State Rankings

Each state has experienced unique challenges during the COVID-19 public health crisis. The rankings included in this year’s Annual Report — the first ranking analysis since 2019 — are derived from 51 measures across five categories of health: social and economic factors, physical environment, behaviors, clinical care and health outcomes. The rankings are based on an updated model of health first published in 2020 with the America’s Health Rankings® Senior Report. For a more detailed description of how the overall rank is calculated, see Methodology.

New Hampshire is the healthiest state in this report. It ranks in the top quintile across four out of five categories: social and economic factors (No. 1), clinical care (No. 4), behaviors (No. 1) and health outcomes (No. 6).

Strengths: Low premature death rate, low percentage of household food insecurity and low income inequality.

Challenges: High prevalence of excessive drinking, high Black/white residential segregation and low percentage of community water supply with fluoridated water.

Massachusetts (No. 2), Vermont (No. 3), and Connecticut and Hawaii (tied at No. 4) complete the top five healthiest states.

Louisiana has the most opportunity to improve, ranking in the bottom quintile across all model categories: social and economic factors (No. 50), physical environment (No. 48), clinical care (No. 42), behaviors (No. 50) and health outcomes (No. 50).

Strengths: Low Black/white residential segregation, high prevalence of having a dedicated health care provider and high adolescent HPV vaccination rate.

Challenges: High premature death rate, high economic hardship index score and high prevalence of physical inactivity.

Mississippi (No. 49), Arkansas (No. 48), West Virginia (No. 47) and Alabama (No. 46) complete the five least healthy states.

This graph displays the state scores in order of rank from healthiest to least healthy. The difference between the lengths of the bars indicates the difference between state scores. For example, Mississippi (No. 49) and Louisiana (No. 50) have a large difference in score, making it more of a challenge for Louisiana to move up in the rankings. There is also a large gap in score between Tennessee (No. 44) and Oklahoma (No. 45).

To further explore state-level data, see Explore Data. The website features downloadable State Summaries for each state as well as the District of Columbia. Each summary describes state-specific strengths, challenges, trends and rankings for individual measures, allowing users to identify which measures positively or negatively influenced their state’s overall rank. This can be visualized by selecting a state in the Explore Data section. The website also features the Adjust My Rank tool that allows users to explore how progress and challenges across key measures can impact a state’s overall rank.