Special Report

The Healthiest City in Every State

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Montana: Missoula
> Adult obesity rate: 22.2% (state: 25.8%)
> Adult smoking rate: 17.0% (state: 17.2%)
> Pct. of adults who exercise: 83.3% (state: 78.4%)
> Residents with health insurance: 91.4% (state: 89.6%)
> Median household income: $57,347 (state: $57,153)

Obesity is one of the most direct indicators of poor health, and the condition is associated with many of the most common life-threatening conditions, including heart disease, cancer, diabetes, and hypertension. In Missoula, just 22.2% of adults are obese, compared to the state obesity rate of 25.8% and a national obesity rate of 29.0%.

One likely reason for the metro area’s relatively low obesity rate is the level of exercise the population reports. About 16.7% of Missoula residents report no leisure time physical activity, one of the lowest shares among all metro areas nationwide and well below the national inactivity rate of 23%. The metro area’s premature death rate is also lower than both the state and national averages.

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Nebraska: Lincoln
> Adult obesity rate: 28.8% (state: 32.2%)
> Adult smoking rate: 12.9% (state: 15.4%)
> Pct. of adults who exercise: 82.2% (state: 76.7%)
> Residents with health insurance: 91.7% (state: 90.4%)
> Median household income: $61,539 (state: $63,229)

Lincoln is the only metro area in Nebraska where the adult obesity rate, at 28.8%, is lower than the state’s adult obesity rate of 32.2%. Additionally, just 13.5% of adults in Lincoln report being in fair or poor health, the smallest share of any metro area in the state and below the 14.4% share of adults statewide.

Adults with a college education typically have a greater sense of control over their lives and are better equipped to make healthier choices. In Lincoln, 39.7% of adults have a bachelor’s degree, well above the state bachelor’s degree attainment rate of 33.2% and the national rate of 33.1%.

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Nevada: Reno
> Adult obesity rate: 23.3% (state: 25.7%)
> Adult smoking rate: 15.2% (state: 17.6%)
> Pct. of adults who exercise: 81.5% (state: 76.9%)
> Residents with health insurance: 87.6% (state: 86.9%)
> Median household income: $72,132 (state: $63,276)

None of Nevada’s three metro areas — Reno, Las Vegas, and Carson City — are perfect models of good health behaviors or outcomes. Adults in all three, for example, report more days of poor physical health a month than the national average. However, Reno compares favorably to the other two in several important indicators.

Notably, Reno has by far the lowest adult obesity rate, at just 23.3%, compared to a national obesity rate of 29.0%. Reno’s adults are also the least likely in the state to have sedentary lifestyles. Just 18.5% of city adults report no leisure time physical activity, compared to 22.3% in Carson City and 23.9% in Las Vegas.

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New Hampshire: Manchester-Nashua
> Adult obesity rate: 28.0% (state: 27.9%)
> Adult smoking rate: 13.5% (state: 15.7%)
> Pct. of adults who exercise: 77.5% (state: 78.7%)
> Residents with health insurance: 92.8% (state: 93.0%)
> Median household income: $83,626 (state: $77,933)

Manchester is the only metro area in New Hampshire and therefore ranks as the healthiest city by default. In fact, Manchester is slightly less healthy than the state as a whole in some measures of health outcomes. For example, the city’s premature mortality rate of 313 deaths before age 75 per 100,000 people is slightly higher than the comparable state rate of 308 per 100,000.

Despite a higher premature mortality rate, Manchester residents are more likely to exhibit certain healthier habits than the typical New Hampshire resident. Just 13.5% of metro area adults smoke and 20.2% drink excessively, compared to 15.7% and 20.7% of adults statewide, respectively.

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New Jersey: Trenton
> Adult obesity rate: 25.8% (state: 26.4%)
> Adult smoking rate: 13.6% (state: 13.7%)
> Pct. of adults who exercise: 75.7% (state: 74.0%)
> Residents with health insurance: 90.3% (state: 91.0%)
> Median household income: $79,492 (state: $85,751)

Those who have health insurance are more likely to receive adequate and timely medical care than those without it. In Trenton, just 9.7% of residents under age 65 do not have health insurance coverage, slightly below the national share of 10.0%.

Perhaps the most telling measure of positive health outcomes in Trenton is the metro area’s premature mortality rate. There are 302 deaths before age 75 out of every 100,000 metro area residents, by far the lowest in New Jersey. Of the three remaining metro areas in the state, the next lowest premature mortality rate is Ocean City’s at 402 per 100,000.