Methodology

To create the list, WalletHub compared 182 U.S. cities — including the 150 most populated cities in the country, and at least two of the most populated cities in each state — on 41 metrics across four key dimensions:

• Healthcare, which includes premature death rates, both adult and youth health insurance coverage, and mental health (25 points)
• Food, which includes residents who say they eat healthy, inadequate fruit and vegetable consumption, and limited access to healthy foods (25 points)
• Fitness, which includes share of adults who engage in any physical activity, as well as fitness and instruction centers per capita (25 points)
• Green space, which includes parkland acres per capita, quality of parks, and city "greenness" (25 points)

Data for the ranking was collected from the U.S. Census Bureau, the Council for Community and Economic Research, the U.S. Bureau of Labor Statistics, and more. Each metric was graded on a 100-point scale, with 100 representing the best conditions for a healthy lifestyle. Each city received a weighted average across all 41 metrics, which was used to calculate its overall score and determine its ranking in the list.

The healthiest (and unhealthiest) US cities

According to WalletHub, the 10 healthiest cities in the United States are:

1. San Francisco, CA
2. Honolulu, HI
3. Seattle, WA
4. San Diego, CA
5. Washington, D.C.
6. Portland, OR
7. Denver, CO
8. Salt Lake City, UT
9. Scottsdale, AZ
10. Irvine, CA

In comparison, the 10 unhealthiest cities in the United States are:

1. Brownsville, TX
2. Gulfport, MS
3. Laredo, TX
4. Columbus, GA
5. Shreveport, LA
6. Augusta, GA
7. Fayetteville, NC
8. Corpus Christi, TX
9. Detroit, MI
10. Huntington, WV

WalletHub also provided rankings for certain metrics, including:

Cost of medical visits: Laredo, Texas, had the lowest costs, while there was a five-way tie for the highest costs, with Milwaukee, Wisconsin; Anchorage, Alaska; Madison, Wisconsin; Seattle, Washington; and Juneau, Alaska, all having the highest costs.

• Premature death rate: San Jose, California, had the lowest premature death rate, and there was a five-way tie for the highest premature death rate, with Augusta, Georgia; Charleston, West Virginia; St. Louis, Missouri; Huntington, West Virginia; and Baltimore, Maryland, all having the highest rate.
• Healthy restaurants per capita: Portland, Oregon, had the greatest number of healthy restaurants while Montgomery, Alabama, had the fewest.
• Percentage of physically active adults: South Burlington, Vermont, had the highest percentage of active adults while Hialeah, Florida, had the lowest.

Commentary

According to WalletHub analyst Cassandra Happe, "where people live can have a big influence on how successful they are at staying in good health, so the best cities are the ones that provide the greatest access to high-quality healthcare, green spaces, recreation centers, and healthy food."

WalletHub also spoke to a panel of experts about building good personal health, including how to choose a city that is good for your health and how to live healthily on a budget.

Pete Muennig, a professor in the department of health policy and management at Columbia University, said that the main health factors you should look for when choosing a city are clean air, opportunities for exercise, and the availability of healthy food.

Separately, Jia Yu, an associate professor of economics at Southern Connecticut State University's School of Business, said the top three factors that she would consider are affordability and cost of living, access to healthcare and quality of care, and safety and social support.

"A city, that is affordable regarding to housing, medical, and daily expenses, allows a comfortable standard of living," Yu said. "It can reduce financial stress and lead to overall health and well-being.

For people who want a healthier lifestyle on a budget, Muennig recommends investing in exercise and learning how to cook healthy meals. "The return is both the financial and the intangible value of having a longer time on earth with fewer diseases and problems," he said.

Yu also noted that there are many free resources that can help you live a healthier lifestyle. "There are tons of books, apps, and social influencers, talking about healthy lifestyles for free," she said. "Choosing a strategy that suits yourself and sticking to it would result in a significantly positive change in your life." (McCann, WalletHub, 4/1)

The impact of social factors such as food insecurity, poverty, and transportation on health status is undeniable.  Learn how to choose impactful interventions to address patients' unmet social needs and extend your population health goals.