> Healthiest county: Gallatin
> Smoking rate: 13.5%
> Obesity rate: 15.5%
> Median household income: $55,553
Gallatin County is situated in the southwestern corner of Montana and contains a slight portion of Yellowstone National Park. With access to several national parks and forests, just 13.0% of county adults do not exercise, a smaller share than both the 20.5% state and 22.0% national inactivity rates. Additionally, only 13.5% of adults in the county smoke, less than both the 18.9% state and 18.0% national rates.
Healthy behaviors reduce the risk of premature death. In Gallatin County, 216 people die before the age of 75 per 100,000 people annually, less than the state premature mortality rate of 345 deaths per 100,000 residents and the national rate of 333 deaths per 100,000 Americans.
> Healthiest county: Polk
> Smoking rate: 14.2%
> Obesity rate: 29.5%
> Median household income: $57,312
Based on a number of self-reported measures of health outcomes, the typical Nebraskan is healthier than the typical American. For example, adults in Nebraska report an average of only 3.1 physically unhealthy days and 3.0 mentally unhealthy days a month compared to national averages of 3.6 and 3.7 days, respectively. In Polk County, residents are even healthier. Adults in Polk report an average of only 2.6 physically unhealthy days and 2.7 mentally unhealthy days a month.
Better self-reported outcomes in the county are likely the result of healthy behaviors. The shares of adults who smoke and drink to excess in Polk are lower than the comparable statewide shares.
> Healthiest county: Douglas
> Smoking rate: 14.7%
> Obesity rate: 21.4%
> Median household income: $58,535
Nevada is not an especially healthy state, and even the state’s healthiest county trails the nation as a whole in a number of important measures. Adults in Douglas County spend an average of 3.9 days a month in poor mental health and the same amount of time in poor physical health. By contrast, adults nationwide spend 3.7 days in poor mental health and 3.6 days in poor physical health each month on average.
Health insurance coverage helps people access needed medical care, as it encourages individuals to make regular visits to their doctor and receive preventive care. But unlike many relatively healthy areas, the 14.6% of county adults who lack insurance is slightly larger share than the 14.0% of American adults who are uninsured.
29. New Hampshire
> Healthiest county: Rockingham
> Smoking rate: 13.9%
> Obesity rate: 26.1%
> Median household income: $81,198
Located in one of the healthiest states, Rockingham County, New Hampshire is also among the healthiest areas in the nation. An estimated 90.5% of county adults report being in good or excellent health, the largest share in New Hampshire and much larger than the 85.0% national figure.
While Rockingham is the healthiest county in New Hampshire, the community has not completely resisted the opioid epidemic that has swept much of the Northeast. Roughly 62 in every 100,000 county residents die from injuries annually, the same as the national injury mortality rate. Nationwide, the leading cause of injury death is poisoning — primarily from opioid overdose.
30. New Jersey
> Healthiest county: Hunterdon
> Smoking rate: 10.9%
> Obesity rate: 22.3%
> Median household income: $105,444
Hunterdon is not only the healthiest county in New Jersey, but also one of the healthiest in the United States. Some 91% of adults in Hunterdon report being in good health, a larger share than in all but 10 other counties nationwide.
Good health outcomes may partially be the product of access to care. Only 6.2% of county residents are uninsured, less than half the statewide 12.6% uninsured rate. Even with insurance, health care can be expensive. This is not likely a major problem for many in the county, however, as the typical area household earns $105,444 a year, far more than the $72,222 median income across New Jersey and the $53,889 national median.