(Photo by Arnaud Mariat on Unsplash+)
MIAMI — Which American cities are leading the way in fostering wellness for their residents? According to WalletHub’s annual “Healthiest & Unhealthiest Cities in America” report, San Francisco claims the top spot as the nation’s healthiest metropolitan area, followed by Honolulu and Seattle. The elaborate study examines factors ranging from healthcare access to green space availability to obesity rates.
City Planning Meets Health Outcomes
“Location matters when it comes to health,” explains Adam McCann, WalletHub Financial Writer, in a statement. “Some places promote wellness by expanding access to nutritious food and recreational facilities. Others strive to keep healthcare costs affordable for everyone or keep parks clean and well-maintained.”
This analysis comes at a critical time when public health experts are increasingly focusing on how built environments and community resources shape individual health outcomes. The study compared more than 180 of the most populated U.S. cities across 41 key indicators of good health, examining everything from medical costs to fruit and vegetable consumption and physical activity rates.
What Makes San Francisco America’s Healthiest City?
San Francisco secured its position at the top of the rankings largely due to having the second-lowest share of obese adults in the country, with just 18% of the population meeting obesity criteria. The city’s excellence in nutritional habits is evident in the fact that San Francisco has the second-lowest percentage of residents consuming less than one serving of fruits or vegetables daily.
The city’s commitment to accessible recreation shows in its infrastructure: 100% of residents live within reasonable proximity to locations for physical activity. San Francisco also ranks second nationally in per capita spending on parks and recreation, investing heavily in maintaining spaces where residents can stay active and connect with nature.
Only 18% of people in San Francisco have obesity, with residents making fruits and vegetables a more prominent part of their diets than residents of other major cities.. (Photo by Daniel Abadia on Unsplash)
Transportation design plays a crucial role in the city’s health outcomes as well. The Golden Gate City ranks among America’s most walkable and bikeable cities, allowing residents to incorporate physical activity into their daily commutes rather than relying exclusively on sedentary transportation options.
San Francisco also boasts one of the highest concentrations of healthy restaurants per capita and excels in providing vegetarian and gluten-free dining options, making nutritious eating more accessible to residents with varying dietary needs.
Hawaii’s capital secured the second position, with particular strength in addressing mental health needs. Honolulu has one of the nation’s lowest rates of prolonged mental health challenges, with approximately 13% of adults reporting 14 or more mentally unhealthy days in the past month.
Honolulu, Hawaii (Photo by Zetong Li on Unsplash)
The city’s healthcare coverage is impressive, with over 95% of adults and 98% of children having health insurance, placing Honolulu in the top 25 cities nationally for coverage rates. Nutritional access is another strong point, as the city has the highest number of farmers markets per capita, giving residents direct access to fresh, locally grown food.
Honolulu’s natural environment also contributes significantly to its high ranking, boasting the most hiking trails per capita among all cities studied, allowing residents to stay physically active while enjoying the island’s stunning landscapes.
Seattle: The Emerald City’s Active Lifestyle
Securing third place, Seattle stands out for having the highest physical activity rates nationwide, with an impressive 87% of adults engaging in physical activity during the past month. Like San Francisco, Seattle ranks among the top cities for parks and recreation spending per capita, ensuring residents have well-maintained spaces for outdoor activities.
Notably, Seattle residents demonstrate a strong interest in healthy living through their online search behaviors. They search for health-related terms like “healthy dinner ideas” and “health food stores” more frequently than people in most other cities, indicating a community-wide commitment to nutritional wellness.
The report also highlights Seattle’s status as one of America’s greenest cities, noting that environmental quality and sustainability initiatives contribute positively to residents’ overall health.
Expert Insights on Urban Health
“Staying healthy is a personal responsibility, and everyone should strive to eat nutritious food, exercise regularly and look after their mental health,” notes Chip Lupo, WalletHub Analyst. “However, 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.”
Dr. Amy Justice, a professor of medicine and public health at Yale University, emphasizes the importance of neighborhood-level factors beyond city-wide metrics.
“At a city level, air and water quality, traffic safety, commute times, and availability of reliable public transport (to encourage walking rather than driving) are important,” Dr. Justice explains. “However, the most important factors have more to do with neighborhood than with city level factors. Safety, green space and sidewalks are clearly important to encourage outdoor activities and exercise.”
Dr. Justice also highlights the role of food environments and social connectivity in community health: “Groceries that carry affordable fresh food and a lower density of stores that only carry liquor, sugar-infused drinks, and highly processed food are also important factors. Social fabric is another very important factor. People need to feel connected to each other and to their communities.”
The Bottom of the Rankings
At the opposite end of the spectrum, Brownsville, Texas, ranked as America’s least healthy city (182nd), preceded by Gulfport, Mississippi (181st), and Shreveport, Louisiana (180th). These cities consistently underperformed across multiple health indicators.
Other cities in the bottom ten include Laredo, Texas (178th); Columbus, Georgia (179th); Huntington, West Virginia (177th); Corpus Christi, Texas (176th); and Fort Smith, Arkansas (175th). Many of these cities face challenges with healthcare access, limited healthy food options, and fewer recreational opportunities.
Notable Health Disparities Across America
The study revealed significant disparities in key health metrics across American cities. For instance, the cost of a medical visit in the least expensive city (Laredo, Texas) is approximately three times lower than in the most expensive cities, which include Milwaukee, Anchorage, Madison, Seattle, and Juneau.
Even more striking is the difference in premature death rates—measured as years of potential life lost—between cities. San Jose, California, has a premature death rate approximately four times lower than Huntington, West Virginia, representing a substantial gap in life expectancy and quality of life.
Other interesting findings include Scottsdale, Arizona, which ranked first for fitness despite ranking only 16th overall, and South Burlington, Vermont, which topped the healthcare rankings while placing 17th overall.
While individual choices matter, community resources and infrastructure play crucial roles in enabling healthy behaviors. Cities providing better access to quality healthcare, nutritious food options, and recreational facilities create environments where making healthy choices becomes easier for residents.
Dr. Justice emphasizes this point: “Health is not owned by healthcare. As people age, healthy longevity requires a well-integrated fabric of personal, social, and community resources.”
She suggests that local authorities can improve health outcomes by facilitating better coordination between healthcare systems and community resources: “Healthcare systems need to know how to refer individuals to these resources and these resources need to understand how to help individuals navigate healthcare systems. At present these groups largely function in silos—both providing redundant services and leaving large gaps in services that are not provided anywhere.”
For cities looking to improve their health rankings, Dr. Justice recommends concrete actions: “Create and maintain safe green spaces. Support farmers markets and other programs providing access to affordable fresh food. Maintain sidewalks where they exist and create walking paths that are safe and accessible. Bring people together in support of these activities.”
Healthiest Places to Live in the U.S.
Overall Rank City Total Score Health Care Rank Food Rank Fitness Rank Green Space Rank
1 San Francisco, CA 68.05 51 1 35 1
2 Honolulu, HI 63.34 63 8 48 2
3 Seattle, WA 63.00 36 7 18 9
4 Salt Lake City, UT 62.82 14 38 3 3
5 San Diego, CA 62.62 53 5 45 6
6 Portland, OR 62.26 61 9 26 7
7 Denver, CO 61.18 37 13 21 12
8 Minneapolis, MN 61.17 13 17 27 10
9 Washington, DC 61.08 64 10 16 13
10 Huntington Beach, CA 60.51 9 34 6 34
11 Irvine, CA 60.33 4 29 34 17
12 Glendale, CA 59.91 33 36 5 11
13 Los Angeles, CA 59.46 77 2 80 18
14 Austin, TX 58.61 19 25 37 21
15 Boston, MA 58.47 5 12 59 49
16 Scottsdale, AZ 58.01 38 77 1 22
17 South Burlington, VT 57.87 1 11 132 61
18 Pittsburgh, PA 57.64 17 23 43 33
19 New York, NY 57.46 108 3 126 14
20 Atlanta, GA 57.21 74 19 19 30
21 Fremont, CA 56.94 29 20 11 71
22 San Jose, CA 56.93 16 15 95 39
23 Madison, WI 56.79 18 43 36 26
24 Oakland, CA 56.42 94 4 53 54
25 St. Louis, MO 56.21 100 31 4 46
26 Long Beach, CA 56.02 47 21 49 38
27 Orlando, FL 55.64 80 18 24 44
28 Chicago, IL 55.27 122 14 62 27
29 Garden Grove, CA 55.25 34 41 98 5
30 Portland, ME 55.09 32 27 131 4
31 Grand Rapids, MI 55.00 30 60 20 41
32 Burlington, VT 54.94 7 26 120 42
33 St. Paul, MN 54.78 59 49 66 15
34 Raleigh, NC 54.60 20 32 2 139
35 Columbia, MD 54.51 3 68 30 96
36 Cincinnati, OH 54.38 90 50 23 25
37 Missoula, MT 54.25 8 100 75 20
38 Overland Park, KS 54.20 2 101 17 88
39 Oceanside, CA 54.09 52 58 10 93
40 Rochester, NY 54.03 67 33 88 16
41 Tampa, FL 53.89 75 22 31 65
42 Sacramento, CA 53.56 128 16 93 32
43 Las Vegas, NV 53.27 163 30 28 28
44 Tempe, AZ 52.67 73 87 15 36
45 Philadelphia, PA 52.59 112 24 75 48
46 Fort Lauderdale, FL 52.35 71 39 73 51
47 Richmond, VA 52.33 92 62 9 79
48 Miami, FL 52.11 101 6 129 68
49 Lincoln, NE 52.04 11 106 22 66
50 Vancouver, WA 51.98 79 86 8 83
51 Santa Clarita, CA 51.93 12 48 99 58
52 Santa Rosa, CA 51.80 88 61 29 60
53 Phoenix, AZ 51.79 86 40 54 57
54 Plano, TX 51.75 21 108 12 82
55 St. Petersburg, FL 51.26 91 56 32 62
56 Wilmington, DE 51.13 54 72 67 40
57 Santa Ana, CA 50.97 60 45 56 81
58 Boise, ID 50.93 39 122 38 47
59 Sioux Falls, SD 50.87 6 99 63 112
60 Anaheim, CA 50.79 28 35 121 78
61 Aurora, CO 50.42 41 66 13 132
62 Albuquerque, NM 50.31 145 54 101 23
63 Virginia Beach, VA 50.23 15 79 46 110
64 Buffalo, NY 50.21 82 44 103 56
65 Pembroke Pines, FL 50.19 76 92 47 35
66 Yonkers, NY 50.15 27 42 150 43
67 Providence, RI 49.88 48 65 130 29
68 Billings, MT 49.34 70 63 60 127
69 Bismarck, ND 49.23 42 144 33 101
70 West Valley City, UT 49.23 85 46 117 55
71 Manchester, NH 49.13 40 110 61 89
72 Charleston, SC 49.08 23 113 42 137
73 Nashua, NH 48.88 25 104 55 135
74 Baltimore, MD 48.73 116 28 90 103
75 Omaha, NE 48.58 26 94 74 94
76 Jersey City, NJ 48.56 57 37 143 77
77 Tacoma, WA 48.54 131 70 25 107
78 Colorado Springs, CO 48.51 87 78 50 90
79 Charlotte, NC 48.47 49 47 44 153
80 Spokane, WA 48.32 69 59 84 111
81 Chula Vista, CA 48.30 55 74 41 129
82 Fargo, ND 47.99 31 91 105 99
83 Milwaukee, WI 47.76 103 82 118 45
84 Lexington-Fayette, KY 47.75 45 69 96 117
85 Louisville, KY 47.68 95 57 70 105
86 Chesapeake, VA 47.62 35 131 83 63
87 Worcester, MA 47.50 46 112 81 95
88 Bridgeport, CT 47.41 62 121 142 8
89 Pearl City, HI 47.14 43 85 136 75
90 Warwick, RI 46.94 24 93 125 124
91 Jacksonville, FL 46.92 133 81 72 74
92 Aurora, IL 46.84 78 102 128 24
93 Houston, TX 46.76 135 52 51 121
94 Salem, OR 46.72 81 71 122 80
95 Reno, NV 46.63 154 89 68 64
96 Durham, NC 46.62 10 64 78 173
97 Peoria, AZ 46.56 72 120 57 104
98 Oxnard, CA 46.49 106 75 133 52
99 Dallas, TX 46.31 118 80 52 113
100 Kansas City, MO 46.12 104 107 86 76
101 Riverside, CA 46.11 138 88 40 108
102 Modesto, CA 46.09 136 90 97 69
103 Gilbert, AZ 46.09 44 114 7 172
104 Tucson, AZ 45.99 161 50 114 70
105 Juneau, AK 45.78 149 96 168 19
106 New Haven, CT 45.67 56 98 163 31
107 Springfield, MO 45.62 117 118 89 91
108 San Antonio, TX 45.47 151 76 91 92
109 Chandler, AZ 45.44 50 116 14 162
110 Columbus, OH 45.36 65 84 123 109
111 New Orleans, LA 45.21 157 115 100 53
112 Mesa, AZ 44.67 93 111 79 114
113 Anchorage, AK 44.59 147 97 153 37
114 Knoxville, TN 44.39 129 105 65 152
115 Rancho Cucamonga, CA 44.32 142 135 39 106
116 Cleveland, OH 44.23 119 53 134 115
117 Glendale, AZ 44.15 121 119 58 118
118 Fort Worth, TX 43.92 66 127 71 143
119 Nashville, TN 43.73 139 73 104 126
120 Indianapolis, IN 43.29 107 95 94 156
121 Henderson, NV 43.20 137 137 112 73
122 Columbia, SC 42.99 84 142 64 167
123 Cedar Rapids, IA 42.88 22 153 147 119
124 Tallahassee, FL 42.87 83 159 77 142
125 Nampa, ID 42.42 148 146 69 122
126 Des Moines, IA 42.24 68 130 140 116
127 Dover, DE 42.21 96 155 109 158
128 Birmingham, AL 42.13 126 140 82 133
129 Rapid City, SD 41.84 58 117 155 145
130 Chattanooga, TN 41.81 125 160 106 72
131 Newport News, VA 41.62 98 138 137 85
132 Tulsa, OK 41.09 99 162 92 136
133 Fresno, CA 40.99 141 83 149 141
134 Huntsville, AL 40.56 113 152 116 161
135 Akron, OH 40.48 102 147 158 67
136 Norfolk, VA 40.37 89 126 127 155
137 Cheyenne, WY 40.27 110 177 139 130
138 Hialeah, FL 40.24 144 55 146 165
139 Garland, TX 40.01 140 145 138 98
140 Casper, WY 39.92 109 168 174 87
141 Ontario, CA 39.30 172 123 154 50
142 Newark, NJ 39.29 164 67 166 148
143 Oklahoma City, OK 39.22 97 139 145 147
144 Stockton, CA 39.21 168 109 165 102
145 Little Rock, AR 39.21 124 148 135 151
146 Cape Coral, FL 39.16 155 150 107 163
147 Bakersfield, CA 39.06 160 132 144 134
148 Greensboro, NC 38.96 115 143 108 170
149 Grand Prairie, TX 38.78 111 161 171 59
150 Lubbock, TX 38.71 152 175 102 144
151 Irving, TX 38.65 134 134 115 160
152 El Paso, TX 38.55 170 124 157 100
153 Port St. Lucie, FL 38.20 120 136 113 179
154 Toledo, OH 38.11 167 156 162 86
155 Arlington, TX 38.02 105 157 148 146
156 Lewiston, ME 38.02 132 154 169 140
157 Las Cruces, NM 37.94 114 172 176 84
158 Charleston, WV 37.91 123 141 141 178
159 Moreno Valley, CA 37.90 153 125 177 125
160 Mobile, AL 37.64 162 149 110 180
161 Wichita, KS 37.58 158 164 87 164
162 Baton Rouge, LA 37.51 150 171 119 138
163 Fontana, CA 37.15 169 129 160 120
164 Fort Wayne, IN 37.13 146 133 124 176
165 Winston-Salem, NC 37.00 127 174 85 177
166 San Bernardino, CA 36.94 179 128 164 97
167 Amarillo, TX 36.62 165 167 156 123
168 Detroit, MI 36.30 176 103 167 150
169 Montgomery, AL 35.28 166 178 111 175
170 Augusta, GA 34.48 130 173 161 168
171 North Las Vegas, NV 34.17 175 163 178 128
172 Fayetteville, NC 34.03 156 169 151 182
173 Jackson, MS 33.81 143 165 175 174
174 Memphis, TN 33.52 173 170 152 154
175 Fort Smith, AR 33.05 171 158 179 166
176 Corpus Christi, TX 32.30 174 166 173 159
177 Huntington, WV 31.53 177 151 181 131
178 Laredo, TX 31.21 181 179 180 149
179 Columbus, GA 30.61 182 176 159 157
180 Shreveport, LA 30.34 159 181 170 171
181 Gulfport, MS 28.30 178 180 172 181
182 Brownsville, TX 24.07 180 182 182 169
Note: With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that city, where a rank of 1 represents the best conditions for that metric category.
Methodology
WalletHub’s study examined 182 cities, including the 150 most populated U.S. cities and at least two of the most populated cities from each state. The analysis focused exclusively on city proper boundaries and excluded surrounding metropolitan areas.
The research team evaluated cities across four key dimensions: Health Care, Food, Fitness, and Green Space. These dimensions encompassed 41 relevant metrics, each graded on a 100-point scale with 100 representing the most favorable conditions for a healthy lifestyle.
For the Health Care dimension (25 points total), researchers analyzed factors including premature death rates, mental and physical health statistics, healthcare provider density, costs of medical services, insurance coverage rates, and preventive care utilization.
The Food dimension (25 points) examined metrics such as fruit and vegetable consumption, farmer’s market density, healthy restaurant availability, obesity rates, and Google search trends for health-related food terms.
The Fitness component (25 points) looked at physical activity rates, fitness center density and affordability, availability of weight loss resources and fitness instructors, and community well-being scores.
Finally, the Green Space dimension (25 points) evaluated parkland per capita, park quality (measured through per capita spending), hiking trail availability, walkability and bike-friendliness, and overall city “greenness.”
The data was collected as of March 3, 2025, from sources including the U.S. Census Bureau, Council for Community and Economic Research, U.S. Bureau of Labor Statistics, County Health Rankings, Centers for Disease Control and Prevention, and various other governmental and private research organizations.