America's Healthiest Metros

In the spirit of the New Year, a look at how U.S. cities stack up on measures like obesity and smoking

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Flickr/Seattle Municipal Archives

The New Year brings with it a renewed commitment to health and fitness. People across the country hit the gym, take up new diets and quit smoking to get in shape. 

In that spirit, I looked at variation in health and fitness across the country. I didn't want to use fleeting indicators like gym memberships or the amount of running gear sold, but more systematic measures of levels of actual health and fitness.

With the help of my Martin Prosperity Institute colleague Charlotta Mellander, I developed a Metro Health Index based on two key Centers for Disease Control indicators - the level of smoking and obesity. Smoking and obesity comprise two of the most significant health problems confronting American citizens and other advanced industrial nations today.

Obesity has reached epidemic proportions: 17 percent of American children (12.5 million) and 33.3 percent of American adults (72 million) now meet the Centers for Disease Controls’ criteria for obesity, percentages that have doubled since 1980.

And although smoking has been trending downward, more than 46 million Americans (about one in five adults) still smoke. The two are associated with myriad health problems, especially cancer, heart disease and diabetes. Smoking takes an average of 10 years off Americans’ average life spans, while obesity reduces life-spans between five and 20 years, depending on age and race.

Each year, about 443,000 Americans die from smoking-related diseases; some 300,000 premature deaths are attributed to obesity. The Centers for Disease Control estimates that smoking and obesity combined generate annual health costs of more than $300 billion.

The Metro Health Index measures the share of people who smoke or are obese across 315 U.S. metro regions. The higher the score on the index, the lower the rates of smoking and obesity, and the better a metro’s health outlook. Smoking is measured as the percentage of the population who are regular smokers. Obesity is measured as the percent of the population with a Body Mass Index of 30 or more. It's notable that smoking and obesity themselves are closely related across the United States, with a statistical correlation of .55) across U.S. metros. 
 
 

The map above, by the MPI’s Zara Matheson, charts the Metro Health Index across the United States. The healthiest metros are dark blue; the unhealthiest are yellow. Most of the dark blue ones can be found on the West Coast, mainly in California, with a few scattered in the northeast and southern Florida. San Jose, Santa Cruz, Boulder, and Napa had the highest scores on the index.

The least healthy metros – those with the most elevated levels of smoking and obesity - are largely located in the South and the Midwest. Below, our slideshow of the top 20 healthiest U.S. metros.

About the Author

  • Richard Florida is Co-founder and Editor at Large of CityLab.com and Senior Editor at The Atlantic. He is director of the Martin Prosperity Institute at the University of Toronto and Global Research Professor at NYU. More
    Florida is author of The Rise of the Creative ClassWho's Your City?, and The Great Reset. He's also the founder of the Creative Class Group, and a list of his current clients can be found here