Special Report

The Healthiest County in Every State

okimo / iStock via Getty Images

The Roman poet Virgil said “The greatest wealth is health” more than 2,000 years ago and that still holds true. America is a wealthy country but that doesn’t necessarily mean it’s a healthy one. In fact, affluence may result in a less healthy population, as people use more labor-saving devices, exercise less, and have ready access to calorie-laden food. That said, some parts of the country are healthier than others overall.

To identify the healthiest county in every state, 24/7 Tempo reviewed data tracking rates of smoking, obesity, and physical activity from County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Counties were ranked within their state for health outcomes and health factors, which were then averaged to find the healthiest county in the state. County median household income comes from the American Community Survey 2020 five-year estimates.

The results are startling. For example, Douglas County, the healthiest county in Colorado, has an obesity rate of 21.4%. That’s the lowest rate on our list, but it still means that more than one in five people in the state is obese. (These are America’s most obese counties.) 

Click here to see the healthiest county in every state

Smoking has been described as the single most preventable cause of death, yet people across the country still smoke. Ironically, Virginia, a state strongly associated with tobacco, has a relatively low statewide smoking rate of 14.2% and has the county with the lowest rate on our list: Falls Church City (an independent city with county-level governance status), where only 8.8% of the population light up. However, neighboring West Virginia has a statewide smoking rate of 26.1% and its healthiest county, Monongalia, has a smoking rate of 20.3%. (For a number of reasons, these are the worst counties to live in.)

Physical activity is another factor strongly linked to health outcomes, and exercise rates also vary dramatically from state to state and within states. Colorado also scores well by this metric. Only a relatively low 18.7% of adults do not exercise regularly in the state and in Douglas County the figure is only 12.9%. 

Jacqueline Nix / iStock Editorial via Getty Images

1. Alabama: Shelby
> Smoking rate: 15.3% (state: 21.1%)
> Obesity rate: 30.2% (state: 36.3%)
> Adults who do not exercise regularly: 23.6% (state: 30.8%)
> Median household income: $78,889

[in-text-ad]

urbanglimpses / iStock via Getty Images

2. Alaska: Juneau
> Smoking rate: 15.1% (state: 17.3%)
> Obesity rate: 27.5% (state: 30.7%)
> Adults who do not exercise regularly: 16.7% (state: 21.6%)
> Median household income: $88,077

Sean Pavone / iStock via Getty Images

3. Arizona: Maricopa
> Smoking rate: 14.3% (state: 15.6%)
> Obesity rate: 31.0% (state: 31.9%)
> Adults who do not exercise regularly: 24.8% (state: 23.6%)
> Median household income: $67,799

raksyBH / iStock Editorial via Getty Images

4. Arkansas: Benton
> Smoking rate: 16.4% (state: 21.1%)
> Obesity rate: 29.8% (state: 38.0%)
> Adults who do not exercise regularly: 26.5% (state: 30.4%)
> Median household income: $71,556

[in-text-ad-2]

tiburonstudios / E+ via Getty Images

5. California: Marin
> Smoking rate: 9.5% (state: 10.1%)
> Obesity rate: 22.5% (state: 26.2%)
> Adults who do not exercise regularly: 17.3% (state: 22.3%)
> Median household income: $121,671

SWKrullImaging / iStock via Getty Images

6. Colorado: Douglas
> Smoking rate: 9.8% (state: 13.6%)
> Obesity rate: 21.4% (state: 23.6%)
> Adults who do not exercise regularly: 12.9% (state: 18.7%)
> Median household income: $121,393

[in-text-ad]

7. Connecticut: Middlesex
> Smoking rate: 13.2% (state: 12.6%)
> Obesity rate: 27.9% (state: 29.1%)
> Adults who do not exercise regularly: 21.3% (state: 23.3%)
> Median household income: $84,907

aimintang / iStock Unreleased via Getty Images

8. Delaware: New Castle
> Smoking rate: 15.4% (state: 16.4%)
> Obesity rate: 33.0% (state: 34.2%)
> Adults who do not exercise regularly: 26.8% (state: 25.3%)
> Median household income: $75,275

SeanPavonePhoto / iStock via Getty Images

9. Florida: St. Johns
> Smoking rate: 16.4% (state: 15.3%)
> Obesity rate: 26.7% (state: 26.3%)
> Adults who do not exercise regularly: 22.2% (state: 25.9%)
> Median household income: $83,803

[in-text-ad-2]

BOB WESTON / iStock via Getty Images

10. Georgia: Oconee
> Smoking rate: 13.6% (state: 16.5%)
> Obesity rate: 28.0% (state: 33.4%)
> Adults who do not exercise regularly: 21.8% (state: 27.4%)
> Median household income: $95,064

okimo / iStock via Getty Images

11. Hawaii: Honolulu
> Smoking rate: 13.6% (state: 12.9%)
> Obesity rate: 25.4% (state: 25.5%)
> Adults who do not exercise regularly: 25.1% (state: 23.9%)
> Median household income: $87,722

[in-text-ad]

mtcurado / Getty Images

12. Idaho: Ada
> Smoking rate: 13.2% (state: 15.9%)
> Obesity rate: 28.4% (state: 29.5%)
> Adults who do not exercise regularly: 21.1% (state: 23.3%)
> Median household income: $69,952

DenisTangneyJr / iStock via Getty Images

13. Illinois: DuPage
> Smoking rate: 11.2% (state: 14.8%)
> Obesity rate: 26.8% (state: 31.5%)
> Adults who do not exercise regularly: 22.7% (state: 25.1%)
> Median household income: $94,930

Jose A Perez / Getty Images

14. Indiana: Hamilton
> Smoking rate: 12.5% (state: 19.9%)
> Obesity rate: 26.3% (state: 35.4%)
> Adults who do not exercise regularly: 20.8% (state: 30.6%)
> Median household income: $98,880

[in-text-ad-2]

15. Iowa: Dallas
> Smoking rate: 12.8% (state: 17.4%)
> Obesity rate: 29.9% (state: 34.3%)
> Adults who do not exercise regularly: 21.7% (state: 26.1%)
> Median household income: $88,368

BOB WESTON / iStock via Getty Images

16. Kansas: Johnson
> Smoking rate: 11.9% (state: 16.8%)
> Obesity rate: 31.1% (state: 35.6%)
> Adults who do not exercise regularly: 19.3% (state: 26.7%)
> Median household income: $91,650

[in-text-ad]

17. Kentucky: Oldham
> Smoking rate: 17.0% (state: 24.5%)
> Obesity rate: 33.1% (state: 36.4%)
> Adults who do not exercise regularly: 25.3% (state: 31.6%)
> Median household income: $103,761

Judy Darby / iStock via Getty Images

18. Louisiana: St. Tammany Parish
> Smoking rate: 19.1% (state: 22.6%)
> Obesity rate: 30.7% (state: 36.2%)
> Adults who do not exercise regularly: 25.7% (state: 31.5%)
> Median household income: $70,730

Faina Gurevich / iStock via Getty Images

19. Maine: Cumberland
> Smoking rate: 14.1% (state: 19.1%)
> Obesity rate: 25.3% (state: 31.4%)
> Adults who do not exercise regularly: 24.0% (state: 29.5%)
> Median household income: $76,014

[in-text-ad-2]

AppalachianViews / iStock via Getty Images

20. Maryland: Howard
> Smoking rate: 9.6% (state: 12.8%)
> Obesity rate: 25.5% (state: 32.0%)
> Adults who do not exercise regularly: 19.4% (state: 23.0%)
> Median household income: $124,042

DenisTangneyJr / E+ via Getty Images

21. Massachusetts: Middlesex
> Smoking rate: 11.6% (state: 12.2%)
> Obesity rate: 22.6% (state: 25.4%)
> Adults who do not exercise regularly: 22.4% (state: 26.0%)
> Median household income: $106,202

[in-text-ad]

BobPalosaari / Getty Images

22. Michigan: Ottawa
> Smoking rate: 16.2% (state: 19.6%)
> Obesity rate: 31.9% (state: 35.8%)
> Adults who do not exercise regularly: 22.0% (state: 24.6%)
> Median household income: $72,418

storkalex / iStock Editorial via Getty Images

23. Minnesota: Carver
> Smoking rate: 12.9% (state: 15.0%)
> Obesity rate: 28.7% (state: 30.0%)
> Adults who do not exercise regularly: 17.9% (state: 19.7%)
> Median household income: $104,011

24. Mississippi: Madison
> Smoking rate: 13.6% (state: 21.1%)
> Obesity rate: 32.7% (state: 41.2%)
> Adults who do not exercise regularly: 28.3% (state: 36.9%)
> Median household income: $71,621

[in-text-ad-2]

TriggerPhoto / iStock via Getty Images

25. Missouri: Platte
> Smoking rate: 15.4% (state: 20.4%)
> Obesity rate: 32.2% (state: 34.6%)
> Adults who do not exercise regularly: 26.1% (state: 29.6%)
> Median household income: $82,448

26. Montana: Gallatin
> Smoking rate: 12.4% (state: 17.7%)
> Obesity rate: 22.9% (state: 28.0%)
> Adults who do not exercise regularly: 15.7% (state: 18.6%)
> Median household income: $70,124

[in-text-ad]

Bkell / Public Domain / Wikimedia Commons

27. Nebraska: Hamilton
> Smoking rate: 15.4% (state: 15.1%)
> Obesity rate: 36.1% (state: 34.3%)
> Adults who do not exercise regularly: 26.5% (state: 26.6%)
> Median household income: $68,649

johnrandallalves / iStock via Getty Images

28. Nevada: Douglas
> Smoking rate: 16.2% (state: 15.3%)
> Obesity rate: 31.3% (state: 30.5%)
> Adults who do not exercise regularly: 22.5% (state: 25.6%)
> Median household income: $71,415

DenisTangneyJr / iStock via Getty Images

29. New Hampshire: Rockingham
> Smoking rate: 14.3% (state: 16.9%)
> Obesity rate: 27.4% (state: 32.1%)
> Adults who do not exercise regularly: 20.2% (state: 21.1%)
> Median household income: $93,962

[in-text-ad-2]

DenisTangneyJr / iStock via Getty Images

30. New Jersey: Morris
> Smoking rate: 12.2% (state: 13.2%)
> Obesity rate: 25.4% (state: 25.5%)
> Adults who do not exercise regularly: 20.8% (state: 27.9%)
> Median household income: $117,298

benedek / iStock via Getty Images

31. New Mexico: Los Alamos
> Smoking rate: 9.2% (state: 16.5%)
> Obesity rate: 24.4% (state: 32.2%)
> Adults who do not exercise regularly: 15.1% (state: 24.8%)
> Median household income: $119,266

[in-text-ad]

Kirkikis / iStock Editorial via Getty Images

32. New York: Putnam
> Smoking rate: 13.5% (state: 12.9%)
> Obesity rate: 26.9% (state: 27.2%)
> Adults who do not exercise regularly: 22.8% (state: 27.0%)
> Median household income: $107,246

BSPollard / iStock Editorial via Getty Images

33. North Carolina: Orange
> Smoking rate: 14.1% (state: 18.9%)
> Obesity rate: 29.8% (state: 34.0%)
> Adults who do not exercise regularly: 21.4% (state: 25.9%)
> Median household income: $74,803

34. North Dakota: Burleigh
> Smoking rate: 16.5% (state: 17.4%)
> Obesity rate: 32.3% (state: 35.8%)
> Adults who do not exercise regularly: 25.5% (state: 27.9%)
> Median household income: $72,974

[in-text-ad-2]

35. Ohio: Delaware
> Smoking rate: 15.0% (state: 21.8%)
> Obesity rate: 30.4% (state: 34.6%)
> Adults who do not exercise regularly: 20.9% (state: 27.6%)
> Median household income: $111,411

36. Oklahoma: Canadian
> Smoking rate: 17.4% (state: 19.2%)
> Obesity rate: 33.3% (state: 37.1%)
> Adults who do not exercise regularly: 29.7% (state: 33.4%)
> Median household income: $73,591

[in-text-ad]

Flutter_97321 / iStock via Getty Images

37. Oregon: Benton
> Smoking rate: 13.8% (state: 14.9%)
> Obesity rate: 28.1% (state: 28.8%)
> Adults who do not exercise regularly: 22.2% (state: 23.5%)
> Median household income: $65,142

DenisTangneyJr / iStock via Getty Images

38. Pennsylvania: Chester
> Smoking rate: 13.7% (state: 17.8%)
> Obesity rate: 29.3% (state: 33.1%)
> Adults who do not exercise regularly: 20.2% (state: 24.6%)
> Median household income: $104,161

DenisTangneyJr / iStock via Getty Images

39. Rhode Island: Bristol
> Smoking rate: 14.5% (state: 13.8%)
> Obesity rate: 26.8% (state: 30.1%)
> Adults who do not exercise regularly: 20.1% (state: 26.0%)
> Median household income: $85,413

[in-text-ad-2]

Sean Pavone / iStock via Getty Images

40. South Carolina: Beaufort
> Smoking rate: 15.6% (state: 18.4%)
> Obesity rate: 27.8% (state: 35.5%)
> Adults who do not exercise regularly: 22.5% (state: 28.5%)
> Median household income: $71,430

kkay / iStock via Getty Images

41. South Dakota: Lincoln
> Smoking rate: 15.3% (state: 19.0%)
> Obesity rate: 30.0% (state: 33.1%)
> Adults who do not exercise regularly: 25.9% (state: 28.9%)
> Median household income: $84,260

[in-text-ad]

mavdesign / iStock via Getty Images

42. Tennessee: Williamson
> Smoking rate: 13.3% (state: 20.7%)
> Obesity rate: 28.5% (state: 36.6%)
> Adults who do not exercise regularly: 21.5% (state: 29.0%)
> Median household income: $111,196

Gary Fink / iStock via Getty Images

43. Texas: Collin
> Smoking rate: 12.4% (state: 14.7%)
> Obesity rate: 30.2% (state: 34.1%)
> Adults who do not exercise regularly: 22.5% (state: 26.9%)
> Median household income: $100,541

(c) Salil Bhatt / iStock via Getty Images

44. Utah: Morgan
> Smoking rate: 8.9% (state: 7.9%)
> Obesity rate: 29.3% (state: 29.9%)
> Adults who do not exercise regularly: 18.0% (state: 18.7%)
> Median household income: $100,408

[in-text-ad-2]

DenisTangneyJr / E+ via Getty Images

45. Vermont: Chittenden
> Smoking rate: 12.9% (state: 16.2%)
> Obesity rate: 23.1% (state: 27.1%)
> Adults who do not exercise regularly: 17.4% (state: 19.3%)
> Median household income: $76,316

krblokhin / iStock Editorial via Getty Images

46. Virginia: Falls Church City
> Smoking rate: 8.8% (state: 14.2%)
> Obesity rate: 27.5% (state: 31.8%)
> Adults who do not exercise regularly: 17.4% (state: 24.8%)
> Median household income: $146,922

[in-text-ad]

aiisha5 / iStock via Getty Images

47. Washington: King
> Smoking rate: 10.0% (state: 12.8%)
> Obesity rate: 22.3% (state: 28.2%)
> Adults who do not exercise regularly: 16.4% (state: 18.9%)
> Median household income: $99,158

48. West Virginia: Monongalia
> Smoking rate: 20.3% (state: 26.1%)
> Obesity rate: 39.9% (state: 39.7%)
> Adults who do not exercise regularly: 26.2% (state: 29.5%)
> Median household income: $54,198

49. Wisconsin: Ozaukee
> Smoking rate: 13.1% (state: 16.2%)
> Obesity rate: 31.6% (state: 34.3%)
> Adults who do not exercise regularly: 18.3% (state: 22.3%)
> Median household income: $84,394

[in-text-ad-2]

Zachary Joing / iStock via Getty Images

50. Wyoming: Teton
> Smoking rate: 11.3% (state: 18.4%)
> Obesity rate: 22.2% (state: 29.6%)
> Adults who do not exercise regularly: 18.5% (state: 24.0%)
> Median household income: $87,053

Sponsored: Attention Savvy Investors: Speak to 3 Financial Experts – FREE

Ever wanted an extra set of eyes on an investment you’re considering? Now you can speak with up to 3 financial experts in your area for FREE. By simply
clicking here
you can begin to match with financial professionals who can help guide you through the financial decisions you’re making. And the best part? The first conversation with them is free.


Click here
to match with up to 3 financial pros who would be excited to help you make financial decisions.

Thank you for reading! Have some feedback for us?
Contact the 24/7 Wall St. editorial team.