How Healthy Is Your State? A Comprehensive Look at Health Across the U.S.

A healthy nation is a prosperous nation.

Public health influences not only individual lives, but also the strength of our communities, workforce productivity, and national resilience. As public health challenges continue to rise, promoting both physical and mental well-being has never been more urgent.

At Drip Hydration, a U.S.-based wellness provider offering mobile IV therapy and personalized support for recovery and immunity, we empower people to take proactive steps toward better health.

To further this mission, we conducted a data-driven study analyzing the health status of all 50 U.S. states. By highlighting both risk factors and areas of strength, our goal is to spark awareness, inspire conversation, and drive action—because better health benefits everyone.

Key Findings: What the Numbers Say About America’s Health

Our analysis reveals striking differences in how health is experienced and supported across the United States.

Some states lead the way with strong access to wellness resources, high rates of physical activity, and low levels of mental distress. Others continue to face persistent challenges, including high obesity rates and limited health insurance coverage.

While no state is without its shortcomings, the data clearly shows that investing in health-promoting infrastructure and addressing risk factors yields measurable, meaningful results. States that perform well across both clusters—Health Risk Factors and Health Promotion Factors—tend to have not only healthier populations, but also more resilient communities.

Hawaii Tops the Ranking as America’s Healthiest State

 

🏝️ 26% obesity rate (vs. 34% U.S. avg)
🧠 Lowest mental distress nationwide
🩵 Cleanest air (with Wyoming)
🏥 97% health insured
🧘 741 wellness facilities (51 per 100,000 people)

 

Hawaii leads the nation in health. With an adult obesity rate of just 26% and the lowest levels of frequent mental distress, the state sets a strong example of well-being. Nearly 97% of residents are insured, providing broad access to healthcare.

Its clean air, low pollution, and lack of heavy industry contribute to excellent environmental health. Along with Wyoming, Hawaii records the lowest levels of fine particulate matter (PM2.5)—a strong indicator of air quality.

On the other end of the spectrum, states like Arkansas, Ohio, Mississippi, Alabama, and Georgia show significantly higher pollution levels, which can increase the risk of respiratory and cardiovascular conditions.

The island lifestyle—closely tied to nature, outdoor activity, and community—likely plays a key role in maintaining both physical and mental balance. Hawaii also benefits from a thriving wellness infrastructure driven by tourism, with 741 facilities ranging from traditional spas to yoga studios.

💡 What this tells us Hawaii’s success is no accident. Its blend of natural advantages and a deeply rooted culture of prevention shows how well-being can be embedded into daily life. From access to clean air and outdoor activity to a robust wellness infrastructure, Hawaii offers a powerful model—reminding us that when health is a shared priority, communities thrive.

Coverage Counts: Why Health Insurance Still Defines U.S. Health Outcomes

 

🏥 97% insured in Vermont, Hawaii and Massachusetts
❗ Only 84% insured in Texas – lowest nationwide (vs. 93% U.S. avg)
⚠️ Insurance gaps linked to worse health outcomes

 

Health insurance is one of the most important health promotion factors for long-term well-being. It improves access to preventive care, reduces financial stress during illness, and ensures timely treatment. On average, 93% of U.S. adults are insured—but coverage is far from evenly distributed.

Vermont, Hawaii, and Massachusetts lead with 97% of their residents insured, reflecting strong access to care and robust health systems.

In contrast, Texas ranks lowest, with just 84% of the population covered. States like Wyoming, Florida, Georgia, Nevada, and Oklahoma also fall below the national average, each with 89% insured.

The reasons for these gaps are complex—ranging from state-level healthcare policies and Medicaid expansion decisions to employment patterns and population demographics. 

But the consequences are clear: lower insurance rates often correlate with poorer health outcomes, higher rates of untreated illness, and increased strain on emergency services. 

💡The takeaway Improving health insurance coverage remains a crucial step toward a healthier and more equitable nation.

Beyond the Scale: The Measurable Impact of Diet and Physical Activity

 

🍩 1 in 3 Americans is obese
🍏 5% or less meet diet goals in MS, OK, ID, AL, MO, WV
🏋 35% of Coloradans exercise regularly – highest
🛋️ Only 1 in 5 West Virginians meets activity standards – lowest

 

Obesity remains one of the most urgent health crises in the United States, largely driven by lifestyle choices. One in three adults is considered obese, which significantly raises their risk for heart disease, diabetes, and premature death.

These statistics reflect clear patterns in how Americans eat and move. Many consume high-calorie, nutrient-poor diets and fail to get regular physical activity. Only 8% of adults meet the daily recommendations for fruits and vegetables, while fewer than 1 in 3 follow federal physical activity guidelines.

The effects are particularly evident in West Virginia, the state with the highest obesity rate and lowest levels of physical activity. Here, 41% of adults are obese, and only 1 in 5 engage in regular exercise. In contrast, Colorado shows the power of healthy habits: it boasts the lowest obesity rate (25%) and the highest activity levels, with over 35% of adults meeting physical activity guidelines.

💡Why it matters Obesity is not a random occurrence—it’s the result of daily habits influenced by access, education, and infrastructure. Creating healthier environments leads to healthier choices and, ultimately, better health outcomes.

America’s Ongoing Struggle with Smoking and Drinking

 

❗️14% of Americans still smoke tobacco (down from 40% in 1960s)
🚬 Fewer than 10% smoke in CA, MD & UT
🍺 4+ gallons of pure alcohol per adult in NH & DE
❤️ Utah = lowest smoking and alcohol use in the U.S.

 

The dangers of smoking are no secret—but old habits die hard. While smoking rates have dropped significantly over the past decades (from over 40% in the 1960s to just 14% today), a sizable portion of Americans still hold onto the myth of the Marlboro Man. Smoking remains especially common in West Virginia, Arkansas, and Tennessee, where rates are among the highest. On the other end, California, Maryland, and Utah have seen the sharpest declines, with fewer than 1 in 10 adults still smoking.

Alcohol consumption, too, continues to pose a major health risk. Easy availability, cultural normalization, and stress-related drinking contribute to widespread overconsumption. The most alcohol per capita is consumed in New Hampshire and Delaware, with residents averaging over 4 gallons of pure alcohol per year—through beer, wine, spirits, and beyond. In stark contrast, Utah reports the lowest alcohol use nationwide, reflecting cultural and policy influences that limit access and consumption.

💡What we are seeing Smoking and alcohol remain two of the most preventable causes of chronic disease in the U.S. The data makes it clear: while progress has been made, the long shadow of these everyday stimulants still weighs heavily on public health.

Methodology

Wondering how the rankings were determined? Here’s an inside look at the data sources, scoring methodology, and the reasoning behind our health index.

Health risk factors

Obesity

The data presented reflects the percentage of adult citizens perceived as ‘obese.’ An ‘obese adult’ is defined by a body mass index (BMI) of 30 kg/m² or greater. The BMI threshold of 30 for obesity is established based on extensive population studies, which demonstrate a significant and clinically relevant increase in the risk of serious health issues such as type 2 diabetes, cardiovascular diseases, and certain types of cancer at and above this level. The BMI data presented is based on self-reported weight and height measurements from the year 2023. This information was sourced from the ‘CDC 2023 Adult Obesity Prevalence Maps’, published by the official U.S. Centers for Disease Control and Prevention. Obesity is widely recognized as detrimental to citizens’ health; therefore, it is a significant negative factor in the index. The lower the obesity rate, the better the state’s position in the ranking.

Smoking

The data presented shows the cigarette smoking rates among adults for the most recent year with available data (2022), specifically the percentage of adults who smoke cigarettes. A smoker is defined as someone who has smoked 100 or more cigarettes in their lifetime and at least one cigarette in the past 30 days. The data originates from the U.S. Centers for Disease Control and Prevention and has been analyzed by the American Lung Association, an organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy, and research. Smoking is widely recognized as detrimental to citizens’ health; therefore, it is a significant negative factor in the index. The lower the smoking rate, the better the state’s position in the ranking

Alcohol cosumption

The data presented details on per capita ethanol consumption in gallons, based on the population ages 14 and older. This information is sourced from the National Institute on Alcohol Abuse and Alcoholism’s Division of Epidemiology and Prevention Research Alcohol Epidemiologic Data Systems, in their ‘Surveillance Report #121: Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977–2022’ (page 13-14) published in April 2024. Alcohol consumption is widely recognized as detrimental to citizens’ health; therefore, it is a significant negative factor in the index. Excessive alcohol intake is linked to a range of serious health issues, including liver disease, cardiovascular problems, and an increased risk of certain cancers. The lower the rate of alcohol consumption, the better the state’s position in the ranking, reflecting the public health benefit of reduced alcohol use.

Mental distress

The data presented captures the percentage of adults who reported that their mental health was not good for 14 or more days in the past 30 days, based on the 2023 findings from the CDC’s Behavioral Risk Factor Surveillance System, published by America’s Health Rankings®, a platform by United Health Foundation. Frequent mental distress is widely recognized as detrimental to citizens’ health; therefore, it is a significant negative factor in the index. Chronic stress and prolonged mental distress can lead to severe health problems, including depression, anxiety, and heart disease, as well as a decrease in overall physical health. The lower the percentage of adults experiencing frequent mental distress, the better the state’s position in the ranking, reflecting the public health benefit of sound mental health management and support systems.

Low air quality

The data presented captures the average annual concentration of fine particulate matter (PM2.5) in the air, measured in micrograms per cubic meter (µg/m³) for the year 2019. PM2.5 refers to tiny air pollution particles with a diameter of 2.5 micrometers or smaller, which can be harmful to human health when inhaled. This measurement indicates the level of air quality, with higher values suggesting worse air quality and lower values indicating cleaner air. The data is sourced from the HD Pulse platform by the National Institute of Health from the U.S. Department of Health & Human Services. Poor air quality and high levels of PM2.5 are recognized as detrimental to citizens’ health and are therefore significant negative factors in the index. Long-term exposure to high PM2.5 levels can lead to serious health issues, including respiratory infections, heart disease, COPD, and an increased risk of lung cancer. The lower the PM2.5 levels, the better the state’s position in the ranking, reflecting the public health benefit of cleaner air and effective pollution control measures.

Health promotion factor

Athleticism

The data presented captures the percentage of adults who met the federal physical activity guidelines in the past 30 days, as of 2023. These guidelines recommend at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity, along with two days of muscle-strengthening exercises per week. Unfortunately, no data was available for Kentucky and Pennsylvania, so the average value from all states was used instead. This information is sourced from the CDC’s Behavioral Risk Factor Surveillance System and published by America’s Health Rankings®, a platform by United Health Foundation. Meeting these physical activity guidelines is recognized as highly beneficial to individuals’ health and is, therefore, a significant positive factor in the index. Regular physical activity, including both aerobic and muscle-strengthening exercises, can lead to numerous health benefits such as improved cardiovascular health, enhanced muscle and bone strength, better weight management, and reduced risk of chronic diseases such as diabetes, heart disease, and certain cancers. Furthermore, regular exercise contributes to better mental health by reducing symptoms of depression and anxiety, and enhancing cognitive function. The higher the percentage of adults adhering to these activity guidelines, the better the state’s position in the ranking, reflecting the public health advantage of an active and athletic lifestyle.

A balanced diet

The data presented captures the percentage of adults who reported consuming at least two fruits and three vegetables daily in the year 2021, according to the CDC’s Behavioral Risk Factor Surveillance System, published by America’s Health Rankings®, a platform by United Health Foundation. Unfortunately, no data was available for Florida, so the national average was used for that state instead. Maintaining a balanced diet, particularly one rich in fruits and vegetables, is crucial for good health and well-being. Fruits and vegetables are packed with essential vitamins, minerals, fiber, and antioxidants, which play significant roles in preventing chronic diseases such as heart disease, diabetes, and cancer. Regular consumption of these foods promotes healthy digestion, supports immune function, and contributes to skin health and overall vitality. Moreover, a diet rich in fruits and vegetables can help maintain a healthy weight, reduce blood pressure, and lower the risk of heart diseases. The percentage of adults adhering to this dietary recommendation is a positive factor in the index. Higher rates of fruit and vegetable consumption are associated with better public health outcomes, reflecting the fundamental role that nutrition plays in enhancing health and preventing disease. States with higher percentages of adults who meet these dietary guidelines typically demonstrate stronger public health metrics and healthier populations.

Health insurance

The data presented shows the percentage of the population that had any type of health insurance coverage in the year 2023, according to the United States Census Bureau. Health insurance coverage is critical as it provides individuals and families with access to necessary medical services that might otherwise be unaffordable. This includes preventive care, which helps detect health issues early when they are most treatable, and reduces overall healthcare costs by preventing diseases from progressing to more severe stages. Health insurance also covers a significant portion of costs for major health events such as surgeries and long-term medical treatments, reducing financial stress and improving quality of life. Moreover, individuals with health insurance are more likely to visit a doctor regularly and receive timely medical care, which is essential for maintaining overall health and managing chronic conditions effectively. This accessibility to healthcare services not only supports individual health but also contributes to public health by preventing the spread of infectious diseases and managing population health more broadly. The percentage of insured individuals is a positive factor in the index as higher insurance coverage rates typically correlate with better health outcomes across the population. States with higher rates of health insurance coverage tend to have healthier populations, which is reflective of the critical role that access to healthcare plays in ensuring public well-being.

Wellness resources

The number of wellness and spa facilities in each U.S. state was determined by analyzing Tripadvisor data from March 2025, using state-specific listings. This comprehensive measure reflects the availability of a diverse array of establishments designed to enhance personal health and well-being, including traditional spas and saunas, public swimming pools, thermal baths, cosmetic studios, hydration drip therapy bars, yoga and meditation centers, massage therapy clinics, wellness retreats, aromatherapy centers, and floatation tanks. Each facility offers unique health benefits. Yoga and meditation centers enhance mental clarity and physical balance while reducing stress. Massage therapy clinics alleviate muscle tension and promote relaxation through enhanced blood flow. Wellness retreats provide holistic programs that address nutrition, fitness, and mental health. Aromatherapy centers use essential oils to reduce anxiety and improve sleep, while floatation tanks support deep relaxation and chronic pain management. Notably, hydration drip therapy bars offer tailored nutrient infusions that can rapidly restore hydration, boost immune function, detoxify the body, and increase energy levels, making them a valuable resource for health maintenance and recovery. The presence of such facilities significantly contributes to the health index as they encourage a culture of health and wellness. States with a higher number of these facilities typically see improved public health outcomes, highlighting the importance of accessible wellness options in promoting a healthier, more relaxed population.

Scoring system

To create a comprehensive and comparable state health ranking, each factor within the categories—’Health Risk Factors’ and ‘Health Promotion Factors’—was first normalized. Normalization is a crucial statistical process that adjusts diverse data points to a common scale. In this context, the normalization formula was used to scale each factor such that the resulting values range from 0 to 100. This scaling ensures that all factors contribute equally to the overall analysis, despite original differences in data ranges or units.