Living in a big city may come with better job opportunities or more weekend activities — but it might not be the healthiest choice you can make.
That’s according to a recent report from the U.S. News & World Report, which ranked the 500 healthiest counties in America in categories like population health, education, economic strength and public safety. Counties in the Midwest dominated the list, occupying five of the top 10 spots.
Neither the Northeast nor the West coast appeared in the top 10 at all: The top bicoastal qualifier, New Jersey’s Morris County, checked in at No. 16.
Here’s the report’s top 10:
- Los Alamos County, New Mexico
- Falls Church, Virginia
- Douglas County, Colorado
- Morgan County, Utah
- Carver County, Minnesota
- Sioux County, Iowa
- Ozaukee County, Wisconsin
- Hamilton County, Indiana
- Broomfield County, Colorado
- Delaware County, Ohio
Los Alamos County, located northwest of Santa Fe, New Mexico, took the top spot for the third year in a row, scoring a perfect 100 in the “housing” category, which evaluated data on housing affordability, capacity and quality. The county also scored a 94 in infrastructure and population health, which indicated — among other traits — strong access to care for both physical and mental health.
The U.S. News & World Report also noted in 2020 that Los Alamos County exceled in accessibility of healthy food. The small county may be punching above its weight: It only has a population of 18.976, according to the 2020 Census.
Falls Church, a city just west of Arlington, Virginia — and less than 10 miles from downtown Washington D.C. — snagged the second spot, earning perfect scores in both population health and education. The city’s public school system was ranked the best school district in Virginia in 2020 and 2021, according to Niche, an organization that provides in-depth looks at every school and college in the U.S.
In third place, Colorado’s Douglas County, which sits just south of Denver, notched a perfect score in the economic health category, which factored in data on employment, income and opportunity. The county’s unemployment rate in May was just 2.3%, according to the U.S. Bureau of Labor Statistics. Colorado’s other top 10 entrant — Broomfield County — also scored highly in economic health, as well as population health and infrastructure.
Notably, the top three counties on the list all directly border counties with larger cities and populations — Santa Fe, Washington D.C. and Denver, respectively — but none of the top three house those cities themselves.
The ranking assessed almost 3,000 counties and county equivalents in the U.S., comparing 10 different categories associated with community health: population health, equity, education, economy, housing, food & nutrition, environment, public safety, community vitality, and infrastructure.
More than a dozen population health and wellbeing experts participated in an online survey to decide the weight of each category, ranking its importance in relation to community health. The overall score for each county was calculated by averaging all 10 category scores.
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