Health Insurance

The Fittest States Often Report High Levels of Binge Drinking, Which Isn’t Always the Case in Less-Fit Areas

A significant percentage of obesity cases and a large population of adult smokers are common in the fittest states, too.
Gym-goers running on treadmill.
Gym-goers running on treadmill. Source: Getty Images

An analysis of health- and fitness-adjacent qualities reveals which states have the fittest and least-fit populations. In addition to creating a ranked list of the best states for physical fitness, ValuePenguin researchers discovered that even the fittest states rank relatively poorly on certain metrics, especially regarding drinking.

Among the top quarter of the fittest states, six of 12 rank above the national median for adults who report binge drinking in the past 30 days. Additionally, obesity and smoking remain prevalent among populations no matter the overall fitness of a state. At least 25% of adults are obese in nearly every state, and 1 in 8 are smokers in 47 of 50 states.

Key findings

The fittest states perform well when it comes to access to exercise and physical fitness, giving them an advantage over their less-fit counterparts

ValuePenguin researchers evaluated the health of states according to eight metrics, pertaining to access to exercise and healthy behaviors. By comparing a state's performance in a given area to the rest of the states in the country, researchers were able to rank the overall fitness of all states. The fittest states — which scored better than 75% of the rest of the country in the rankings — are:

  • Massachusetts
  • Connecticut
  • California
  • Colorado
  • New Jersey
  • Maryland
  • Vermont
  • New York
  • Washington
  • Utah
  • New Hampshire
  • Illinois

The analysis shows that the fittest states don’t always perform the best relative to their less-fit counterparts, but they often benefit from better fitness-related infrastructure. Specifically, the fittest states have much more ready access to gyms, recreation centers, personal trainers and others who could work one-on-one with residents to ensure healthy exercise habits.

chart 80 to 160 fitness workers per 100,000 people

Data for fitness workers is from 2020, while fitness establishments data is from 2018 — both the most recent federal data.

Each of these states has more fitness instructors or trainers per 100,000 residents than the median across all 50 states (80). Each state except for Utah has the same or more than the median number of training centers per 100,000, too. (Utah, in fact, scores so low in this area that it lands in the bottom quarter of states for fitness centers per resident.) On the other hand, the states at the bottom of the national rankings for overall fitness tend to have much lower rates of access to both instructors and facilities.

chart 25 to 68 fitness workers per 100,000 people

To this end, just two of these states (Oklahoma and Ohio) have fewer trainers or instructors per 100,000 residents than the national median, while still remaining above the bottom 25% mark for the metric. All other states in the above graph rank in the bottom 25% for access to trainers. The discrepancy is similarly stark when it comes to fitness establishments per 100,000: All of the lowest-scoring states are below the median of 23 gyms or recreational centers per 100,000 people.

How getting fit can lower the cost of health insurance: Consumers may be more likely to find affordable health insurance coverage if they're more physically fit because they're generally less likely to need medical care. Depending on one's provider, they may also be offered discounts for staying in shape.

Working alongside the lack of widespread or universal access to health instructors and facilities is a widespread lack of free time for physical activity. Just one of the least-fit states (Michigan) has a percentage of residents that reported no leisure time for physical activity in the past month that was equal to the national median (23%), according to the most up-to-date data from 2017. The rest of the least-fit states score at or in the bottom 25% for this metric. Conversely, in the top 25% of the fittest states, only New Jersey scores worse than the national median for this metric.

Similarly, in the least-fit states, there is a high percentage who don't live within a reasonable distance from a park or other recreational center or facility. In eight of the 13 states with the lowest overall fitness scores, fewer than 75% of residents have access to exercise opportunities.

ValuePenguin health score
Fitness workers per 100,000
Fitness establishments per 100,000
Percentage physically inactive
Percentage with ready access to exercise
5New Jersey28813527%95%
8New York27842723%93%
11New Hampshire261103821%88%
Show All Rows

Access to food is another problem that persists in states with lower overall fitness scores. The food environment index — which uses data from 2015 and 2018 — quantifies access to healthy food and dependable access to any food. Data indicates that all of the least-fit states (those scoring in the bottom 25% of ValuePenguin's matrix) have food index scores that are lower than the national average. Conversely, all the states at the top of the list are above average.

Residents of the fittest states frequently admit to drinking excessively or bingeing alcohol — more commonly than the least-fit states

While the lower-performing states tend to be at a disadvantage due to their insufficient access to physical activity, they outperform the fittest states when it comes to alcohol consumption. Just three of the least-fit states have more than 19% (the national median) of residents 21 and older who say they’ve binged alcohol in the past 30 days. The analysis of the fittest states tells a different story.

binge drinking chart 14 to 21%

Data for excessive binge drinking is from 2018, the most recent federal data.

Among the top 25% best-performing states, six of 12 have more than the median share of residents who say they overindulge in alcohol consumption. In three states — Illinois, Colorado and the most-fit-overall Massachusetts — the share of residents who admit to binge drinking puts these states in the top quarter for alcohol consumption.

binge drinking chart 11 to 24%

Overall, three of the fittest states — New Jersey, Maryland and Utah — place in the top quarter of residents who admit to binge drinking. Utah has the lowest percentage of its population (11%) binge drinking of any state.

Percentage who drank excessively in the past 30 days
3South Dakota24%
4North Dakota24%
Show All Rows

Table displays states according to the highest percentage who drank excessively in the past 30 days.

Obesity, cigarette use imperil the overall health of the fittest and least-fit states alike

The fittest states are indeed more likely to have smaller shares of their populations diagnosed with high enough body mass indexes (BMIs) to qualify as medically obese. Maryland is the only state in which the percentage of obese people is higher than the national median of 31%. In the least-fit states, each has more than 31% of the population measured as obese. However, these statistics are deceptive.

The floor for obesity is much higher than the other measurements used to gauge a state's fitness. If a state has an obese population less than or equal to 27%, it would place in the best quarter for this category. As a result, the percentage of obese residents was less than 25% of the total popuation in just two states — Colorado and California. Even in these two, more than 1 in 5 residents are considered medically obese.

It can be harder for obese Americans to get cheap life insurance. But it's not common for companies to outright reject an application based on BMI alone.

Similarly, ValuePenguin found an enduring prevalence of smokers in nearly every state, despite the financial impacts of smoking regularly. At least 1 in every 8 adults are smokers in all but three states — Washington, California and Utah — the last of which is the only state where fewer than 10% of the population smokes.

The excise tax for smokers in Washington and California is higher than the average across all states, but not Utah. In fact, despite the high percentage of smokers nationwide, there's a slight correlation between higher-than-average taxes and a lower percentage of smokers.

In states with an excise tax higher than $1.86 per pack (the average across all states), 15% of the population identifies as smokers. In states with a lower tax, 19% are smokers — which turns out to be higher than the national median of 17%. Still, the trend is only general.

Excise tax per pack
Percentage who are smokers
West Virginia$1.2027%
South Dakota$1.5320%
Show All Rows

Smoking population figures are from 2018.


ValuePenguin created a health score based on how a state placed in eight health metrics, including:

  • Fitness workers per 100,000 residents
  • Gyms, other fitness establishments per 100,000 residents
  • Percentage of adults who smoke
  • Percentage of adults (age 20 or older) with a body mass index (BMI) over 30
  • Access to healthy foods
  • Percentage of adults (age 20 or older) reporting no leisure-time physical activity
  • Percentage of individuals in a county who live reasonably close to a location for physical activity, classified as within a half-mile of a park, within a mile of a recreational facility or in a rural census block that is within 3 miles of a recreational facility
  • Adults who report binge or heavy drinking in the past 30 days

Our figures for fitness workers and gyms relative to states' populations were collected from the U.S. Bureau of Labor Statistics and reflect numbers for May 2020. Data on fitness centers comes from the U.S. Census Bureau’s County Business Patterns, which most recently measured business by industry for 2018.

All other figures were published in the 2021 County Health Rankings, which itself compiles the most up-to-date information from a range of federal databases.