Where you live can say a lot about your health and lifestyle. In other words, just knowing a home’s zip code can give insight into a population’s overall well-being. But that doesn’t mean you should let your community’s focus on health (or lack thereof) impact your own.
Whether a community is designed to provide access to public transportation, healthy food, safe housing, and public spaces that encourage wellness can have a big impact on health, according to the U.S. Centers for Disease Control and Prevention (CDC). For example, if you live close to work or school, you’re likely to walk there. Or, if there are parks close by, you may be active there.
On the flip side, when your community doesn’t prioritize these things, it can have a negative impact on your physical fitness. Just living near a highway away from green spaces can mean lower quality air—which contributes to health problems like asthma or cardiovascular disease. Physical fitness and risk for chronic disease impact how long you will live, or your life expectancy. If the community you live in doesn’t prioritize your health, that could shorten your life span—but it doesn’t have to.
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Healthiest cities in America
Wallethub analyzed how location affects health by examining which places promote wellness—by providing access to healthy food, low-cost health care, or well-maintained recreational areas. These are the top 10 healthiest U.S. cities, according to their research:
- San Francisco, California
- Seattle, Washington
- San Diego, California
- Portland, Oregon
- Washington, D.C.
- New York, New York
- Denver, Colorado
- Irvine, California
- Scottsdale, Arizona
- Chicago, Illinois
Unhealthiest cities in America
The qualities of the healthiest cities fell in stark contrast to the cities that ranked the lowest on the list.
- Detroit, Michigan
- Fort Smith, Arkansas
- Augusta, Georgia
- Huntington, West Virginia
- Montgomery, Alabama
- Memphis, Tennessee
- Shreveport, Louisiana
- Gulfport, Mississippi
- Laredo, Texas
- Brownsville, Texas
Factors for health by zip code
The healthiest cities in the Wallethub analysis have some things in common: cost of living, exercise spaces, access to healthy food, and low-cost health care. Alternatively, the unhealthiest locations tended to have higher poverty rates, less access to places to exercise and healthy food, and more barriers to healthcare. Here are the factors that determine a healthy city versus an unhealthy one.
Cost of living
Less expensive neighborhoods often have the elements—or lack thereof—that contribute to poor health. Meaning, community design is linked to income (how much you can afford to pay for housing), and cost of living (the expense associated with living in a certain area and getting healthcare there).
Notably, all of the top cities are high cost-of-living areas. For instance, in the No. 1 spot is San Francisco, where the average cost of a one bedroom apartment is $3,629. Only 9% of residents are considered low-income, and the median household income is $87,701, which is high, considering the overwhelming number of homeless individuals.
The cities farther down the list—those considered the most unhealthy—have much lower costs of living. For instance, Detroit is 165th on the list of 175 cities. The average cost of a one-bedroom apartment in Detroit is $1,100, and 33.4% of their population is living in poverty.
Exercise spaces
The Global Wellness Institute defines wellness as “the active pursuit of activities, choices, and lifestyles that lead to a state of holistic health.” The pursuit of wellness can be complicated by factors including environmental or geographic barriers (think-extreme weather or crime), cost, social stigma, and time constraints. Or, it can be helped with a variety of places to be active. The healthiest cities provide some of the most access to exercise spaces. The unhealthiest cities have among the least.
Fitness centers
With residents having easy access to 16 fitness centers per square mile it’s no wonder San Francisco tops the list. A five-year study showed that 21% to 23% of Californians get exercise daily, which is higher than most states, while Mississippi statistics show that 32% of the state’s population are physically inactive.
The same study connects exercise to your level of income, showing an increase with your education, (which often leads to higher income). This helps to explain why these cities with a higher cost of living are more readily pursuing good health.
Green spaces
This factor is made up of walkable space, greenspace, and air quality. Air and noise pollution tend to be more profound in major cities, but the addition of green space is said to have a positive impact. A 2019 study revealed that having access to a green space, even just viewing it, reduces physiological stress, which is a major factor in many cardiometabolic health concerns. The multisensory experience of being in a grassy park is excellent for promoting a sense of well-being and encouraging movement.
The top five cities are ranked in the top 10 for green space, rightfully so, since they all offer hiking trails, biking lanes, waterfront views and walks, and preserved parks. The very bottom of the list, Brownsville, Texas is a border city with an underdeveloped waterfront, an area which typically provides walking paths, greenspace and recreation. A developed waterfront also drives sustainability efforts. Fortunately for residents, the city is undergoing a massive revitalization project.
Access to healthy food
It is more difficult to eat healthy if you don’t have access to a variety of foods in your neighborhood, or reliable transportation to go get it. Most cities have food deserts—areas where it’s difficult to buy healthy, affordable food—which typically is where you’d find low-income families, yet some have created initiatives to close the gap. For instance, San Francisco’s Food Security Task Force has made its mission ensuring that low-income families or those in food deserts have access to quality choices. The cities with a higher cost of living typically have better systems in place to remedy food insecurity for the majority of the population, with the help of good transportation systems, food pantries, and more food markets.
Jen Tang, MD, internist in Lawrenceville, New Jersey has practiced in upper middle class areas, then impoverished areas only a half hour away, and she has seen how your zip code can change your access. “It’s very easy to see in your office [patients who are] not taking their meds or eating the diet I prescribed,” she explains. “We’re all guilty of doing that, but with many patients, it’s easy to overlook the complex issues of what can get in their way.” One major factor for her patients was transportation. Without a car or access to a reliable bus or train route, patients struggle meeting basic needs.
When transportation is an issue, convenience is prioritized. For someone struggling with food security in a rural area, fresh food may be even farther away. Without a car or consistent bus route, a gas station convenience store may be the only option for groceries. Sometimes these smaller stores sell their items at a higher price point. They may not offer fresh produce, and instead provide highly processed, high sugar, high sodium packaged items. Families living in these areas are more likely to be obese, because unhealthy food is the only food available. Lower cost of living locations are less likely to have aid available for families who cannot afford healthy food. In Detroit, for instance, 48% of residents are considered food insecure, and 30,000 don’t have access to a full-line grocer.
Health care
It is not a coincidence that residents of the unhealthiest cities face barriers to quality health care. Cost is a major factor in many places, with many places at the bottom in states that did not participate in the Medicaid expansion, which would control cost of care for lower-income individuals. Being uninsured or underinsured can directly affect one’s ability to have early interventions for serious conditions such as diabetes and hypertension, which are tied to obesity.
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Life expectancy by zip code
According to the Robert Wood Johnson Foundation, the top healthiest cities also boast the best life expectancies. In San Francisco, the average life expectancy is 85, which is well above the national average. Gulfport, Mississippi which is one of the most unhealthy metros in the country, has a life expectancy of just 75.19 years.
How does your area rank? Enter your zip code here to determine how your area’s life expectancy stacks up against the national average. Compare that to Wallethub’s list, which ranks the 175 top cities in the United States.
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Steps to improve your health—no matter where you live
No matter where your city is on the list, here are five steps you can take to cultivate a healthy lifestyle.
- Calculate your weekly grocery budget before you head to the store. Search for store sales and coupons to help reduce the cost of any more expensive items.
- Create a family menu for the week. “Regardless of where you live, planning out your meals in advance can save you time, money, and help you maintain a healthy diet,” says Jaime Coffino, Ph.D., MPH, a clinical psychologist in New York City.
- Make a list before grocery shopping—and stick to it. That way you’re not tempted to purchase extra snacks (which is good for your health, and your wallet). “Choosing healthy food options can be difficult when you are surrounded by an abundance of unhealthy food options,” Coffino says. “If you feel like you are constantly tempted by your food environment, it can be useful to set specific and attainable goals related to your health to hold yourself accountable.”
- Determine if you are eligible to receive benefits from the government through the Supplemental Nutrition Assistance Program (SNAP). This program can help provide you with financial assistance to purchase groceries. As an added benefit, 90% of SNAP participants are now allowed to use their benefits to purchase groceries online.
- Exercise at home. It’s possible to get physical activity with only an internet connection—no fancy equipment or gym membership required. Virtual workouts are increasingly common during the COVID-19 pandemic, and many are possible from your living room, without a greenspace or gym. There are many free workouts available online that can help you stay active. Just be sure to choose an activity that you enjoy and search for free classes that are available online.
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With smart shopping and at-home exercise, Americans can help boost their own well-being even if their city doesn’t have the ideal conditions for a healthy life.
