the country, the rural parts of Delaware tend to be less healthy than its urban areas. New Castle County is part of the Philadelphia-Camden-Wilmington metro area and is 95.4% urban. Its residents are the healthiest of Delaware’s three counties by a small margin, and they are about as healthy as the average American overall.

The county’s 17.3% smoking and 26.8% obesity rates are slightly lower than the corresponding state rates. In both New Castle County and Delaware, however, the premature death rate is equal to roughly 343 deaths for every 100,000 residents, somewhat higher than the corresponding nationwide rate of 330 per 100,000 Americans.

9. Florida
> Healthiest county: St. Johns
> Pct. without health insurance: 15.6%
> Pct. food insecure: 13.3%
> Obesity rate: 22.9%
> 2014 unemployment rate: 4.7%

A good education has several advantages, including helping residents lead healthier lifestyles and also find better employment opportunities. Of adults in St. Johns, Florida’s healthiest county, 76.6% have completed at least some college, far higher than the state rate of 60.6% and the national attainment rate of 64.0%.

Compared to the rest of the state, more St. Johns residents have access to exercise venues such as parks and gyms. Perhaps as a result, residents are also less likely to report completely sedentary lifestyles, which in turn may partially explain the county’s relatively low obesity rate of 22.9%. By contrast, 25.5% of state residents and 27.0% of Americans are obese.

10. Georgia
> Healthiest county: Oconee
> Pct. without health insurance: 15.5%
> Pct. food insecure: 10.2%
> Obesity rate: 30.9%
> 2014 unemployment rate: 5.1%

Some of the least healthy places in the United States tend to be rural counties in the Southeast. Rural Oconee County, however, is the healthiest county in Georgia and among the healthiest in the country. Just 11.3% of county adults report fair or poor health compared to 17.0% in Georgia as a whole. Oconee County’s proximity to the University of Georgia may partially account for the area’s high incomes and educational attainment, which ultimately helps residents lead healthier lifestyles. More than three in four county young working-age adults have gone to college, the highest share in the state. Also, the area’s median household income of $80,631 a year is about $31,000 more than the statewide figure and the second highest of any Georgia county.

11. Hawaii
> Healthiest county: Honolulu
> Pct. without health insurance: 6.7%
> Pct. food insecure: 12.8%
> Obesity rate: 21.9%
> 2014 unemployment rate: 4.1%

Hawaii’s health insurance coverage rate is better than in every state except for Massachusetts. In Honolulu County, the state’s healthiest area, the coverage rate of 93.3% is even higher. In addition to the peace of mind and medical care provided by insurance coverage, Honolulu residents also have relatively healthy behaviors. For example, 12.9% of adults smoke, lower than the statewide rate of 13.6%, which itself is nearly the lowest smoking rate of any state. County residents likely have relatively healthy diets and exercise habits as the obesity rate of 21.9% is also lower than the state and national rates.

12. Idaho
> Healthiest county: Ada
> Pct. without health insurance: 14.5%
> Pct. food insecure: 14.8%
> Obesity rate: 24.5%
> 2014 unemployment rate: 4.1%

The urban Ada County is part of the Boise City metropolitan area and is the healthiest county in Idaho. The premature death rate of 260 deaths per 100,000 residents is lower than the 309 per 100,000 Idaho residents. Just 10.9% of Ada County adults report feeling in fair or poor health, a smaller share than the 13.8% of adults who report such poor health statewide.

High incomes and educational attainment may partially explain Ada County’s strong health outcomes. The typical household in the county earns $57,908 a year, about $10,000 more than the statewide median household income. Similarly, and perhaps the result of their proximity to Boise State University, 73.9% of Boise’s young working-age adults have gone to college, well above the state college attainment rate of 64.0%.

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13. Illinois
> Healthiest county: DuPage
> Pct. without health insurance: 10.8%
> Pct. food insecure: 9.3%
> Obesity rate: 23.9%
> 2014 unemployment rate: 5.6%

DuPage County is one of the five wealthy collar counties that surround the Chicago metropolitan area. The typical DuPage County household earns $80,037 a year, among the highest incomes in the nation. The county’s population is also among the most educated as 76.9% of adults have attended college — well above the state and national college attainment rates.

High incomes and educational attainment likely help DuPage County residents lead relatively healthy lifestyles. Just 11.6% of county adults smoke and only 23.9% are obese, each the smallest such shares in Illinois. Similarly, 98.9% of the DuPage County population has access to opportunities for physical activity, and only 18.3% of adults do not exercise, each better than the corresponding statewide 89.4% access and 22.2% inactivity rates.

14. Indiana
> Healthiest county: Hamilton
> Pct. without health insurance: 9.6%
> Pct. food insecure: 10.0%
> Obesity rate: 25.1%
> 2014 unemployment rate: 4.1%

While Indiana is one of the least healthy states, Hamilton is one of the healthiest counties nationwide. Just 13.3% of Hamilton County adults smoke compared to 20.4% of all Indiana adults. Similarly, the county’s 25.1% obesity rate is much lower than the statewide 31.4% obesity rate.

Healthy behaviors among Hamilton County residents have likely contributed to relatively strong health outcomes. Only 10.9% of county adults report having fair or poor health, a much smaller share than the 16.6% of Indiana adults who assess their health so poorly. Each year, there are 207 premature deaths per 100,000 county residents, lower than the 382 deaths per 100,000 Indianians that occur annually.

15. Iowa
> Healthiest county: Sioux
> Pct. without health insurance: 11.8%
> Pct. food insecure: 9.1%
> Obesity rate: 27.7%
> 2014 unemployment rate: 3.0%

Sioux County is the healthiest in Iowa. Yet, more than one-quarter of residents report completely sedentary lifestyles, higher than both the state and national levels of physical inactivity. Residents have worse access to exercise venues than their peers across the state and the nation. Perhaps as a consequence, the area’s obesity rate is also slightly higher than the national rate.

Despite the relatively poor physical health, there are 203 preventable deaths per 100,000 people each year, well below the premature death rates for the state and the nation — each higher than 300 per 100,000 people. Also, 11% of adults living in Sioux say they are in fair or poor health, lower than the percentages of adults reporting such low health levels statewide and nationally.

16. Kansas
> Healthiest county: Johnson
> Pct. without health insurance: 9.7%
> Pct. food insecure: 11.9%
> Obesity rate: 23.3%
> 2014 unemployment rate: 3.8%

Generally, city residents have better health than rural residents. In Johnson County, which is part of the Kansas City metro area, only 3.8% of residents live in rural areas. Johnson residents likely benefit from greater employment opportunities and higher incomes, both of which make staying healthy substantially easier. As in many other healthy areas, the median income among Johnson households of $76,104 is well above both the state and national median incomes. Compared with the state and nation, adults in Johnson are less likely to say they are in fair or poor health. Just 9.1% report such low levels of health compared to the state and national rates of 13.6% and 14.0%, respectively.

17. Kentucky
> Healthiest county: Oldham
> Pct. without health insurance: 10.0%
> Pct. food insecure: 9.9%
> Obesity rate: 30.1%
> 2014 unemployment rate: 4.8%

Oldham County is by far the wealthiest county in Kentucky and among the wealthiest in the nation. The typical county household earns $92,097 a year, the most of any Kentucky county by nearly $25,000 and more than twice the statewide figure of $42,914. Educational attainment is also high in the area. The 71.1% of young working-age adults who have completed at least some college is a much larger share than the 58.6% statewide rate.

High incomes and educational attainment likely help residents lead the healthiest lifestyles in Kentucky. Just 22.5% of residents are physically inactive, a smaller share than the statewide 28.6% inactivity rate. Each year, there are 264 premature deaths per 100,000 residents, about 180 fewer deaths than the statewide premature death rate of 443 per 100,000 people.

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18. Louisiana
> Healthiest parish: Cameron
> Pct. without health insurance: 19.1%
> Pct. food insecure: 8.1%
> Obesity rate: 34.7%
> 2014 unemployment rate: 4.8%

Safe, affordable, and adequate housing is often the minimal requirement for healthy living. Housing problems such as deficient kitchen and plumbing facilities, as well as overcrowding and severe cost burdens afflict just 7.9% of households in Cameron — Louisiana’s healthiest county. This is in stark contrast with the comparable rates for the state and nation of 16.5% and 19.0% of households, respectively.

Cameron residents, while the healthiest in the state, are not especially healthy compared to the nation. The smoking rate of 19.9%, and the 28.2% of adults who report sedentary lifestyles in the area, for example, are each better than the state as a whole but worse than the national rates.

19. Maine
> Healthiest county: Cumberland
> Pct. without health insurance: 11.7%
> Pct. food insecure: 14.2%
> Obesity rate: 22.0%
> 2014 unemployment rate: 4.4%

A strong economy in Cumberland County likely helps keep negative health outcomes at bay. The county is part of the Portland metropolitan area, which includes the Port of Portland and the headquarter locations of a number of major companies. Cumberland County’s 4.4% unemployment rate is the lowest in Maine, and its $61,436 median annual household income is the highest.

The high incomes and financial security may help residents lead relatively healthy lifestyles. Just 12.3% of county residents smoke and only 22.0% are obese, each the lowest such rates in Maine and among the lowest nationwide. Similarly, 15.9% of adults are physically inactive, the smallest share in the state.

20. Maryland
> Healthiest county: Howard
> Pct. without health insurance: 7.7%
> Pct. food insecure: 8.1%
> Obesity rate: 22.6%
> 2014 unemployment rate: 4.4%

Residents living in more urban areas in general and near the D.C. area in particular tend to report relatively strong health outcomes. Howard residents, who live within commuting distance of both Baltimore and Washington D.C., are Maryland’s healthiest. Each year, there are 184 preventable deaths per 100,000 area residents, much lower than the state and national premature death rates and one of the lowest in the United States.

Proper medical care, healthy food, and healthy habits frequently require resources, and the high incomes in Howard likely play a major role in helping residents to live healthy. The area’s median household income of $106,871 is the highest in the state, and nearly double the national income level.

21. Massachusetts
> Healthiest county: Norfolk
> Pct. without health insurance: 3.0%
> Pct. food insecure: 9.1%
> Obesity rate: 19.7%
> 2014 unemployment rate: 5.0%

Unlike the nation and the state, fewer than one in five Norfolk, Massachusetts adults are obese. Residents of Massachusetts’ healthiest county are also less likely to smoke than their peers across the state and the nation. More frequent and reliable medical care may play a role in the health of residents. Only 3% of Norfolk residents do not have health insurance, lower even than the state uninsured rate, which is the lowest of all states in the country. Death before age 75, brought on by long-term smoking and obesity or any number of other sources contributing to premature death is almost always preventable. In Norfolk, there are 238 preventable deaths per 100,000 people, well below the state’s premature death rate, which itself is lower than all but two other states.

22. Michigan
> Healthiest county: Ottawa
> Pct. without health insurance: 11.0%
> Pct. food insecure: 11.0%
> Obesity rate: 25.7%
> 2014 unemployment rate: 4.7%

In Ottawa County, just 15.0% of adults smoke and 25.7% are obese, better than the statewide 17.7% smoking and 31.4% obesity rates. Despite similar access to exercise opportunities, adults in Ottawa County exercise more often than adults in Michigan as a whole. Just 19.4% of county residents are physically inactive compared to 22.8% statewide.

These healthy behaviors have likely led to the best health outcomes in the state. There are 224.0 premature deaths per 100,000 county residents, a lower premature mortality rate than the 356.5 deaths per 100,000 people statewide.

23. Minnesota
> Healthiest county: Carver
> Pct. without health insurance: 6.3%
> Pct. food insecure: 7.1%
> Obesity rate: 24.2%
> 2014 unemployment rate: 3.6%

By many measures, Minnesota is one of the nation’s healthiest states. Therefore, residents of Carver, the state’s healthiest county, are perhaps some of the healthiest Americans in the country. Only 8.6% of adults in the area say they are in poor or fair health, lower than the 10.7% and 14.0% of adults who report such poor health across the state and the nation. Also, the incidence of premature death of fewer than 200 per 100,000 county residents is lower than the level of preventable deaths across the state, which at 262 per 100,000 people is the lowest of all states.

24. Mississippi
> Healthiest county: Rankin
> Pct. without health insurance: 15.5%
> Pct. food insecure: 14.7%
> Obesity rate: 31.3%
> 2014 unemployment rate: 4.7%

Mississippi is one of the least healthy states and the only place in the country where more than 10,000 years of potential life are lost due to premature death per 100,000 people. Although Rankin County residents are the healthiest in the state, they are still less healthy than the average American.

Rankin County’s 31.3% obesity rate is lower than the statewide 35.3% figure, yet still significantly higher than the national 27.0% obesity rate. Similarly, the 28.8% of county adults who do not exercise is a smaller share than the 33.4% of sedentary residents statewide, but it is far greater than the national figure of 23.0% of Americans who report no physical activity.

25. Missouri
> Healthiest county: St. Charles
> Pct. without health insurance: 9.7%
> Pct. food insecure: 11.8%
> Obesity rate: 28.3%
> 2014 unemployment rate: 4.8%

Missouri residents are some of the nation’s least healthy Americans compared to other state populations. St. Charles residents are substantially healthier than Missouri residents overall. People in St. Charles are relatively wealthy and have the benefit of a safe community, each major factors contributing to stronger health outcomes. The typical area household earns $74,220 annually, far more than households across the state and the nation. There are also fewer than 150 violent crimes per 100,000 county residents annually, in stark contrast with the state violent crime rate of 452 incidents per 100,000 Missourians.

26. Montana
> Healthiest county: Gallatin
> Pct. without health insurance: 17.0%
> Pct. food insecure: 13.1%
> Obesity rate: 16.4%
> 2014 unemployment rate: 3.5%

Gallatin, located in the Rocky Mountains, is the healthiest county in Montana. County residents may be taking advantage of their proximity to Yellowstone National Park, as only 14.7% of adults do not exercise, a much lower figure than the state’s 22.0% inactivity rate. Residents maintain other relatively healthy habits as well. Only 14.7% of adults smoke, lower than the statewide 17.9% smoking rate. In Gallatin County, healthy behaviors likely yield healthy outcomes. For every 100,000 county residents, 233 die before the age of 75 — more than 100 fewer premature deaths than the corresponding statewide rate of 339 deaths per 100,000 residents.

27. Nebraska
> Healthiest county: Seward
> Pct. without health insurance: 9.1%
> Pct. food insecure: 11.7%
> Obesity rate: 29.1%
> 2014 unemployment rate: 3.0%

Nebraska is one of the healthier states, and Seward is one of the healthiest counties in the nation. The average county resident feels physically unhealthy for just 2.5 days each month compared to 2.9 days for the average Nebraskan and 3.5 days for the average American.

Unlike many of the healthiest counties in the United States, Seward County residents are about as idle as the state as a whole. The county’s population is significantly more rural than the state as a whole, and only 48.3% of residents have access to locations for physical activity, compared to 79.7% who do statewide.

28. Nevada
> Healthiest county: Douglas
> Pct. without health insurance: 20.2%
> Pct. food insecure: 14.1%
> Obesity rate: 22.4%
> 2014 unemployment rate: 7.9%

Like the healthiest county in most states, Douglas residents have healthier behaviors and better health outcomes compared to people across the state and country as a whole. With a smoking rate of 15.3%, area residents are less likely to use tobacco than Nevadans or Americans in general. Regular physical activity is also important — not only to combat obesity, but also for overall mental and physical health. Only 16.0% of Douglas residents report completely sedentary lifestyles, a relatively low percentage compared to the 20.9% of adults statewide and the 23.0% of adults nationally who report no physical activity whatsoever.

29. New Hampshire
> Healthiest county: Rockingham
> Pct. without health insurance: 10.7%
> Pct. food insecure: 9.1%
> Obesity rate: 25.7%
> 2014 unemployment rate: 4.7%

Many believe that country living supports healthy lifestyles. While this may be true for some, residents of rural areas are more likely to smoke, less likely to eat healthy foods, and they tend to exercise less compared to urban dwellers. In New Hampshire, a relatively rural state, the population bucks this trend. In Rockingham, the state’s healthiest county, residents seem to have access to the best of both worlds. Rockingham is part of the Boston-Cambridge-Newton metro area, but is still has a larger share of residents living rural areas than the country as a whole. Residents benefit from employment opportunities, higher incomes, and access to more options for staying healthy. Of adults in the area, 11.5% report fair or poor health, slightly lower than the state share of people who report such poor health, which itself is among the lowest such percentages in the country.

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30. New Jersey
> Healthiest county: Hunterdon
> Pct. without health insurance: 7.7%
> Pct. food insecure: 7.2%
> Obesity rate: 21.3%
> 2014 unemployment rate: 4.7%

Hunterdon County is a wealthy suburb in the New York-Newark-Jersey City metropolitan area. Only 9.6% of residents report being in fair or poor health, making it one of only a few U.S. counties where less than one in 10 residents report such levels of health.

High incomes likely help keep negative health outcomes at bay. The typical county household earns $103,876 a year, the most in New Jersey and the eighth most of any county nationwide. Children are much more susceptible to the negative health effects caused by financial instability than adults. Just 4.6% of Hunterdon County children live in poverty, far less than the 15.8% statewide child poverty rate and the 22.0% national rate.

31. New Mexico
> Healthiest county: Los Alamos
> Pct. without health insurance: 5.3%
> Pct. food insecure: 13.3%
> Obesity rate: 20.3%
> 2014 unemployment rate: 4.1%

The stark contrast between the health of Los Alamos residents and the health of New Mexicans overall reveals poor distribution of income in the state. While, by many measures, New Mexico is one of the least healthy states, Los Alamos residents are some of the wealthiest and healthiest Americans. A typical county household earns $108,477 annually, more than double both the state and national median incomes. Also, just 4.6% of children live in poverty in Los Alamos, a fraction of the statewide child poverty rate of 28.0%, which is the second highest of all states. The incidence of preventable death in Los Alamos of 177 per 100,000 people annually is also lower than half the state’s premature death rate.

32. New York
> Healthiest county: Nassau
> Pct. without health insurance: 10.3%
> Pct. food insecure: 15.3%
> Obesity rate: 22.7%
> 2014 unemployment rate: 4.8%

Primarily as a result of financial well-being and greater access to adequate health care and infrastructure, Nassau residents are less likely than New Yorkers in general and Americans nationwide to report physically or mentally unhealthy days as well as poor health overall. The incidence of preventable death, at 237 lives lost before age 75 per 100,000 area residents, is also lower in the county.

Nearly all residents — 99.0% — have access to exercise venues, and only 10.3% of people do not have health insurance. Also, there are far more doctors and dentists available to area residents relative to the state and national dentist and doctor to population ratios.

33. North Carolina
> Healthiest county: Orange
> Pct. without health insurance: 15.3%
> Pct. food insecure: 15.4%
> Obesity rate: 19.9%
> 2014 unemployment rate: 4.4%

While North Carolina is one of the less healthy states, high incomes and educational attainment in Orange County likely helps residents maintain relatively healthy lifestyles. The typical county household earns $60,304 a year, much more than the statewide median household income of $46,596. Similarly, the presence of large research universities in the county may help explain the 80.1% of young working-age adults who have completed at least some college, the highest in North Carolina and nearly the highest nationwide.

Residents maintain healthier habits than state residents overall. Just 15.1% of adults do not exercise compared to the 25.0% state inactivity rate. Also, just 19.9% of adults are obese, a smaller share than the 29.1% obesity rate across North Carolina.

34. North Dakota
> Healthiest county: Sargent
> Pct. without health insurance: 10.1%
> Pct. food insecure: 5.7%
> Obesity rate: 31.7%
> 2014 unemployment rate: 2.4%

Unlike many of the healthiest counties, Sargent County’s population is somewhat idle. The county is entirely rural, and just two in five residents have adequate access to opportunities for physical activity. Likely as a result, 33.0% of county adults do not exercise, higher than the statewide inactivity rate of 25.2%. Also, the county’s 31.7% obesity rate is higher than the 30.2% state rate.

Nevertheless, Sargent County residents have the best health outcomes in the state. Just 10.3% of adults report being in fair or poor health, lower than the 12.1% state rate. Likewise, county residents report feeling in poor physical and mental health for 2.4 days a month on average, among the least in North Dakota and nationwide.

35. Ohio
> Healthiest county: Delaware
> Pct. without health insurance: 7.4%
> Pct. food insecure: 9.9%
> Obesity rate: 27.1%
> 2014 unemployment rate: 4.0%

Education helps support healthy lifestyles in a variety of ways, and the high education level among Delaware County residents likely helps explain the area’s state-leading health outcomes. The county’s high school graduation rate of 96.6% and the percentage of young working-age adults who have completed at least some college of 83.1% are each far higher than the respective state and national rates. Partially as a result, Delaware county’s median annual household income of $97,802 is one of the highest not just in Ohio but of any U.S. county. Financial stability likely helps county residents stay healthy. Less than than 10% of adults say they are in poor or fair health, one of the lowest shares of adults reporting such low levels of health.

36. Oklahoma
> Healthiest county: Kingfisher
> Pct. without health insurance: 22.6%
> Pct. food insecure: 11.3%
> Obesity rate: 29.1%
> 2014 unemployment rate: 3.1%

Oklahoma is one of the least healthy states in the nation. While Kingfisher County residents are the healthiest in the state, they are still less healthy than the average American. The county’s obesity rate of 29.1% is lower than the state rate of 32.4% yet still higher than the national rate of 27.0%. Health outcomes in Kingfisher County are also better than those of the average Oklahoman but worse than those of the average American. For every 100,000 county residents, 382 die before the age of 75, a lower incidence of premature death than the state rate of 452.7 premature deaths per 100,000 people, but higher than the national rate of 330 premature deaths per 100,000 Americans.

37. Oregon
> Healthiest county: Washington
> Pct. without health insurance: 14.9%
> Pct. food insecure: 12.4%
> Obesity rate: 24.4%
> 2014 unemployment rate: 5.7%

As in many other healthy counties, the better health of Washington residents can be partially attributed to the benefits of living in a major metropolitan area. The county is part of the Portland-Vancouver-Hillsboro urban region, where the greater access to health services and employment opportunities helps residents stay healthier.

Nearly all of the area’s adults have access to exercise venues such as gyms and parks, versus the state and national proportions of 87.7% and 84.0% of adults with similar access. Likely as a consequence, relatively few Washington County residents, 13.7%, report completely sedentary lifestyles — a much lower percentage than the state and national shares.

38. Pennsylvania
> Healthiest county: Chester
> Pct. without health insurance: 8.8%
> Pct. food insecure: 9.5%
> Obesity rate: 23.9%
> 2014 unemployment rate: 4.1%

Social isolation increases the risk of adverse health outcomes and is particularly common among adults and children in single-parent households. Of households in Chester, Pennsylvania’s healthiest county, 18.1% are single-parent households. By contrast, 33.4% of households statewide and nationwide are single-parent households, which could partly explain the relatively good health of county residents.

County residents also have relatively healthy behaviors. For example, just 14.4% of adults smoke, well below the state and national smoking rates of 18.9% and 17.0%, respectively.

39. Rhode Island
> Healthiest county: Bristol
> Pct. without health insurance: 10.8%
> Pct. food insecure: 11.9%
> Obesity rate: 21.3%
> 2014 unemployment rate: 6.4%

Residents of Bristol, Rhode Island’s healthiest county, have adequate access to affordable and nutritious food, a major factor in the health of a population. Across the state and the nation, more than one in every five children lives in poverty. In Bristol, the child poverty rate is less than one in 10. The county’s food insecurity rate of 11.9% is also lower than the state and national rates.

Area residents also benefit from living in a relatively safe community. Each year, there are 85 violent crimes per 100,000 people in Bristol, far lower than the state violent crime rate of 252 incidents per 100,000 and one of the lowest in the country.

40. South Carolina
> Healthiest county: Beaufort
> Pct. without health insurance: 21.9%
> Pct. food insecure: 12.2%
> Obesity rate: 22.5%
> 2014 unemployment rate: 5.7%

South Carolina’s population is not especially healthy, which could explain why residents of Beaufort, the state’s healthiest county, do not stand out relative to Americans overall. In fact, the percentage of adults without health insurance in Beaufort of 21.9% is worse than the national uninsured rate of 17%. Similarly, 18.8% of county adults report excessive drinking, higher than the national percentage.

County residents are still far better off healthwise compared to South Carolinians. The county reports far fewer preventable deaths than the state as a whole. Also, while the 12.6% of county adults who report fair or poor health is only slightly lower than the national percentage, it is well below the state share of 17.4% who say they are in such poor health.

41. South Dakota
> Healthiest county: Lincoln
> Pct. without health insurance: 6.9%
> Pct. food insecure: 8.6%
> Obesity rate: 28.3%
> 2014 unemployment rate: 2.4%

Staying healthy is often quite expensive, and the healthiest counties in the United States are often home to some of the nation’s wealthiest individuals. Lincoln is no exception. The typical household in the area earns $79,857 annually, in stark contrast with the state median household income of $51,059, which is lower than the national figure. Perhaps due in part to the greater access to costly but healthful activities and medical care, only 8.9% of adults report fair or poor health, far lower than both the state and national percentages. On the other hand, while Lincoln’s obesity rate of 28.3% is lower than South Dakota’s obesity rate, it is higher than the national rate of 27.0%.

42. Tennessee
> Healthiest county: Williamson
> Pct. without health insurance: 8.9%
> Pct. food insecure: 9.4%
> Obesity rate: 27.2%
> 2014 unemployment rate: 4.5%

Compared to Tennesseans as a whole, who are some of the nation’s least healthy residents, Williamson residents are exceptionally healthy. Due in part to access to health care services and healthy living options, people in Williamson tend to live relatively long lives. For instance, only 8.9% of adults do not have health insurance, and 9.4% of residents do not have access to a reliable food source, each among the lowest such rates in the country. The incidence of preventable death in Williamson, at 196 deaths per 100,000 people, is less than half the state premature death rate and one of the lowest nationwide.

High incomes also help explain the high level of health. The typical household earns $97,936 annually, more than double the state median household income and one of the highest of all U.S. counties.

43. Texas
> Healthiest county: Collin
> Pct. without health insurance: 16.2%
> Pct. food insecure: 16.7%
> Obesity rate: 25.0%
> 2014 unemployment rate: 4.5%

Nearly 20% of Texan adults say they are in poor or fair health, higher than the percentage of adults nationwide reporting such low levels of health. In Collin, the state’s healthiest county, only 10.7% assess their health so poorly. Healthy behaviors in the area partly account for the strong self assessments. For example, 11.7% of adults smoke in Collins, lower than the state smoking rate of 14.7%, itself better than the national smoking rate of 17.0%. Financial well-being is also a major contributor to strong health. Statewide, 24.5% of children live in poverty, higher than the national child poverty rate of 22.0%. In Collins, on the other hand, 9.0% of children live in poverty.

44. Utah
> Healthiest county: Morgan
> Pct. without health insurance: 9.9%
> Pct. food insecure: 11.0%
> Obesity rate: 22.5%
> 2014 unemployment rate: 3.4%

Utah residents are some of the nation’s healthiest residents. Compared to other states, Utah has the lowest smoking rate and the lowest incidence of alcohol impaired deaths, for example. In both of these measures, Morgan residents fare even better. Single-parent households are often more vulnerable to social isolation and other hindrances to well-being. In Utah, 18.6% of households are single-parent households, also the lowest of all states. In Morgan, the percentage is half the state rate, at 9.0%.

While the nation’s healthiest counties are relatively clustered around major metropolitan areas and often relatively urban, 62.8% of Morgan’s population lives in a rural setting, far higher than the state and national percentages.

45. Vermont
> Healthiest county: Chittenden
> Pct. without health insurance: 7.6%
> Pct. food insecure: 12.5%
> Obesity rate: 20.9%
> 2014 unemployment rate: 3.1%

Just 10% of Vermonters say they are in poor or fair health, the lowest percentage of all states. Of adults living in Chittenden, the state’s healthiest county, an even lower 8.4% assess their health so poorly. Chittenden is home to Burlington. As the state’s largest city, area residents have greater access to employment opportunities as well as health services common in more urban regions. Only 3.1% of Chittenden’s workforce is unemployed, one of the lowest rates of any U.S. county. The ratio of primary care physicians to area residents, at 1 to 558, is also far better than most areas in both the state and nationwide.

46. Virginia
> Healthiest county: Arlington
> Pct. without health insurance: 10.5%
> Pct. food insecure: 8.7%
> Obesity rate: 16.9%
> 2014 unemployment rate: 3.2%

The country’s healthiest areas tend to cluster around major metropolitan areas in general, and the healthiest Americans are especially concentrated around the nation’s capital. Arlington, Virginia’s healthiest county, is in the Washington D.C. metro area, where high incomes, excellent access to services, and relatively healthy behaviors help make the population one of the healthiest in the United States. The typical Arlington household earns $107,143 a year, close to double the national median. Only 10.5% of area residents do not have health insurance, versus the respective state and national uninsured rates of 14.0% and 17.0%. The county’s obesity rate of 16.9% is also substantially lower than it is across the state and the nation, where around 27% of adults are obese.

47. Washington
> Healthiest county: King
> Pct. without health insurance: 13.7%
> Pct. food insecure: 13.4%
> Obesity rate: 22.3%
> 2014 unemployment rate: 4.6%

King County residents, many of whom live in Seattle, are the healthiest in Washington. Access to medical professionals and health services are among several contributors to good health in the area. The ratio of primary care physicians and dentists to the population, at 1 to 839 and 1 to 978 respectively, are each among the best in the country. Nearly all county residents also have access to exercise venues, which partially explains the relatively low rates of physical inactivity.

On the other hand, the county is not especially safe compared to the state. There are 343 violent crimes per 100,000 people annually, lower than the national violent crime rate but still considerably higher than the state rate of 301 incidents per 100,000 people.

48. West Virginia
> Healthiest county: Jefferson
> Pct. without health insurance: 15.9%
> Pct. food insecure: 11.3%
> Obesity rate: 32.5%
> 2014 unemployment rate: 4.5%

Jefferson county is part of the Washington D.C. metro area, and many residents benefit from the economic opportunities available in the nation’s capital. However, West Virginians as a whole are some of the nation’s least healthy Americans, and residents of the state’s healthiest county are not especially healthy compared to residents nationwide. For example, with 337 deaths before age 75 per 100,000 people occurring each year, preventable deaths in Jefferson county are far less common than they are across the state but still more common than they are nationwide. Similarly, while the percentage of adults who say they are in fair or poor health of 17.9% is lower than the state’s nation-leading 21.6% of adults, it is still worse than the 14.0% of adults nationwide who assess their health poorly.

49. Wisconsin
> Healthiest county: Ozaukee
> Pct. without health insurance: 6.0%
> Pct. food insecure: 8.7%
> Obesity rate: 27.3%
> 2014 unemployment rate: 4.3%

The population of Ozaukee, Wisconsin’s healthiest county, is relatively well educated. The high school graduation rate of 94.6% is much higher than the respective state and national rates of 88.0% and 82.0%. While around 66.8% of young working-age adults across the state have completed at least some college, slightly higher than the national rate, 81.7% of young adults in Ozaukee have similar education. A good education often improves job opportunities, but it also often leads to healthier lifestyle choices. In Ozaukee, 12.9% of adults smoke, well below the state and national smoking rates of 16.3% and 17.0%, respectively. Fewer than one in every 10 adults say they are in fair or poor health, also well below the state and national proportions of adults reporting such poor health.

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50. Wyoming
> Healthiest county: Teton
> Pct. without health insurance: 19.9%
> Pct. food insecure: 12.1%
> Obesity rate: 12.5%
> 2014 unemployment rate: 4.8%

As is the case in many of the nation’s healthiest counties, financial stability among Teton residents likely contributes to the good health of the population. Across the state, 13.7% of children live in poverty, nearly the lowest child poverty rate of all states. In Teton, 9.5% of children live in poverty.

Good habits also help Teton residents stay healthy. Only 10.6% of adults report completely sedentary lifestyles, less than half the proportion of adults statewide and nationwide who report absolutely no physical activity. The obesity rate of 12.5% in Teton is exceptionally low even among the country’s healthiest areas. It is in stark contrast to the state and national obesity rates of 26.6% and 27.0%, respectively.