Study says California is one of the top five healthiest states in America – but expert warns there is still work to be done to improve the population’s wellbeing

A new index ranking has revealed America’s healthiest and unhealthiest states, crowning Hawaii as the health capital of the US, with California in fifth.

The study, conducted by Injury Lawyers Bader Scott,compiled data for a range of factors, such as the number of deaths from infectious diseases and adult obesity rates to the percentage of adults who consume less than one piece of fruit per day.

Each state was then scored out of 100 based on performance across six categories: nutrition, air quality, obesity and fitness, drug and alcohol consumption, mortality and disease and tobacco and e-cigarette use.

It turns out Hawaii is the leading state for a healthy lifestyle, with an impressive score of 71.8 out of 100. The national average score was 50.1, meaning Hawaii is over 43 percent healthier than the average state.

This leading position is largely attributed to the Aloha State’s air quality, which ranks as the cleanest in the US, 143 percent higher than the national average. Low drug and alcohol consumption rates also contribute to this high score.

The state’s weakest area was nutrition, where 56.3 percent of adults consume less than one piece of fruit per day – this is a higher percentage of Americans with a minimal daily fruit intake than anywhere else in the US.

Washington takes second place, close behind Hawaii, with a score of 71.6 out of 100, more than two-fifths (44 percent) healthier than the national average.

A low percentage of smokers, clean air and low mortality rates contribute to Washington’s position, but obesity and fitness are the Evergreen State’s downfall.

In third place is Utah, with a score of 70.2 out of 100, 40 percent higher than the national average (50.1 out of 100). Utah ranks in first place for its low mortality and disease rates (which are 80 percent lower than the national average) and has the lowest drug and alcohol consumption rates in the country.

Unfortunately, in Utah, poor air quality knocks the state down into third place, as it has the fourth worst figures in the country.

Fourth place goes to Alaska, with a score of 65.3 out of 100 – nearly one third (30 percent) above the national average. Alaska’s best-performing category was mortality and disease, reporting significantly lower rates than elsewhere in the US.

However, tobacco and e-cigarette usage are high in Alaska, with 26 percent of high school students admitting to using an e-cigarette.

In fifth is California. It scored 64.6 out of 100, 29 percent above the national average, but had comparatively low tobacco and e-cigarette use, with only 5.6 percent of young residents admitting to using vapes. Air quality was the worst performing category for the state.

The study also identified the unhealthiest states in America – and it’s bad news for West Virginia.  Scoring just 20.5 out of 100, 59 percent lower than the national average (50.1 out of 100). West Virginia has the third highest number of deaths from infectious diseases per 100k residents across the US.

The Mountain State also has the highest adult tobacco and e-cigarette usage and the highest rate of adult obesity in the states.

Kentucky takes second place for the unhealthiest states, as it’s two-fifths (40 percent) less healthy than the national average with a score of 30 out of 100. Obesity and fitness was the worst-performing category in the state.

Missouri is third, with a score of 32.4, more than a third (35 percent) below the national average. Missouri’s air quality ranks the poorest in the United States, which can cause ill health, particularly amongst children and the elderly.

In fourth is Mississippi, scoring 32.8. The state’s overall score is 35 percent below the national average, largely due to nutrition being the second worst in the US.

Arkansas is fifth. A score of 34.5 means the state is 31 percent less healthy than the national average, largely due to poor nutrition and high tobacco and e-cigarettes use. However, the state performs comparatively well for drug and alcohol consumption.

Seth Bader from injury law firm Bader Scott spoke on the findings.

“One of the key lessons from these health rankings is the significance of small, consistent habits,” Bader Scott said. “In today’s fast-paced world, it’s easy for health to become a secondary concern, but small actions can lead to significant long-term effects.

“Incorporating regular movement into the day — whether it’s a quick walk during lunch or choosing the stairs over the elevator — helps keep the body active.

“Nutrition is equally important. Prioritizing healthy eating, even when on the go, can make a big difference. Choosing fresh fruits, vegetables, and whole foods instead of processed snacks supports sustained energy levels and improves focus throughout the day.

“For many of the states who scored poorly in the ranking, air quality is one of the biggest problems. While this is hard to avoid, the more time you can spend out of built-up areas, the better. Trips to green spaces are good for both your mental and physical health.

“By making sure your health is a priority and being conscious of the health habits that affect your local community, you can improve your quality of life by making small but impactful changes.”