These Are America’s Healthiest Cities

While poor health can eat into your finances with higher medical costs and reduced wages, good health is generally correlated with higher productivity, increased earnings, and lower health care expenses. Healthier habits and outcomes can also reduce long-term costs on aggregate populations, and improve quality of life for local residents in a multitude of ways.

With this in mind, SmartAsset ranked 100 of the largest U.S. cities based on 10 health factors, including self-reported physical and mental well-being, obesity, smoking, drinking, air pollution, sleep quality, and more. The earnings of local households—including the relative portion of high earners in the area—are also examined.

San Jose claims the title of the healthiest city, jumping up from third place. San Jose ranked first in four out of 10 health metrics, including self-reported physically healthy days (27.52 out of 30), mentally healthy days (26.00 out of 30), smoking (7.4% of adults), and obesity rates (18.5% of adults). The city ranked within the top 20% for all metrics except for air pollution, where it ranked 60th.

New Orleans is the unhealthiest city this year. Taking the title from Detroit, New Orleans’ ranking was influenced by the worst rate of drug overdose deaths at 72.45 per 1,000 residents, as well as the worst rate of poor mental health days (6.5 per 30). It also ranked particularly low for average amount of sleep (97th), diabetes prevalence (97th), and excessive drinking (95th). 

People are getting the most sleep in this city. 75.6% of residents report getting an average of at least seven hours of sleep in Minneapolis. On average, only 66% of people in cities report getting this much sleep. Overall, Minneapolis ranked as the ninth healthiest city, with high levels of physically healthy days and a particularly low rate of diabetes.

Over 44% of people are obese in Webb County, TX. This stat puts Laredo, TX at 99th healthiest city, second-to-last, and just barely beats New Orleans, LA. Laredo ranked worst for the number of self-reported physically healthy days, rate of physical activity, and adult diabetes.

Despite its overall health ranking, Portland residents report poor mental health. Physical health metrics help earn Portland the rank of 23rd-healthiest city overall. However, Portland is associated with the fifth-lowest number of self-reported mentally healthy days at 24.23 out of 30. 

• Average number of physically unhealthy days per 30 days: 2.48
• Average number of mentally unhealthy days per 30 days: 4
• Percentage of adults who are current smokers: 7.4%
• Percentage of adults who are obese: 18.5%
• Percentage of adults reporting no leisure-time physical activity: 16.6%
• Percentage of adults reporting binge or heavy drinking: 14.9%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.2
• Percentage of adults aged 20 and above with diagnosed diabetes: 9%
• Number of drug poisoning deaths per 100,000 in population: 14.67
• Percentage of adults who report fewer than 7 hours of sleep on average: 28.7%
• Median household income: $136,229
• Percent of households earning $200k+: 33.4%

• Average number of physically unhealthy days per 30 days: 2.59
• Average number of mentally unhealthy days per 30 days: 4.04
• Percentage of adults who are current smokers: 7.9%
• Percentage of adults who are obese: 23.9%
• Percentage of adults reporting no leisure-time physical activity: 14.2%
• Percentage of adults reporting binge or heavy drinking: 21.7%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 8
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.6%
• Number of drug poisoning deaths per 100,000 in population: 11.27
• Percentage of adults who report fewer than 7 hours of sleep on average: 28.4%
• Median household income: $140,219
• Percent of households earning $200k+: 30.5%

• Average number of physically unhealthy days per 30 days: 2.97
• Average number of mentally unhealthy days per 30 days: 4.88
• Percentage of adults who are current smokers: 9%
• Percentage of adults who are obese: 23.3%
• Percentage of adults reporting no leisure-time physical activity: 14.3%
• Percentage of adults reporting binge or heavy drinking: 19%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 8.3
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.1%
• Number of drug poisoning deaths per 100,000 in population: 23.25
• Percentage of adults who report fewer than 7 hours of sleep on average: 27.4%
• Median household income: $120,608
• Percent of households earning $200k+: 29.2%

• Average number of physically unhealthy days per 30 days: 3
• Average number of mentally unhealthy days per 30 days: 4.78
• Percentage of adults who are current smokers: 12.3%
• Percentage of adults who are obese: 28.5%
• Percentage of adults reporting no leisure-time physical activity: 17%
• Percentage of adults reporting binge or heavy drinking: 18.9%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 5.4
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.8%
• Number of drug poisoning deaths per 100,000 in population: 17.34
• Percentage of adults who report fewer than 7 hours of sleep on average: 28.5%
• Median household income: $79,977
• Percent of households earning $200k+: 11.7%

• Average number of physically unhealthy days per 30 days: 3.15
• Average number of mentally unhealthy days per 30 days: 4.71
• Percentage of adults who are current smokers: 12.9%
• Percentage of adults who are obese: 25.2%
• Percentage of adults reporting no leisure-time physical activity: 17.1%
• Percentage of adults reporting binge or heavy drinking: 19.7%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 6
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.4%
• Number of drug poisoning deaths per 100,000 in population: 21.08
• Percentage of adults who report fewer than 7 hours of sleep on average: 29.2%
• Median household income: $89,300
• Percent of households earning $200k+: 12.3%

• Average number of physically unhealthy days per 30 days: 2.84
• Average number of mentally unhealthy days per 30 days: 4.05
• Percentage of adults who are current smokers: 10.5%
• Percentage of adults who are obese: 26.7%
• Percentage of adults reporting no leisure-time physical activity: 19.4%
• Percentage of adults reporting binge or heavy drinking: 17.8%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.9
• Percentage of adults aged 20 and above with diagnosed diabetes: 8.7%
• Number of drug poisoning deaths per 100,000 in population: 9.08
• Percentage of adults who report fewer than 7 hours of sleep on average: 33%
• Median household income: $108,594
• Percent of households earning $200k+: 23.3%

• Average number of physically unhealthy days per 30 days: 2.84
• Average number of mentally unhealthy days per 30 days: 4.82
• Percentage of adults who are current smokers: 8.9%
• Percentage of adults who are obese: 18.7%
• Percentage of adults reporting no leisure-time physical activity: 17.4%
• Percentage of adults reporting binge or heavy drinking: 17.3%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 7.7
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.1%
• Number of drug poisoning deaths per 100,000 in population: 58.63
• Percentage of adults who report fewer than 7 hours of sleep on average: 29.4%
• Median household income: $126,730
• Percent of households earning $200k+: 33.7%

• Average number of physically unhealthy days per 30 days: 2.99
• Average number of mentally unhealthy days per 30 days: 5.07
• Percentage of adults who are current smokers: 9.2%
• Percentage of adults who are obese: 24.8%
• Percentage of adults reporting no leisure-time physical activity: 18.2%
• Percentage of adults reporting binge or heavy drinking: 15.8%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.4
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.4%
• Number of drug poisoning deaths per 100,000 in population: 18.10
• Percentage of adults who report fewer than 7 hours of sleep on average: 29.9%
• Median household income: $96,828
• Percent of households earning $200k+: 21.8%

• Average number of physically unhealthy days per 30 days: 2.70
• Average number of mentally unhealthy days per 30 days: 4.66
• Percentage of adults who are current smokers: 12.2%
• Percentage of adults who are obese: 27.7%
• Percentage of adults reporting no leisure-time physical activity: 17.6%
• Percentage of adults reporting binge or heavy drinking: 21.6%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 8.3
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.6%
• Number of drug poisoning deaths per 100,000 in population: 26.36
• Percentage of adults who report fewer than 7 hours of sleep on average: 25.4%
• Median household income: $81,001
• Percent of households earning $200k+: 14.3%

• Average number of physically unhealthy days per 30 days: 3.09
• Average number of mentally unhealthy days per 30 days: 4.47
• Percentage of adults who are current smokers: 9.7%
• Percentage of adults who are obese: 25.3%
• Percentage of adults reporting no leisure-time physical activity: 17%
• Percentage of adults reporting binge or heavy drinking: 16.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.4
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.5%
• Number of drug poisoning deaths per 100,000 in population: 20.96
• Percentage of adults who report fewer than 7 hours of sleep on average: 32.1%
• Median household income: $84,872
• Percent of households earning $200k+: 13.8%

• Average number of physically unhealthy days per 30 days: 3.09
• Average number of mentally unhealthy days per 30 days: 4.47
• Percentage of adults who are current smokers: 9.7%
• Percentage of adults who are obese: 25.3%
• Percentage of adults reporting no leisure-time physical activity: 17%
• Percentage of adults reporting binge or heavy drinking: 16.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.4
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.5%
• Number of drug poisoning deaths per 100,000 in population: 20.96
• Percentage of adults who report fewer than 7 hours of sleep on average: 32.1%
• Median household income: $127,989
• Percent of households earning $200k+: 30%

• Average number of physically unhealthy days per 30 days: 3.09
• Average number of mentally unhealthy days per 30 days: 4.47
• Percentage of adults who are current smokers: 9.7%
• Percentage of adults who are obese: 25.3%
• Percentage of adults reporting no leisure-time physical activity: 17%
• Percentage of adults reporting binge or heavy drinking: 16.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 9.4
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.5%
• Number of drug poisoning deaths per 100,000 in population: 20.96
• Percentage of adults who report fewer than 7 hours of sleep on average: 32.1%
• Median household income: $85,914
• Percent of households earning $200k+: 12.6%

• Average number of physically unhealthy days per 30 days: 2.60
• Average number of mentally unhealthy days per 30 days: 4.08
• Percentage of adults who are current smokers: 11.2%
• Percentage of adults who are obese: 25%
• Percentage of adults reporting no leisure-time physical activity: 19.9%
• Percentage of adults reporting binge or heavy drinking: 18.3%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 3.9
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.2%
• Number of drug poisoning deaths per 100,000 in population: 19.43
• Percentage of adults who report fewer than 7 hours of sleep on average: 42.3%
• Median household income: $84,907
• Percent of households earning $200k+: 15.8%

• Average number of physically unhealthy days per 30 days: 2.70
• Average number of mentally unhealthy days per 30 days: 4.03
• Percentage of adults who are current smokers: 10.5%
• Percentage of adults who are obese: 31.6%
• Percentage of adults reporting no leisure-time physical activity: 15.5%
• Percentage of adults reporting binge or heavy drinking: 21.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 10.2
• Percentage of adults aged 20 and above with diagnosed diabetes: 8.8%
• Number of drug poisoning deaths per 100,000 in population: 16.41
• Percentage of adults who report fewer than 7 hours of sleep on average: 30.5%
• Median household income: $86,309
• Percent of households earning $200k+: 15%

• Average number of physically unhealthy days per 30 days: 2.73
• Average number of mentally unhealthy days per 30 days: 4.69
• Percentage of adults who are current smokers: 11.7%
• Percentage of adults who are obese: 28%
• Percentage of adults reporting no leisure-time physical activity: 15.5%
• Percentage of adults reporting binge or heavy drinking: 25.7%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 8.8
• Percentage of adults aged 20 and above with diagnosed diabetes: 7%
• Number of drug poisoning deaths per 100,000 in population: 25.97
• Percentage of adults who report fewer than 7 hours of sleep on average: 25.8%
• Median household income: $70,484
• Percent of households earning $200k+: 9.6%

• Average number of physically unhealthy days per 30 days: 2.83
• Average number of mentally unhealthy days per 30 days: 4.66
• Percentage of adults who are current smokers: 13.9%
• Percentage of adults who are obese: 33.9%
• Percentage of adults reporting no leisure-time physical activity: 20.1%
• Percentage of adults reporting binge or heavy drinking: 22.1%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 6.7
• Percentage of adults aged 20 and above with diagnosed diabetes: 8.6%
• Number of drug poisoning deaths per 100,000 in population: 13.27
• Percentage of adults who report fewer than 7 hours of sleep on average: 28.3%
• Median household income: $68,050
• Percent of households earning $200k+: 7.9%

• Average number of physically unhealthy days per 30 days: 3.67
• Average number of mentally unhealthy days per 30 days: 5.02
• Percentage of adults who are current smokers: 13.7%
• Percentage of adults who are obese: 28.1%
• Percentage of adults reporting no leisure-time physical activity: 17.2%
• Percentage of adults reporting binge or heavy drinking: 18%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 5
• Percentage of adults aged 20 and above with diagnosed diabetes: 7.4%
• Number of drug poisoning deaths per 100,000 in population: 36.77
• Percentage of adults who report fewer than 7 hours of sleep on average: 31.2%
• Median household income: $83,215
• Percent of households earning $200k+: 12%

• Average number of physically unhealthy days per 30 days: 3.06
• Average number of mentally unhealthy days per 30 days: 4.21
• Percentage of adults who are current smokers: 12.4%
• Percentage of adults who are obese: 29%
• Percentage of adults reporting no leisure-time physical activity: 25.3%
• Percentage of adults reporting binge or heavy drinking: 17.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 6.9
• Percentage of adults aged 20 and above with diagnosed diabetes: 10.1%
• Number of drug poisoning deaths per 100,000 in population: 24.60
• Percentage of adults who report fewer than 7 hours of sleep on average: 33.1%
• Median household income: $76,577
• Percent of households earning $200k+: 16.7%

• Average number of physically unhealthy days per 30 days: 3
• Average number of mentally unhealthy days per 30 days: 4.64
• Percentage of adults who are current smokers: 13.7%
• Percentage of adults who are obese: 31.5%
• Percentage of adults reporting no leisure-time physical activity: 19.1%
• Percentage of adults reporting binge or heavy drinking: 18%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 6.8
• Percentage of adults aged 20 and above with diagnosed diabetes: 9.6%
• Number of drug poisoning deaths per 100,000 in population: 20.46
• Percentage of adults who report fewer than 7 hours of sleep on average: 34.3%
• Median household income: $91,141
• Percent of households earning $200k+: 13.7%

• Average number of physically unhealthy days per 30 days: 3.06
• Average number of mentally unhealthy days per 30 days: 4.34
• Percentage of adults who are current smokers: 13.9%
• Percentage of adults who are obese: 35.2%
• Percentage of adults reporting no leisure-time physical activity: 23.1%
• Percentage of adults reporting binge or heavy drinking: 21.5%
• Average daily density of fine particulate matter in air (micrograms per cubic meter): 7
• Percentage of adults aged 20 and above with diagnosed diabetes: 8.9%
• Number of drug poisoning deaths per 100,000 in population: 13.93
• Percentage of adults who report fewer than 7 hours of sleep on average: 28.3%
• Median household income: $71,238
• Percent of households earning $200k+: 11.4%

SmartAsset examined data for 2024 and from County Health Rankings & Roadmaps. Data was examined for the largest 100 cities by population, for which data was available. Cities are mapped to county-level data. Variables are age-adjusted and self-reported, and include:

• Average number of physically unhealthy days reported in the past 30 days.
• Average number of mentally unhealthy days reported in the past 30 days.
• Percentage of adults who are current smokers.
• Percentage of the adult population that reports a body mass index (BMI) greater than or equal to 30 kg/m2.
• Percentage of adults age 18 and over reporting no leisure-time physical activity.
• Percentage of adults reporting binge or heavy drinking.
• Average daily density of fine particulate matter in micrograms per cubic meter (PM2.5).
• Percentage of adults aged 20 and above with diagnosed diabetes.
• Number of drug poisoning deaths per 100,000 population.
• Percentage of adults who report fewer than 7 hours of sleep on average.

Income data from the Census Bureau’s 1-Year American Community Survey for 2023 was also examined.

This story was produced by SmartAsset and reviewed and distributed by Stacker.It was written by Jaclyn DeJohn, CFP.