Special Report

The Healthiest City in Every State

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South Dakota: Sioux Falls
> Adult obesity rate: 32.2% (state: 31.8%)
> Adult smoking rate: 14.9% (state: 19.3%)
> Pct. of adults who exercise: 80.2% (state: 78.7%)
> Residents with health insurance: 91.8% (state: 89.2%)
> Median household income: $65,566 (state: $59,533)

Of the two metro areas in South Dakota — Sioux Falls and Rapid City — Sioux Falls is the healthiest. Unlike in Rapid City, adults in Sioux City report fewer than three physically unhealthy days and fewer than three mentally unhealthy days per month on average.

Americans with health insurance are more likely to make regular doctor visits, and in Sioux Falls, 8.2% of the population lacks health insurance compared to 11.4% of Rapid City residents.

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Tennessee: Nashville-Davidson–Murfreesboro–Franklin
> Adult obesity rate: 31.4% (state: 33.2%)
> Adult smoking rate: 18.5% (state: 22.6%)
> Pct. of adults who exercise: 75.5% (state: 72.8%)
> Residents with health insurance: 89.0% (state: 88.7%)
> Median household income: $70,262 (state: $56,071)

The typical household in the Nashville metro area earns $70,262 a year, approximately $14,000 more than the median household income across Tennessee as a whole and the most of any city in the state. People with higher incomes tend to have greater access to quality health care and have better health outcomes overall.

In Nashville, 17.0% of adults report being in fair or poor health, the smallest share in Tennessee and far below the 19.7% share of adults across the state. Some 384 in every 100,000 residents in Nashville die before the age of 75 annually, far less than the state premature mortality rate of 451 per 100,000 and the lowest of any city in the state.

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Texas: Austin-Round Rock
> Adult obesity rate: 26.6% (state: 30.1%)
> Adult smoking rate: 12.9% (state: 15.7%)
> Pct. of adults who exercise: 81.8% (state: 75.6%)
> Residents with health insurance: 85.6% (state: 80.6%)
> Median household income: $80,954 (state: $64,034)

Of the 25 metro areas in Texas, Austin is by far the healthiest. Only 26.6% of adults in the metro area are obese, the smallest share of any city in the state and well below the 30.1% state obesity rate. Regular physical activity can help in maintaining a healthy weight, and in Austin, only 18.2% of adults do not exercise, well below the 24.4% inactivity rate across the state as a whole.

Wealthier individuals tend to have better access to health care and can afford a greater range of healthy options related to diet and lifestyle, and incomes tend to be higher than average in Austin. The typical metro area household earns $80,954 a year, well above the median household income of $64,034 across Texas.

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Utah: Provo-Orem
> Adult obesity rate: 25.1% (state: 25.9%)
> Adult smoking rate: 6.0% (state: 8.9%)
> Pct. of adults who exercise: 84.1% (state: 81.9%)
> Residents with health insurance: 91.9% (state: 90.0%)
> Median household income: $79,152 (state: $75,780)

Provo-Orem has one of the lowest premature mortality rates in the United States. There are 254 deaths before age 75 for every 100,000 people annually in the metro area. Across the state, there are 289 premature deaths for every 100,000 people and 340 per 100,000 nationwide.

The low premature death rate is partially attributable to healthy habits. For example, Provo is one of only two metro areas in the United States where fewer than one in every 10 adults drink excessively. Additionally, just 6.0% of area adults smoke, the lowest smoking rate in the country and well below the 8.9% rate statewide, and 17.0% rate nationwide.

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Vermont: Burlington-South Burlington
> Adult obesity rate: 25.6% (state: 26.3%)
> Adult smoking rate: 12.8% (state: 15.8%)
> Pct. of adults who exercise: 82.8% (state: 80.9%)
> Residents with health insurance: 95.0% (state: 94.5%)
> Median household income: $74,909 (state: $63,001)

Burlington is the only metro area in Vermont, and as a result, it ranks as the healthiest city in the state by default. Still, by several measures, city residents are more likely to report healthier lifestyles and have better health outcomes than the average Vermont resident. For example, just 12.8% of adults in Burlington smoke, compared to the 15.8% state smoking rate. Adults in Burlington are also more likely to regularly exercise and less likely to be obese than the typical adult in the state.

Healthy behaviors can lead to healthy outcomes, and in Burlington, adult residents report an average of just 4.0 mentally unhealthy days per month, compared to an average of about 4.5 days across the state.