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The overall state rankings derive from 49 measures across five categories of health: Social and Economic Factors, Physical Environment, Behaviors, Clinical Care, and Health Outcomes. Visit the America’s Health Rankings Methodology page for a more detailed description of how the overall rank is calculated.
New Hampshire Ranks No. 1
New Hampshire is the healthiest state in this year’s report for the third consecutive year. It ranks among the top five states in Social and Economic Factors (No. 1), Behaviors (No. 2) and Clinical Care (No. 4). New Hampshire is No. 9 in Health Outcomes and No. 13 in Physical Environment.
- Challenges: High prevalence of multiple chronic conditions, high prevalence of excessive drinking, low percentage of population served by community water systems with fluoridated water.
Vermont (No. 2), Massachusetts (No. 3), Minnesota (No. 4) and Connecticut (No. 5) complete the top five healthiest states. These states were also the top five states in last year’s report.
Louisiana Ranks No. 50
Louisiana is the least healthy state in this year’s report after also ranking No. 50 in the 2022 and 2023 Annual Reports. The state ranks in the bottom five states in Social and Economic Factors (No. 50), Physical Environment (No. 47), Behaviors (No. 49) and Health Outcomes (No. 50). Louisiana is No. 34 in Clinical Care.
- Strengths: Low prevalence of non-medical drug use, high childhood immunization rate, high percentage of adults with a dedicated health care provider.
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 last year’s report. West Virginia returned to the bottom five this year, switching spots with Alabama (No. 45).
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).
To further explore state-level data, see Explore Data. The website features downloadable State Summaries for each state and 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 each state’s overall rank. This can be visualized by selecting a state in the Explore Data section. Disparity ratios, which show the relative difference between two groups within a demographic, have been added to the State Summaries on the website this year. The website also features an Adjust My Rank tool that allows users 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:
- Florida (No. 39 to No. 31), Massachusetts (No. 11 to No. 3), New Hampshire (No. 9 to No. 1) and New Jersey (No. 21 to No. 13) improved eight spots.
- Illinois (No. 34 to No. 27), Maine (No. 19 to No. 12), South Carolina (No. 44 to No. 37), Virginia (No. 22 to No. 15) and Washington (No. 14 to No. 7) improved seven places.
- Kentucky (No. 47 to No. 41), Michigan (No. 35 to No. 29) and North Carolina (No. 36 to No. 30) improved six spots.
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).
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.
- Indiana (No. 30 to No. 36) declined six places.
