Special Report

The Healthiest City in Every State

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Hawaii: Urban Honolulu
> Adult obesity rate: 23.4% (state: 23.7%)
> Adult smoking rate: 11.0% (state: 12.8%)
> Pct. of adults who exercise: 79.4% (state: 79.5%)
> Residents with health insurance: 95.9% (state: 95.4%)
> Median household income: $87,470 (state: $83,102)

Of the two metro areas in Hawaii — Kahului-Wailuku-Lahaina and Honolulu — Honolulu is the healthiest. Unlike the other metro area, adults in Honolulu are less likely to be obese and less likely to smoke than those in the Kahului-Wailuku-Lahaina metro area.

Americans with health insurance are more likely to make regular doctor visits for checkups and preventative care, and in Honolulu, only 4.1% of the population under 65 is uninsured, below both the 5.4% uninsured rate in Kahului-Wailuku-Lahaina and the state uninsured rate of 4.6%.

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Idaho: Boise City
> Adult obesity rate: 29.6% (state: 29.3%)
> Adult smoking rate: 12.8% (state: 14.3%)
> Pct. of adults who exercise: 81.5% (state: 79.2%)
> Residents with health insurance: 89.1% (state: 88.2%)
> Median household income: $66,466 (state: $60,999)

Boise City ranks as the healthiest of Idaho’s five metro areas. Metro area adults report the fewest days per month of poor physical health as well as the fewest average days per month of poor mental health in the state.

Those in the workforce who are steadily employed are less likely to deal with the stress associated with unemployment and are less likely to face poverty and financial uncertainty. Unemployed people are likely for a number of reasons to have worse health outcomes. Boise’s 2019 unemployment rate, however, was just 2.7%, one of the lowest among U.S. metro areas.

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Illinois: Bloomington
> Adult obesity rate: 33.1% (state: 29.7%)
> Adult smoking rate: 15.0% (state: 15.5%)
> Pct. of adults who exercise: 76.6% (state: 77.7%)
> Residents with health insurance: 94.9% (state: 92.1%)
> Median household income: $68,784 (state: $69,187)

Just 14.7% of adults in Bloomington report being in fair or poor health, the second smallest share of the 10 metro areas in Illinois. The better outcome is due in part to healthier behaviors. For instance, adults in Bloomington are less likely to smoke than adults across the state as a whole. Additionally, with a 5.1% uninsured rate — the lowest of any metro area in the state — Bloomington residents are more likely to make regular visits to the doctor and receive preventive medical care.

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Indiana: Columbus
> Adult obesity rate: 32.3% (state: 33.4%)
> Adult smoking rate: 18.6% (state: 21.8%)
> Pct. of adults who exercise: 74.7% (state: 73.3%)
> Residents with health insurance: 90.1% (state: 90.4%)
> Median household income: $72,555 (state: $57,603)

The Columbus metro area ranks as the healthiest of Indiana’s 12 metropolitan statistical areas, but compared to the country as a whole, the city ranks as average to slightly worse than average.

There are some exceptions, however. The metro area has a below average rate of newborns with low birth weight, a common indicator of poor regional health. Additionally, the metro area’s flu vaccination rate of 55.0% is significantly higher than both the state rate of 49.0% and the national flu vaccination rate of 46.0%. The premature mortality rate of 369 deaths before age 75 for every 100,000 people is far below the state rate of 401 per 100,000.

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Iowa: Ames
> Adult obesity rate: 26.2% (state: 33.2%)
> Adult smoking rate: 14.9% (state: 17.1%)
> Pct. of adults who exercise: 82.8% (state: 76.3%)
> Residents with health insurance: 94.7% (state: 94.5%)
> Median household income: $62,181 (state: $61,691)

Ames has the lowest premature death rate of any metro area in Iowa. This is likely due in part to healthier behaviors, as adults in Ames are more likely to exercise than adults across the state as a whole. The metro area is one of two in Iowa with an adult obesity rate lower than the national rate of 29.0%, and much lower than the state obesity rate of 33.2%.

The high exercise rate among adults in Ames is partially attributable to the presence of certain amenities in the city. For example, 93.1% of the metro area population has easy access to places for physical activity like parks and recreation centers, the largest share of any metro area in the state.