More than 7 in 10 American adults are overweight. Health care costs keep climbing. And depending on which city you call home, the gap between a long, healthy life and an expensive, preventable one may come down to your zip code.
That’s the central finding of WalletHub’s 2026 Healthiest Cities in America report, released Monday, which ranked more than 180 of the largest U.S. cities across 41 metrics — everything from fruit and vegetable consumption to the cost of a doctor’s visit to the share of physically active adults.
The results paint a picture that is, at once, unsurprising and quietly damning.
The Winners and the Losers
San Francisco tops the list, followed by San Diego and Seattle. Salt Lake City and Portland round out the top five. The bottom of the rankings tells a different story: Brownsville, Texas, sits at No. 182. Gulfport, Mississippi, is 181st. Laredo, Texas, Shreveport, Louisiana, and Fort Smith, Arkansas, all land in the bottom ten, alongside Huntington, West Virginia, and Toledo, Ohio.
The full top ten healthiest cities: San Francisco, San Diego, Seattle, Salt Lake City, Portland (Oregon), Washington D.C., Denver, Honolulu, Austin, and Scottsdale.
The ten unhealthiest: Memphis, Montgomery, Corpus Christi, Toledo, Huntington, Fort Smith, Shreveport, Laredo, Gulfport, and Brownsville.
More Numbers
Overland Park, Kansas, has the lowest share of physically unhealthy adults in the country. That rate is two times lower than in Huntington, West Virginia — the city with the highest.
On cost: a doctor’s visit in Augusta, Georgia, is 2.9 times less expensive than in Juneau, Alaska, which carries the highest per-visit cost in the data set.
Diet tells a similar story. Portland, Maine, has the lowest share of adults eating fruit less than once a day. Chattanooga, Tennessee, has the highest — and the gap between them is 1.6 times. Small differences in daily habits, compounded over years, add up.
Then there’s fitness. A monthly gym membership in Columbus, Georgia, costs a fraction of what it does in New York City. 15.7 times less, according to WalletHub’s data.
Why It Matters Beyond the Rankings
WalletHub framed this report explicitly around money — the costs people are saving or incurring based on where they live and how they live. Health in America is inseparable from economics. Preventable illness drives up insurance premiums, emergency room visits, and lost productivity. The cities at the bottom of this list aren’t just struggling with public health. They’re carrying a financial weight that compounds over time.
The full report, including each city’s individual ranking across all 41 metrics, is available at wallethub.com.