We tend to think about health as an individual issue—eating healthy, exercise, and regular doctor visits. But there is an influential, often underestimated force that can take a major impact on our capacity for health: where we are living. Cities are not just the settings of our life; they actually create it in some ways. Some have easy access to green produce, cheap gyms, and clean parks. Others are deserts with no healthcare, few gyms, and no safe exercise areas.

To emphasize this disparity, WalletHub evaluated 182 of America’s most populous cities, comparing them on dozens of metrics ranging from park space and walkability to fitness club expenditures and access to health care. And what it found reflects one clear reality: in some places, healthy living is the rule; in others, it is a challenge.

Ranking US Cities According to Health Factors

WalletHub’s report measured each city on four main dimensions: health care, food, fitness, and green space. These were divided into 41 distinct indicators, such as rates of premature death, fruit and vegetable intake, availability of farmers’ markets, affordability of medical care, fitness center count, and quality of public parks.

All metrics were rated on a scale of 100, with higher ratings being indicative of greater support for an optimal healthy lifestyle. Researchers then computed the weighted composite score in each city in terms of an overall “health score” using data drawn from the U.S. Census Bureau, Centers for Disease Control and Prevention, the County Health Rankings, as well as other reputable national data bases.

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Top Performers: The 10 Healthiest Cities in the U.S.

San Francisco, CA – Having the top overall health in the country, San Francisco features a pedestrian-friendly city layout, varied healthy restaurants, and some of the finest green spaces in the nation. Just 18% of its citizens are obese, one of the lowest percentages in the country. It also heavily invests in park creation and recreation, in addition to having an abundance of gluten-free and vegetarian options for eating out.

Honolulu, HI – It is famous for its tropical beaches, but Honolulu leads the nation in public health. Nine out of ten adults are insured, as are 98 percent of its youngsters, and it has the most farmers markets and hiking paths per capita in the entire nation.

Seattle, WA – Compared to its rainy weather, Seattle is high on the list because of the activity level of its residents, as well as green space the city has in abundance. It allocates heavily for park upkeep and has an active community interested in health in terms of high numbers of health-oriented searches online.

Salt Lake City, UT – This locale glimmers in fitness and access to health care. Coming in third for fitness as well as green space, Salt Lake City makes it easy for its residents to be active throughout the year.

San Diego, CA – San Diego’s mild climate combined with its emphasis on wellness means high marks in green space access as well as food quality, making outdoor life and healthy eating an integral part of daily life.

Portland, OR – Perhaps the most environmentally friendly city in the country, Portland has excellent health care accessibility, a lively health food culture, and vast bicycle trail and park system that promotes physical fitness.

Denver, CO – Outdoor recreation is enjoyed throughout the year in Denver, where there is an emphasis on healthy foods, great access to fitness facilities and public parks,

Minneapolis, MN – Far from being what might be expected as a health center, Minneapolis has one of America’s finest health care infrastructures, in addition to clean parks and availability of healthy foods for eating out.

Washington, DC – America’s capital city pairs robust food establishments with vast fitness facility and park access. Its street layout allows both walking and cycling as realistic commute options.

Huntington Beach, CA – This coastal city is high on the list for fitness culture and health care quality, if not quite as high on the list for green spaces or for its cuisine.

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Health Deserts: The 10 Least Healthy Cities in the U.S.

Brownsville, TX – Placing at the bottom of the list, Brownsville does not fare well in any of the main categories. It is at the lowest in food and fitness, with very poor access to healthy foods, exercise facilities, and green areas.

Gulfport, MS – Lacking nearly any access to nutritious foods and placing among America’s lowest-ranked green space, Gulfport is struggling with significant challenges in building an environment supportive of wellness.

Shreveport, LA – Shreveport is the third-worst overall due to limitations in parks, access to health care, as well as healthy eating options.

Columbus, GA – This city received the lowest health care score overall in the study. Paired with poor food and fitness scores, it is a grim picture for local citizens looking for healthier living options.

Laredo, TX – At or near the bottom in terms of health care, food, and fitness, Laredo is another Texas city whose public health infrastructure is in dire need of improvement.

Huntington, West Virginia – Failing in categories of fitness and green space in particular, Huntington is also challenged in terms of poor nutrition options as well as inadequate medical services.

Corpus Christi, TX – Having some of the lowest ratings in health care as well as in access to food, Corpus Christi has few resources for supporting physical or mental wellness.

Fort Smith, AR – This Arkansas city scores poorly in all areas, especially fitness and health care. Wellness opportunities are slim here.

Memphis, TN – Memphis has inadequate green space as well as access to food, both driving down the level of physical activity as well as overall health.

Jackson, MS – Completing the list at the bottom, Jackson has inadequate fitness, access to food, and park space, leaving its residents with few options for healthy living.

How the biggest American cities measure up

Surprisingly, the nation’s largest cities did not do as well as predicted. New York City ranked at #19, with its culinary scene uplifting but health care and fitness availability pulling it down. Los Angeles ranked at #13, with high scores on the food front but lower support for fitness and medical care. Chicago, the third-largest city, ranked #28 overall, held back by health care scores. Houston, with its economy and size, fell way down on the list at #93 due to its low rankings on green space and medical access. Phoenix did not do as badly, ranking #53, with middle-of-the-road scores on food, fitness, and green space.

Conclusion: It Begins at Home—and in Your Community 

This research points out an important reality: your personal health is shaped significantly by your environment. From availability of healthcare and healthy foods to access to safe parks and gyms, your city’s built environment has an enormous impact on your health. San Francisco, Seattle, and Honolulu are examples of how, if you create healthier environments in your city, residents as a whole are healthier. 

Conversely, the dramatic inequalities in Brownsville, Gulfport, and Shreveport are symptoms of system-wide problems that can’t be addressed through personal decision-making. These communities require investment in public health, infrastructure, and neighborhood assets, not just greater awareness. As people become increasingly aware of these problems, so does the prospect for reform. Urban planners, policymakers, as well as citizens, can push for communities in which healthy living is made possible for everybody. Because in the world today, your ZIP code may be the most significant health choice you’ll ever make.

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