The overall state rankings derive from various measures across
five categories of health: Social and Economic Factors, Physical Environment, Behaviors, Clinical Care and Health Outcomes.
2024: Top Five Healthiest and Least Healthy States
Mississippi (No. 49),
Arkansas (No. 48),
Oklahoma (No. 47) and
West Virginia (No. 46) complete the five least healthy states. With the exception of West Virginia, these states were also in the bottom five states in the
2023 Annual Report. West Virginia returned to the bottom five this year, switching spots with
Alabama (No. 45).
State Rankings: Understanding Differences in Rankings Between States
This graph displays the state scores and ranks with the least healthy states on the left and the healthiest states on the right. The distance between bars shows the difference between state scores. For example, Mississippi (No. 49) and Arkansas (No. 48), while close in ranking, have a sizable difference in score, meaning Mississippi would need to improve in many measures to move up in the rankings. There is also a large gap in score between Massachusetts (No. 3) and the next healthiest state, Minnesota (No. 4), as well as between
Ohio (No. 34) and
Arizona (No. 33).
Use the Adjust My Rank tool to explore how progress and challenges across key measures can affect a state’s overall rank.
State Rankings Since 1990
Since the inception of
America’s Health Rankings in 1990,
Hawaii, Minnesota, New Hampshire and
Utah have been in the top 10 healthiest states, while Louisiana, Mississippi,
Tennessee and West Virginia have consistently ranked among the 10 least healthy states.
Four states improved more than 15 spots between 1990 and 2024:
- Maryland’s rank improved 20 places (No. 31 to No. 11).
- Vermont’s rank improved 18 spots (No. 20 to No. 2).
- Delaware’s rank improved 17 places (No. 38 to No. 21).
- New York’s rank improved 16 spots (No. 40 to No. 24).
Fourteen additional states improved their rank by more than five places:
On the other hand, five states worsened 15 or more spots between 1990 and 2024:
- New Mexico’s rank declined 17 places (No. 25 to No. 42).
- Kansas (No. 12 to No. 28) and Wyoming (No. 16 to No. 32) both declined 16 spots.
- Missouri (No. 24 to No. 39) and Oklahoma (No. 32 to No. 47) both declined 15 spots.
The ranks of nine additional states worsened more than five spots between 1990 and 2024:
- Nebraska (No. 5 to No. 18), North Dakota (No. 1 to No. 14) and Wisconsin (No. 7 to No. 20) declined 13 places.
- Montana (No. 13 to No. 25) declined 12 spots.
- Iowa (No. 6 to No. 16) declined 10 places.
- Arkansas (No. 41 to No. 48), Ohio (No. 27 to No. 34) and Texas (No. 33 to No. 40) declined seven spots.
- Indiana (No. 30 to No. 36) declined six places.
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