How Healthy Is Your State?

Does health care shopping behavior indicate how healthy people are? Let’s look at the data to find out.

When we look at national usage of our health care shopping tools, interesting stories emerge. So, when we recently asked Are shopping trends at all related to how healthy or unhealthy a state’s population is?, we found clear indications that some states are much healthier than others. Furthermore, our findings can actually be referenced with and validated by national studies to make a more complete picture of how healthy – or unhealthy – a state’s population is.

Where do people search most for “healthy” or “unhealthy” conditions?
In order to identify the healthiest and unhealthiest states in the United States, we isolated four key search categories in our tools that we believe can be most closely tied to healthy and unhealthy lifestyles:

  1. Weight-loss surgery – Individuals who qualify for weight-loss surgery have high BMI, are extremely overweight and/or have a combination of obesity-related issues including type 2 diabetes, alcoholic fatty liver disease, heart disease and hypertension.
  2. Diagnostic tests/labs – This category was selected as a likely healthy behavior. That is because diagnostic testing and labs are often part of a routine checkup to look for changes in your health. They also help doctors diagnose conditions, decide on and evaluate treatments, and monitor diseases, all things that can help keep you healthy and balanced!
  3. Heart disease and circulation conditions – Another unhealthy indicator, heart disease can often be prevented or treated just with healthy lifestyle choices. In addition, many of the contributing risk factors for heart disease include things like high cholesterol and blood pressure, smoking, diabetes, obesity, physical inactivity and poor diet.
  4. Endocrinological conditions – While endocrinological conditions vary, many are considered preventable major health risks, including Pre-diabetes, Type 1 Diabetes and Type 2 Diabetes.

Analyzing how frequently these search categories came up in each state gave us a list of states we identified as “healthy” and “unhealthy.” But, our data on these states alone isn’t enough. We cross-referenced our list of rankings with three additional major national reports to validate our findings.

A little more about our top healthy states:

  1. Utah – With an average of 300 sunny days per year and an abundance of gorgeous national parks and nature, it’s no surprise to us that the easy access to active lifestyles has put Utah on top. Fun fact: Salt Lake City is home to the nation’s leading manufacturer of rubber chickens and it’s illegal to fish while on horseback.
  2. Colorado – Known for its outdoor adventures and easygoing lifestyles, this state ranks high on our list. Colorado has the lowest rate of adult obesity in the nation and the highest rate of physical activity! Fun fact: Denver has the largest city park system in the nation with 205 parks within city limits and 20,000 acres of parks in the nearby mountains.
  3. Minnesota – While many of our top 10 healthiest states hail from the West, Minnesota is on the list. Its The Mall of America in Bloomington is the size of 78 football fields, or 9.5 million square feet. Minnesota has 90,000 miles of shoreline, more than California, Florida and Hawaii combined – giving it tons of fair weather beaches and foul-weather mall walking.
  4. Alaska – Seventeen of the 20 highest peaks in the United States are located in this state. With the largest national forest in the United States and an official state sport of dog mushing, it’s no surprise Alaska ranks high in our list of healthiest states. Alaska also boasts the lowest rates in the country for both heart disease-related cost estimate searches as well as and weight loss surgery cost estimate searches.
  5. Montana – The most visited place in Montana is Glacier National Park, known as “the crown jewel of the continent.” Montana also has the second lowest rate of endocrinological cost estimate searches in the country and ranks third in the nation on the Gallup-Healthways State of Well-Being Report.

And the top unhealthy states:

  1. West Virginia – The state ranks lowest on the 2015 Gallup-Healthways State Well-Being Rankings. According to the same rankings, Charleston has the highest incidence of heart attack in the United States. America’s Health Rankings claims West Virginia has the highest prevalence of tobacco use in the country. The state also has the second-highest rate of cancer-related cost estimate searches in our tools, 1.7 times more searches than the average in healthy states.
  2. Mississippi – This state with the highest rate of Type 2 diabetes and the highest rate of physical inactivity in the nation in 2015 also gets an F from the American Lung Association for smoke-free air. Mississippi has the highest prevalence of searches for endocrinological conditions – nearly three times the average search rate of the healthy states.
  3. Arkansas – Second highest in the nation for health care cost searches related to endocrinological conditions and in rate of physical inactivity in the nation, Arkansas is close behind both West Virginia and Mississippi in its unhealthy lifestyle.
  4. Oklahoma – Is not the place to be for healthiness. It ranks 48th on the State Well-Being Rankings and, combined with an average inactivity rate of 33.2%, it’s no surprise this state falls low on our health rankings. Oklahoma is also the only state with zero searches for acupuncture in our cost estimate tools and has the lowest rate of search for chiropractic services.
  5. (Tie) Louisiana – Tied with Kentucky for last on America’s Health Rankings across all determinants, Louisiana is the most interested in getting weight-loss surgery – 11.5% of all cost estimate searches in the state.
  6. (Tie) Kentucky – Kentucky has, by far, the highest search rate for back and neck conditions in the country. These searches comprise 4.66% of all health care cost estimates delivered in the state.

Interesting findings

Alternative medicine

  • Those who live in the top 10 healthy states are nearly twice as likely to search for acupuncture services than those who live in unhealthy states.

Knee conditions

  • Healthier states don’t always have it better. People in healthy states are 33% more likely to search for knee conditions than in the unhealthy states. We attribute this, in part, to active lifestyles.

Weight-loss surgery

  • The biggest difference between healthy and unhealthy states is in weight-loss surgery. Unhealthy states are nearly 80% more likely to search for weight-loss surgery than healthy states.
  • Louisiana is the most interested in getting weight-loss surgery, which accounts for 11.5% of all cost estimate searches.


  • Those in healthy states are 19% more likely to search for imaging/radiology than those in unhealthy states. More active lifestyles may be a factor here.
  • Connecticut is the biggest consumer with 14% of all its cost searches dedicated to imaging and radiology, just edging out Alaska with 13.8%.


  • The unhealthiest states are 45% more likely to search for endocrinological conditions than healthy states are.
  • Mississippi has the highest prevalence of searches for endocrinological conditions – nearly three times the average search rate of the healthy states. Mississippi also had the highest prevalence of Type 2 diabetes in the nation in 2015.