The 25 Healthiest States in 2013

You're probably used to hearing bad news about our nation's health, but a new report indicates it's beginning to look up. In 2013, Americans improved in more than two-thirds of the measures used in America's Health Rankings, an annual state-by-state assessment published jointly by the United Health Foundation, American Public Health Association, and Partnership for Prevention. The range of criteria used to determine the rankings includes concrete health measures (like cancer deaths and diabetes rates), lifestyle factors (smoking and alcohol use), and quality-of-life indicators (air pollution, violent crime).

Declines in the smoking rate (from 21.2% to 19.6%) and levels of physical inactivity (26.2% to 22.9%) are most impressive, says Dr. Reed Tuckson, MD, external senior medical advisor to the United Health Foundation. "We're also relieved that for the first time since 1998, the obesity rate did not worsen."

But despite this progress, there's plenty of room for improvement: nearly 28% of American adults are obese, and close to 20% still smoke.

Residents of the following 25 states are ahead of the curve when it comes to getting (and staying) healthy.

2012 Rank: 24

Change: -2

Strengths:
Low levels of air pollution
Low prevalence of low birthweight
Small disparity in health status by educational attainment

Challenges:
High violent crime rate
High incidence of chlamydia infections
Low immunization coverage among children

2012 Rank: 20

Change: -4

Strengths:
Low prevalence of smoking
Low percentage of children in poverty
Ready availability of primary care physicians and dentists

Challenges:
High violent crime rate
High prevalence of low birthweight and high infant mortality rate
High levels of air pollution

2012 Rank: 28

Change: +5

Strengths:
Low prevalences of obesity and diabetes
Low levels of air pollution
Low rate of cancer deaths

Challenges:
High prevalence of binge drinking
High percentage of uninsured population
Limited availability of primary care physicians

2012 Rank: 23

Change: +1

Strengths:
Low rate of drug deaths
Low levels of air pollution
Few poor mental and physical health days per month

Challenges:
High prevalence of smoking
High prevalence of binge drinking
Low immunization coverage among children and adolescents

2012 Rank: 21

Change: None

Strengths:
Low prevalence of smoking
Low prevalence of physical inactivity
Low infant mortality, cancer deaths, and premature death rates

Challenges:
High levels of air pollution
High percentage of uninsured population
Low immunization coverage among children

2012 Rank: 13

Change: -7

Strengths:
High rate of high school graduation
High immunization coverage among children
Low percentage of uninsured population

Challenges:
High prevalence of binge drinking
High incidence of infectious diseases
Low per capita public health funding

2012 Rank: 16

Change: -3

Strengths:
High prevalence of obesity
High immunization coverage among adolescents
Ready availability of primary care physicians

Challenges:
High rate of drug deaths
High rate of preventable hospitalizations
Large disparity in health status by educational attainment

2012 Rank: 17

Change: -1

Strengths:
High rate of high school graduation
Low percentage of children in poverty
Few poor mental and physical health days per month

Challenges:
High prevalence of obesity
High prevalence of binge drinking
Limited availability of primary care physicians

2012 Rank: 25

Change: +8

Strengths:
Low violent crime rate
Low percentage of children in poverty
Low levels of air pollution

Challenges:
High prevalence of smoking
Low immunization coverage among adolescents
Limited availability of primary care physicians

2012 Rank: 15

Change: -1

Strengths:
Low violent crime rate
Low percentage of uninsured population
Low prevalence of low birthweight

Challenges:
High prevalence of binge drinking
High rate of cancer deaths
Limited availability of dentists

2012 Rank: 18

Change: +3

Strengths:
Low prevalences of obesity and smoking
High per capita public health funding
Ready availability of primary care physicians and dentists

Challenges:
Low rate of high school graduation
High percentage of children in poverty
Low immunization coverage among children

2012 Rank: 12

Change: -2

Strengths:
Low prevalence of physical inactivity
Low rate of preventable hospitalization
Low infant mortality rate and low prevalence of low birthweight

Challenges:
High rate of drug deaths
High incidence of pertussis infections
Low immunization coverage among children

2012 Rank: 14

Change: +1

Strengths:
Low prevalence of physical inactivity
Low rate of preventable hospitalization
Low infant mortality rate and low prevalence of low birthweight

Challenges:
Low high school graduation rate
Low immunization coverage among children
Many poor mental and physical health days per month

2012 Rank: 19

Change: +7

Strengths:
Low prevalence of smoking
Low rate of preventable hospitalization
Low prevalence of low birthweight

Challenges:
Limited availability of primary care physicians
Low immunization coverage among children and adolescents
High incidence of pertussis infections

2012 Rank: 11

Change: None

Strengths:
Low rate of drug deaths
Low prevalence of low birthweight
Few poor mental and physical health days per month

Challenges:
High prevalence of binge drinking
Moderate prevalence of obesity
Large disparity in health status by educational attainment

2012 Rank: 10

Change: None

Strengths:
Low rate of drug deaths
Low percentage of children in poverty
Ready availability of primary care physicians and dentists

Challenges:
High prevalence of physical inactivity
High prevalence of low birthweight
High rate of preventable hospitalizations

2012 Rank: 8

Change: -1

Strengths:
Low rate of drug deaths
High rate of high school graduation
Few poor mental and physical health days per month

Challenges:
High prevalence of binge drinking
High prevalence of obesity
High rate of occupational fatalities

2012 Rank: 9

Change: +1

Strengths:
Low prevalences of obesity, physical inactivity, and diabetes
Low levels of air pollution
Low rate of preventable hospitalizations

Challenges:
High prevalence of binge drinking
High rate of drug deaths
Large disparity in health status by educational attainment

2012 Rank: 7

Change: None

Strengths:
Low prevalence of smoking
Low incidence of infectious diseases
High immunization coverage among children and adolescents

Challenges:
Moderate prevalence of binge drinking
Low high school graduation rate
Large disparity in health status by educational attainment

2012 Rank: 6

Change: None

Strengths:
Low prevalence of smoking and binge drinking
Low prevalences of physical inactivity, obesity, and diabetes
Low rate of preventable hospitalizations

Challenges:
High rate of drug deaths
High incidence of pertussis infections
Limited availability of primary care physicians

2012 Rank: 5

Change: None

Strengths:
Low percentage of children in poverty
High immunization coverage among children
Low infant mortality rate

Challenges:
High prevalence of binge drinking
High incidence of pertussis infections
Low per capita public health funding

2012 Rank: 4

Change: None

Strengths:
Low prevalence of obesity
Low percentage of uninsured population
Ready availability of primary care physicians and dentists

Challenges:
High prevalence of binge drinking
High rate of preventable hospitalizations
Large disparity in health status by educational attainment

2012 Rank: 3

Change: None

Strengths:
Low prevalences of physical inactivity and diabetes
High rate of high school graduation
Low rates of premature death and cardiovascular disease deaths

Challenges:
High prevalence of binge drinking
Low per capita health funding
Low immunization coverage among children

2012 Rank: 2

Change: None

Strengths:
High rate of high school graduation
Low violent crime rate
Low percentage of uninsured population

Challenges:
High prevalence of binge drinking
Low immunization coverage among children
High incidence of pertussis infections

2012 Rank: 1

Change: None

Strengths:
Low prevalences of smoking and obesity
High immunization coverage among children
Low rate of preventable hospitalizations

Challenges:
High prevalence of binge drinking
Low high school graduation rate
High incidence of salmonella infections

You've heard about the healthiest states, but what about the unhealthy ones? The lowest-ranking states are Louisiana (#48), Arkansas (#49), and Mississippi (#50), mostly due to high rates of sedentary living, obesity, and diabetes.

The good news: leaders in several low-ranking states are making efforts to turn it around. This year in Tennessee (#42), for example, governor Bill Haslam launched the Governor's Foundation for Health and Wellness. Texas (#36) is also showing improvement. "San Antonio's mayor, Julian Castro, really gets it," says Dr. Tuckson. Castro created SA2020, a movement to improve well-being among San Antonians across 11 key areas by the year 2020.

To view the full America's Health Rankings report, visit

americashealthrankings.org.