The Fittest And Least Fit States In America, Ranked Across 10 Health Factors
In A Nutshell
- The least fit states are heavily concentrated in the South, with Louisiana, Mississippi, West Virginia, Alabama, and Tennessee all landing in the bottom six, sharing limited exercise infrastructure and high rates of inactivity, obesity, and smoking.
- Vermont ranked as the fittest state in the U.S. with a score of 8.97 out of 10, excelling in sleep, diet, physical activity, and low smoking rates, while Louisiana landed last at 4.25.
- Massachusetts residents are the most active in the country, with 68.1% getting at least 150 minutes of aerobic exercise per week, and West Virginia has the highest adult obesity rate in the nation at 41.4%.
- Colorado managed to rank 4th despite having more fast food locations per capita than any other state, pointing to the outsized role that gym access and outdoor activity culture can play in overall fitness.
Vermont leads the nation in fitness while Louisiana sits dead last, and the gap between them tells a stark story about how geography, lifestyle habits, and access to green space shape the health of an entire population.
How the Fittest States Index Was Built
- Obesity and smoking figures came from the Centers for Disease Control and Prevention.
- Sleep and inactivity data were sourced from America’s Health Rankings, as were diet figures: specifically the percentage of adults who eat at least two servings of fruit and three servings of vegetables per day, based on 2021 data.
- Exercise data came from the Apple Heart & Movement Study, which tracked the share of residents getting 150 or more minutes of moderate aerobic activity per week.
- Alcohol consumption figures came from World Population Review’s 2023 per capita data.
- Gym counts, walking and hiking route tallies, and fast food location density were all drawn from OpenStreetMap data across all 50 states.
Each state was scored on all 10 factors, and a percent-rank method was used to calculate the final composite score out of 10. All data was finalized as of February 19, 2026.
The ranking doesn’t pretend to capture everything about a state’s health. Income, healthcare access, and food environment all play a role that a composite fitness score can’t fully account for. But as a snapshot of where Americans are moving, eating, sleeping, and smoking: it draws a clear enough picture.
Vermont’s top ranking reflects what happens when outdoor access, good sleep habits, low smoking rates, and active residents converge in the same place.
Louisiana’s last-place finish reflects the opposite. Limited infrastructure for exercise, high rates of sedentary behavior, and some of the worst diet and smoking numbers in the country. The gap between them is wide, and it shows up in ways that go far beyond a single fitness score.
- Rankings are based on a composite of publicly available health and lifestyle data and are intended for informational purposes only.
- This analysis should not be interpreted as medical advice or used as a substitute for guidance from a qualified healthcare professional.
Survey Notes
Methodology
Nursa researchers ranked all 50 U.S. states across 10 health and lifestyle factors to produce a composite fitness score out of 10. Gym counts, walking and hiking route tallies, and fast food location density were drawn from U.S. OpenStreetMap data. Adult obesity and smoking rates came from the Centers for Disease Control and Prevention. Sleep data — specifically the share of adults averaging fewer than seven hours per night — and physical inactivity figures were sourced from America’s Health Rankings, as was diet data tracking the percentage of adults consuming two or more daily fruit servings and three or more daily vegetable servings (based on 2021 figures). Exercise participation data — the share of residents getting at least 150 minutes of moderate aerobic activity per week — came from the Apple Heart & Movement Study. Per capita alcohol consumption figures (in gallons) came from World Population Review’s 2023 dataset. Each state was scored on all 10 factors using the percentrank method, which measures how a given value compares to all other values in the dataset, and final composite scores were calculated from those rankings. All data was finalized as of February 19, 2026.
Limitations
This index is a composite ranking, not a clinical study, and it carries the limitations that come with that format. Diet data relies on self-reported consumption figures from 2021, which may not reflect current behavior. Tennessee’s obesity and physical inactivity figures were drawn from 2023 datasets, and Florida’s fruit and vegetable data came from 2019 rankings due to data availability constraints. The index does not account for socioeconomic factors, healthcare access, food deserts, or income inequality — all of which shape health outcomes in meaningful ways. OpenStreetMap data, used for gym, route, and fast food counts, may not reflect every location equally across all states. The ranking also weights all 10 factors equally, which may not reflect the actual relative contribution of each variable to overall fitness.
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