Living a healthy lifestyle sounds simple enough: eat nutritious food, exercise regularly, and avoid risky habits like smoking or excessive drinking. But in reality, it’s not always that straightforward. While healthy habits are essential for long-term health, a new study from healthcare staffing company Nursa suggests that where you live also plays a major role in how easy it is to maintain a healthy lifestyle.
According to the research, Vermont ranks as the healthiest state in the US, followed closely by Washington and New Hampshire. On the other end of the spectrum, Louisiana, West Virginia, Mississippi, and Tennessee are among the lowest-ranked states for overall health.
So, why are some states healthier than others? It largely comes down to access. Things like affordable healthcare, nutritious food, safe spaces for exercise, and the socioeconomic resources that support long-term wellness are vital for a state to thrive.
What makes a state healthy?
To determine which state ranks as the healthiest in the US, Nursa analyzed a range of lifestyle and environmental factors. These included the number of gyms, healthy food stores, parks, public pools, and walking or running routes per 100,000 people. The study also considered smoking rates, life expectancy at birth, hospital readmission rates, and air pollution levels to create a comprehensive picture of public health across the country.
Vermont came out on top, earning an overall health score of nearly 8.7 out of 10. “With some of the lowest pollution levels, as well as a vast amount of green spaces, gyms, and running routes, the Green Mountain State is leading the way when it comes to wellness,” the study notes.
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The state also ranked highest for access to nutritious food, with nearly 40 healthy food stores per 100,000 people. That matters: mounting research shows that what we eat plays a major role in long-term health. Ultra-processed convenience foods, like candy, potato chips, frozen dinners, and fast-food burgers, have been linked to more than 30 negative health outcomes, including heart disease, cancer, and type 2 diabetes. In contrast, whole, plant-based foods are associated with a lower risk of many chronic conditions.
Earlier this year, the Mediterranean diet, which emphasizes nutrient-rich whole foods like fruits, vegetables, whole grains, and legumes, was named the best overall diet by the US News & World Report for the eighth consecutive year.
New Hampshire and Washington also made the top three. Both states scored high for access to healthy food, while New Hampshire had the lowest pollution levels of any state, and Washington boasted the most walking routes. “The number of parks per state had a significant negative correlation with the hospital readmission rate,” the study adds.
Where is the unhealthiest state in the US?
Louisiana ranked at the bottom of Nursa’s study, earning the unfortunate title of the unhealthiest state in the nation. The state had one of the highest smoking rates, the worst air pollution, and the lowest number of gyms in the country. Other low-ranking states included Tennessee, West Virginia, Mississippi, and Nevada. “These states face a combination of environmental challenges, fewer wellness facilities, and higher readmission rates,” the study states.
It’s not the first time Louisiana has landed at the bottom of a health or wellness ranking. Last year, it also took last place in US News & World Report’s Best States list, which considered healthcare, environment, infrastructure, and other key indicators like education and economy.
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About one in five people in Louisiana live below the poverty line. According to Feeding Louisiana, more than 827,000 residents experience food insecurity. The state is also a hotspot for food deserts, which are areas with little or no access to affordable, fresh, and nutritious food.
Some advocates prefer the term “food apartheid” over “food desert,” noting that the issue isn’t accidental. “‘Food apartheid’ looks at the whole food system, along with race, geography, faith, and economics,” food justice advocate Karen Washington told The Guardian in 2018.
“You say ‘food apartheid’ and you get to the root cause of some of the problems around the food system.”
Access to fresh, healthy food, clean air, green spaces, and safe neighborhoods isn’t evenly distributed across the US, and that disparity shows up in health outcomes. It leads to higher hospital readmission rates, and this places a higher burden on the healthcare system.
“High hospital readmission rates strain both patient outcomes and healthcare facilities striving to meet patient care demand,” said Nursa’s CEO, Curtis Anderson. “As facilities work to manage fluctuating patient volumes and avoid financial penalties, they are often faced with increased pressure to scale staff up quickly and flexibly. Managing this effectively requires flexibility and careful workforce planning.”
All of this points to a larger reality: health isn’t just a personal responsibility. Systemic factors like policy, infrastructure, and income inequality shape it. While individuals can do their best to make healthy choices, their environment can either support or hinder those efforts. Vermont is a prime example of what happens when a state invests in public well-being.
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Charlotte is a VegNews editor and writer based in sunny Southsea on England's southern coast.
