The Healthiest and Unhealthiest Cities in the US

Couple Eating Lunch with Fresh Salad and Appetizers

Not surprisingly, people living in the healthiest cities in the U.S. share some common characteristics thanks to their access to quality healthcare, nutritious food sources, clean air, accessible workout facilities, and public green spaces.
The unhealthiest cities in the country often lack some or all of these benefits. As a result, their residents may deal with a long list of health issues and are more likely to develop obesity or engage in harmful behaviors like smoking and a lack of physical activity.

01

Arlington, Virginia

Rosslyn, Arlington, Virginia, USA city skyline on the Potomac River.
When it comes to taking part in healthy behaviors, Arlington ranks high on the list of the fittest cities. A large percentage of the residents report good or excellent levels of health with low rates of high blood pressure, heart disease, and stroke. A majority perform regular exercise that includes both aerobic and strength activities.

Plus, fewer people who live here are smokers. Despite its small size, the city provides many parks and other outdoor public spaces, which research shows encourage better physical activity.

02

Portland, Oregon

Portland Cityscape at Sunset
It’s no wonder Portland is one of the healthiest cities in the U.S. Residents here prefer to spend more time outdoors, and the year-round comfortable temperatures make it possible.

Studies show that folks who spend time in natural surroundings are more likely to be active. Lots of people walk or bike to work in Portland, and this active transportation increases overall fitness. It also reduces transportation-related pollution which leads to cleaner air.

As for access to nourishing food, Portland takes top honors alongside New York City for the number of healthy restaurants per capita.

03

Seattle, Washington

West Point Light is a lighthouse at Discovery Park in Seattle on Puget Sound's Elliott Bay. A hiking path leads to the lighthouse & beautiful view of snow capped Olympic Mountains on clear winter day.
When it comes to prioritizing personal health, Seattle residents land at the top of the list. They are less apt to have high blood pressure and more likely to be physically fit. Miles of walking and running trails provide opportunities for increased physical activity. Many also bike or walk to work, which is good for both the body and the environment.

The city also recognizes the importance of fitness to overall well-being and has ensured that there are parks and recreation facilities for people to enjoy.

04

Honolulu, Hawaii

Aerial View of Sunrise at Waikiki Beach
The capital of the Aloha State has often made the top of the list of healthiest places to live and work. Honolulu boasts some of the best air quality indexes in the nation, which encourages more outdoor activity. Adults regularly bike to work, which improves overall general health.

The city has a low percentage of smokers, due in part to government initiatives to address teen smoking. Increasing access to quality health care has paid off, with heart disease causing fewer deaths in recent years than in previous decades.

05

Minneapolis, Minnesota

Minneapolis Minnesota at Sunset on the  Mississippi River,
In 2019, the American Fitness Index (AFI) program listed Minneapolis as the third fittest city in the country. With more than 200 miles of bikeways to pedal around on and an abundance of cold- and warm-weather athletic events to take part in, opportunities for physical activity abound.

The city also enjoys a large number of restaurants that serve healthy entrees, including vegan and vegetarian options. Minneapolis’ numerous farmers’ markets have increased the population’s access to fruits and vegetables, which studies show leads to fewer health complications and longer lifespans.

06

McAllen, Texas

Sunset at the Duraton Canyon Natural Park, in Sepulveda, Spain.
On the other side of the coin, this border town has one of the highest percentages of adults with obesity in the nation—just under 45 percent. Physical inactivity is one of the leading causes, and more instances of obesity mean more cases of diabetes and other weight-related health issues.

A quarter of McAllen’s population lives in poverty, and poor access to fresh fruits and vegetables in some neighborhoods is a major problem.

Improvements could be on the way, though. In recent years, the city has made efforts to address obesity and combat the population’s inactive lifestyles by offering community wellness programs.

07

Gulfport, Mississippi

beach scenes on west boulevard in pass christian and henderson point
Around 15 percent of Gulfport’s population has diabetes and a high percentage of residents take medications for high blood pressure. Access to healthcare is a major problem due, again, to high poverty rates.

Outdoor activities are available to those who can afford them, and many residents say they recognize the importance of becoming more active. However, there are few locally organized activities to encourage the shift to a more active lifestyle.

08

Tulsa, Oklahoma

Tulsa, Oklahoma, USA skyline at twilight.
Around 24 percent of Tulsans smoke, which pushes this city to one of the top slots on the unhealthy list. Sedentary lifestyles perpetuate high rates of obesity, despite the dozens of public parks and green spaces available.

Limited fruit and vegetable consumption and a lack of access to healthy foods are big problems. While Tulsa has a large number of fast-food restaurants and grocery stores, few sell healthy alternatives and many are not accessible to low-income neighborhoods.

Because Tulsa is a car-centric city, there is little infrastructure to support riding a bike or walking to work.

09

Laredo, Texas

Riverside view of the Rio Grande River in New Mexico. The sun dips is just about to dip below the gorge rim as the river babbles across rocks in the forefront.
While Laredo has one of the lowest costs for medical visits in the state, it also has one of the lowest percentages of physically active adults and a high obesity rate among adults and children. The city also lacks adequate professional mental health services, due to high demand and a large number of uninsured and under-insured residents.

Although the city declared public places and workplaces smoke-free zones in 2006, smoking is still prevalent among adults and teens alike.

10

Jackson, Mississippi

Jackson, Mississippi, USA skyline over the Capitol Building at dusk.
About 35 percent of Mississippi’s population has obesity, and around half of these residents live in rural areas. In Jackson, that count jumps to 50 percent, with 25 percent having diabetes.

Low accessibility to fitness facilities, safe, outdoor green spaces, and healthy food sources stands in the way of Jacksonians adopting a healthier lifestyle. With year-round humidity levels between 70 percent and 80 percent, and an average of 54 inches of rain each year, the weather conditions probably deter outdoor physical activities, too.