Methodology

To create the list, WalletHub compared 182 U.S. cities, including the 150 most populated U.S. cities and at least two of the most populated cities in each state, on 41 different metrics across four key dimensions:

• Healthcare, which includes the premature death rate, mental health, physical health, and health insurance coverage for both adults and children (25 points)
• Food, which includes the share of residents who say they eat healthy, inadequate fruit and vegetable consumption, and limited access to healthy foods (25 points)
• Fitness, which includes the share of adults who engage in any physical activity, a well-being "physical" score, and fitness and instruction centers per capita (25 points)
• Green space, which includes parkland acres per capita, quality of parks, and city "greenness" (25 points)

Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions for a healthy lifestyle. A city's weighted average across all the metrics was used to calculate its overall score and ranking.

Data for the ranking was collected from the U.S. Census Bureau, the Council for Community and Economic Research, the U.S. Bureau of Labor Statistics, and more.

The healthiest (and unhealthiest) cities in America

According to WalletHub, the 10 healthiest cities in America were:

1. San Francisco, CA
2. San Diego, CA
3. Seattle, WA
4. Salt Lake City, UT
5. Portland, OR
6. Washington, D.C.
7. Denver, CO
8. Honolulu, HI
9. Austin, TX
10. Scottsdale, AZ

"Staying healthy is a personal responsibility, and everyone should strive to eat nutritious food, exercise regularly and look after their mental health," said Chip Lupo, an analyst at WalletHub. "However, where people live can have a big influence on how successful they are at staying in good health, so the best cities are the ones that provide the greatest access to high-quality healthcare, green spaces, recreation centers, and healthy food."

How to create healthier cities

WalletHub spoke to several experts about ways cities can create healthier environments for their residents.

Dara Ford, a professorial lecturer at American University, recommends cities increase access to and lower the cost of healthy foods and create systems that promote safe activity. "Basic needs must be met before anyone is able to focus more specifically on health behaviors," she said. "We cannot tell people to eat more fruits and vegetables if there are not accessible stores in their area from which to purchase them."

To improve local healthcare systems, Andrew Burnstine, an associate professor in the College of Business and Management at Lynn University, suggested that governments "[move] medical services out of distant hospitals and directly into the neighborhoods where people live and work."

"As federal subsidies are cut, local authorities and state governments are increasingly stepping in to bridge the gap by funding mobile health units and decentralized community clinics focused on early detection," Burnstine said. "By integrating mental health resources into existing community centers, cities can reduce the burden on local taxpayers and lower the billions spent annually on reactive medical interventions."

Overall, "[h]aving a good infrastructure to facilitate health investments (very broadly defined) is important, and typically comes hand in hand with an affinity for healthy activities in the local population," said Robert Millard, an assistant professor in the department of economics at Stony Brook University. "… Good infrastructure combined with active engagement by locals makes it much more enjoyable to want to engage in the community and invest in your health, such as joining running/biking groups, shopping at local markets, and being part of a like-minded community."