Skip to main content

U.S. News and Aetna Foundation Release 2019 Healthiest Communities Rankings

March 26, 2019 | Health Insurance

Second annual list helps identify best practices and accelerate progress for community health across the country.

Washington, D.C. – March 26, 2019 – Douglas County, Colorado, is the healthiest community in America, according to the 2019 Healthiest Communities rankings by U.S. News & World Report, released today in collaboration with the Aetna Foundation. The second annual report and accompanying analysis are based on an evaluation of nearly 3,000 communities nationwide across 81 health-related metrics in 10 categories, from education and population health to infrastructure and environment. In addition to assessing which communities offer their citizens the greatest opportunity to live a productive, healthy life, the project serves as a tool to inform residents, health care leaders and elected officials about policies and best practices that help drive better health outcomes.

For 2019, the top five Healthiest Communities score above the national average in all 10 categories. Following Douglas County, Colorado, at No. 1, Los Alamos County, New Mexico, rose to No. 2, moving Falls Church city, Virginia, to No. 3, down from No. 1 in 2018. Loudoun County, Virginia, jumped up a spot to No. 4, with Broomfield County, Colorado, rounding out the top five.

“Through the Healthiest Communities initiative, U.S. News expands on three decades of expertise in measuring health care quality to assess how social determinants affect community health,” said Eric Gertler, executive chairman of U.S. News & World Report. “Our second-year endeavor with the Aetna Foundation combines high-quality data with the power of journalism to engage communities about where they can improve and how they can learn from each other.”

The Healthiest Communities rankings, underwritten by the Aetna Foundation, are part of a $100 million commitment by CVS Health and its affiliates to making community health and wellness central to the company’s charge for a better world. The new Building Healthier Communities initiative, which will be funded over five years by CVS Health and the CVS Health and Aetna foundations, builds upon the outstanding tradition of community investment by CVS Health and Aetna and advances CVS Health’s purpose of helping people on their path to better health.

“Through our support of organizations across the country, we know that the most effective and innovative solutions to improve health are consistently developed by addressing the needs of each specific community,” said Larry J. Merlo, president and CEO of CVS Health. “The Healthiest Communities rankings continue to provide the insights that are essential to identify key issues and support community organizations, leaders and residents who are tackling the unique social determinants of health that impact their respective neighborhoods.”

In addition to an overall ranking of the top 500 communities, four peer groupings were developed based on counties’ urban-rural status as tied to population density and economic status. The peer groups assure fair comparisons between communities and are categorized as: urban high-performing, urban up-and-coming, rural high-performing and rural up-and-coming.

Key Findings in the 2019 Healthiest Communities rankings:

  • For 2019, Douglas County, Colorado, is the No. 1 healthiest community in America. The Denver suburb is among the top 10 healthiest communities in the country in at least four of the 81 measures, including physical activity, educational attainment and median household income.
  • Seven communities in Colorado rank among the top 20: Douglas County (1), Broomfield County (5), Chaffee County (11), Routt County (14), San Miguel County (17), Pitkin County (19) and Boulder County (20). In those seven counties, nearly all adults exercise and only about a quarter missed their annual wellness checkup. Across all of its counties, Colorado has the highest average score in the country in the Environment category, which includes measures of natural amenities and air and water quality.
  • Iowa has the strongest presence in the Healthiest Communities rankings overall, with 62 counties landing among the top 500. Average community scores put Iowa among the top 10 states in four of the 10 broad categories assessed, including Population Health and Housing. Iowa’s top-performing community, No. 26 Bremer County, takes top scores in walkability and low toxic releases.
  • 81 counties are new to this year’s top 500 communities, including Montour County, Pennsylvania, which improved in the Population Health category. Bath County, Virginia, saw significant progress in Education and Sweetwater County, Wyoming, rose in Environment.
  • Of the 81 metrics included in the Healthiest Communities analysis, diabetes prevalence and smoking rate have the strongest correlation to life expectancy. According to Healthiest Communities calculations, Hawaii counties perform the best in the country in life expectancy, with an average of 81.15 years
  • At 8.7 percent, the average smoking rate across Utah counties is the lowest in the country. The rate is about half the national average and about 3 percentage points lower than in California, the state with the second-lowest rate.
  • Poor self-reported mental health has about the same negative link to life expectancy as diabetes, smoking and physical inactivity. The same metric also is linked to higher rates of poverty at the community level.
  • Communities in Nebraska take 16 of the top 100 spots in the Mental Health subcategory, including Cherry County and Morrill County, which both score among the top 10 in the subcategory. The state has averaged 26 deaths due to suicide, alcohol-related disease and drug overdoses per 100,000 population; only New York state has averaged fewer “deaths of despair,” with 25 per 100,000 population.

To compile the rankings, U.S. News worked with the University of Missouri Center for Applied Research and Engagement Systems (CARES), a research institution skilled in community health assessment, and consulted with members of the National Committee on Vital and Health Statistics. For the 2019 rankings, three new measures were added: two under the Equity category assessing racial disparities and one under the Housing category measuring households with incomplete plumbing. Overall, the rankings are based on metrics drawn from sources such as the U.S. Centers for Disease Control and Prevention, the Institute for Health Metrics and Evaluation, the U.S. Census Bureau, the Dartmouth Atlas of Health Care and the U.S. Environmental Protection Agency.

The Healthiest Communities rankings are the centerpiece of a platform featuring in-depth reporting and analysis on community and public health issues, as well as comprehensive data covering the full spectrum of factors that influence population health. Healthiest Communities is part of U.S. News’ expanding civic journalism portfolio, which includes the Best States and Best Countries sections that evaluate how government leaders and public policies best serve their citizens.

2019 Healthiest Communities- Top 10

*See the full rankings here

  1. Douglas County, Colorado

  2. Los Alamos County, New Mexico

  3. Falls Church city, Virginia

  4. Loudoun County, Virginia

  5. Broomfield County, Colorado

  6. Teton County, Wyoming

  7. Hamilton County, Indiana

  8. Carver County, Minnesota

  9. Delaware County, Ohio

  10. Howard County, Maryland

Peer Group Rankings – Top 5

Urban, High-Performing

  1. Douglas County, Colorado

  2. Los Alamos County, New Mexico

  3. Falls Church city, Virginia

  4. Loudoun County, Virginia

  5. Broomfield County, Colorado

Rural, High-Performing

  1. Teton County, Wyoming

  2. Chaffee County, Colorado

  3. Morgan County, Utah

  4. Routt County, Colorado

  5. Jefferson County, Montana

Urban, Up-and-Coming

  1. Houston County, Minnesota

  2. Hood River County, Oregon

  3. Bennington County, Vermont

  4. Island County, Washington

  5. Marquette County, Michigan

Rural, Up-and-Coming

  1. Wallowa County, Oregon

  2. Lincoln County, Washington

  3. Calhoun County, Iowa

  4. Iron County, Wisconsin

  5. Baylor County, Texas

Key Health Measures – Top 5

Top 5 Communities for Access to Health Care

  1. Suffolk County, MA

  2. Olmsted County, MN

  3. Montour County, PA

  4. Ohio County, WV

  5. Johnson County, IA

Top 5 Communities for Mental Health

  1. Manassas Park city, VA

  2. Cherry County, NE

  3. Tripp County, SD

  4. Honolulu County, HI

  5. Santa Clara County, CA

Top 5 Communities for Low Cancer Prevalence

  1. Ziebach County, SD

  2. Culberson County, TX

  3. Presidio County, TX

  4. Garfield County, WA

  5. Hudspeth County, TX

The 2019 Healthiest Communities rankings are accompanied by data-driven and narrative stories examining the health island of Williamson County, Tennessee; the conflict of city vs. suburban health as seen in Nassau County, New York; and more.

To view the full rankings and search county profiles, please visit:

For more information on Healthiest Communities explore Facebook and Twitter using #HealthiestCommunities.

About U.S. News & World Report

U.S. News & World Report is a digital news and information company that empowers people to make better, more informed decisions about important issues affecting their lives. Focusing on Education, Health, Money, Travel, Cars and Civic, provides consumer advice, rankings and analysis to serve people making complex decisions throughout all stages of life. More than 40 million people visit each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C.

About the Aetna Foundation

The Aetna Foundation is an independent charitable and philanthropic affiliate of CVS Health (NYSE:CVS). As a national health foundation, the Aetna Foundation promotes wellness, health and access to high-quality health care for everyone. This work is enhanced by the time and commitment of Aetna employees, who volunteered 670,000 hours in 2018 alone. For more information, visit

Media Contacts:

U.S. News & World Report:
Maria Santucci

Aetna Foundation:
Ethan Slavin