Special Report

The Healthiest States in America

Source: thinair28 / Getty Images

15. Virginia
> Premature death rate (per 100,000): 6,914 (20th lowest)
> Adult obesity rate: 30.3% (22nd lowest)
> Adult smoking rate: 14.9% (17th lowest)
> Median household income: $72,577 (10th highest)

Virginia residents report some of the healthiest behaviors of any state. While nationwide 23.8% of U.S. adults do not exercise regularly, in Virginia just 22.0% of adults are inactive — one of the smaller shares of any state. Similarly, just 14.9% of Virginia adults smoke, less than the 16.1% national smoking rate.

One factor contributing to Virginia’s above-average health outcomes and behaviors may be income. It has the tenth highest median household income, at $72,577, compared to the U.S. median of $61,937. Also, 10.7% of households in Virginia earn more than $200,000 a year, the sixth largest share among all states.

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Source: chicablanca / Getty Images

14. North Dakota
> Premature death rate (per 100,000): 6,914 (20th lowest)
> Adult obesity rate: 35.1% (8th highest)
> Adult smoking rate: 19.1% (12th highest)
> Median household income: $63,837 (18th highest)

Even though North Dakota has the 12th highest adult smoking rate and the eighth highest obesity rate in the United States, fewer residents die from cancer and heart disease — the two leading causes of death in the United States– than in a majority of the country. The state has the 10th lowest rate of both cancer and cardiovascular deaths at 176.8 and 227.5 deaths per 100,000 people, respectively. By comparison, the national average is 189.3 cancer deaths and 260.4 heart disease deaths per 100,000 people.

The state also has a relatively small share of adults reporting frequent physical distress, a measure associated with chronic health conditions like diabetes and hypertension. Just 9.8% of adults in North Dakota report feeling in poor physical health for more than 14 days a month, the fifth smallest share of any state and far below the national rate of 12.0%.

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Source: Rhode Island College (RIC)

13. Rhode Island
> Premature death rate (per 100,000): 6,602 (13th lowest)
> Adult obesity rate: 27.7% (11th lowest)
> Adult smoking rate: 14.6% (15th lowest)
> Median household income: $64,340 (17th highest)

Some 89.1% of adults in Rhode Island have at least a high school diploma, slightly above the 88.3% national high school attainment rate. Educational attainment is one of the strongest predictors of health outcomes. Nationwide, the share of adults with a diploma who say they are in optimal health is 27.6 percentage points higher than adults without a diploma. In Rhode Island, the difference is 31.5 percentage points.

The state has the highest immunization rates for various diseases, including human papillomavirus, the most common sexually transmitted infection; meningitis; and diphtheria, tetanus, and whooping cough (the Tdap vaccine). Most people in Rhode Island have health insurance, which may improve health outcomes as it allows for easier access to health care. Only 4.4% of the population lacks health insurance — the fifth lowest percentage in the country and half the national figure.

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12. California
> Premature death rate (per 100,000): 5,665 (the lowest)
> Adult obesity rate: 25.8% (5th lowest)
> Adult smoking rate: 11.2% (2nd lowest)
> Median household income: $75,277 (6th highest)

In California there are 5,665 premature deaths per 100,000 residents, the lowest rate in all of the United States. The cancer death rate in the Golden State is also among the lowest in the country — 168.9 per 100,000 people, compared to the national rate of 189.3 per 100,000 people annually.

Californians also tend to have healthy habits. For example, only 21.0% of adults report no physical activity, the 10th lowest figure nationwide, and only 11.2% of adults say they are regular smokers, the second lowest rate in the country.

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11. New York
> Premature death rate (per 100,000): 5,830 (3rd lowest)
> Adult obesity rate: 27.6% (9th lowest)
> Adult smoking rate: 12.8% (6th lowest)
> Median household income: $67,844 (14th highest)

New York has the third highest number of doctors per capita, which is one factor that helps it rank among the healthiest states. There are 230.7 primary care physicians per 100,000 people in the Empire State, compared to a rate of 159.6 doctors nationwide. According to the United Health Foundation, a large number of general practitioners in an area may lead to better health outcomes and reductions in health disparities across population subgroups.

New York ranks among the healthiest states also because of the amount of money it spends on public health. New York spends an average of $148 per person on public health annually, the fifth most of any state.

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