City Health & Fitness Rankings Can Help You Choose a Location

He's so fit he doesn't even ride his bike, he just carries it around. Image: ImYanis / Shutterstock

There are several compelling reasons for existing and future operators to be aware of the most and least healthy cities.

Location is, obviously, one of the top considerations for anyone planning to open a new bar, restaurant, eatertainment venue, or nightclub.

Several factors can inform an operator’s decision regarding the types of concept that will work in certain markets.

Increased focus on health, fitness and wellness is one of those factors. More people are adopting healthy lifestyles, the results of which range from influencing dietary preferences and how nights out are spent to where they want to work.

I reviewed six WalletHub reports published this year to provide a deep dive into the healthiest and least healthy cities and states in America. WalletHub compared 150 of the most populated cities in America along with a minimum of two of most-populated cities in all 50 states, excluding surrounding metro areas. This methodology resulted in WalletHub ranking 174 cities.

It’s important to note that eight cities included on other WalletHub lists were excluded from their Healthiest & Unhealthiest Cities in America report: Dover, Delaware; Lewiston, Maine; Bismarck, North Dakota; South Burlington, Vermont; Juneau, Alaska; Pearl City, Hawaii; Columbia, Maryland; and Casper, Wyoming.

They then analyzed the four following metrics: health care, fitness, food, and green space. Most relevant to our industry are the food and fitness metrics, although operators should be aware of the health care costs in the areas in which their venues are located. Fitness and food metrics are explained at the bottom of this article.

To start things off, the following are the top 20 healthy American cities overall:

  1. San Francisco, CA
  2. Seattle, WA
  3. San Diego, CA
  4. Portland, OR
  5. Washington, DC
  6. New York, NY
  7. Denver, CO
  8. Honolulu, HI
  9. Scottsdale, AZ
  10. Irvine, CA
  11. Burlington, VT
  12. Minneapolis, MN
  13. Los Angeles, CA
  14. Austin, TX
  15. Chicago, IL
  16. Huntington Beach, CA
  17. Salt Lake City, UT
  18. Fremont, CA
  19. Atlanta, GA
  20. Boston, MA

These rankings change when different metrics are applied. Below are the top 20 cities ranked according to WalletHub’s fitness metric:

  1. Scottsdale, AZ
  2. Denver, CO
  3. San Diego, CA
  4. Raleigh, NC
  5. Seattle, WA
  6. Atlanta, GA
  7. Burlington, VT
  8. Las Vegas, NV
  9. Huntington Beach, CA
  10. San Francisco, CA
  11. Austin, TX
  12. Los Angeles, CA
  13. Salt Lake City, UT
  14. Oceanside, CA
  15. Washington, DC
  16. Irvine, CA
  17. Portland, OR
  18. Vancouver, WA
  19. Chicago, IL
  20. New York, NY

And these are the top 20 cities when measured against WalletHub’s food metric:

  1. San Francisco, CA
  2. New York, NY
  3. San Diego, CA
  4. Los Angeles, CA
  5. Seattle, WA
  6. Portland, OR
  7. Miami, FL
  8. Honolulu, HI
  9. Oakland, CA
  10. Washington, DC
  11. San Jose, CA
  12. Chicago, IL
  13. Philadelphia, PA
  14. Salt Lake City, UT
  15. Denver, CO
  16. Austin, TX
  17. Las Vegas, NV
  18. Sacramento, CA
  19. Orlando, FL
  20. Boston, MA

Conversely, the following are the top ten least healthy cities:

  1. Brownsville, TX (174)
  2. Laredo, TX (173)
  3. Gulfport, MS (172)
  4. Shreveport, LA (171)
  5. Huntington, WV (170)
  6. Fort Smith, AR (169)
  7. Augusta, GA (168)
  8. Memphis, TN (167)
  9. Detroit, MI (166)
  10. Montgomery, AL (165)

The list changes when adjusted to focus on the fitness metric:

  1. Laredo, TX (174)
  2. Huntington, WV (173)
  3. Brownsville, TX (172)
  4. Hialeah, FL (171)
  5. Forth Smith, AR (170)
  6. Detroit, MI (169)
  7. Columbus, GA (168)
  8. Gulfport, MS (167)
  9. Shreveport, LA (166)
  10. Toledo, OH (165)

And changes more significantly when the food metric is applied:

  1. Brownsville TX (174)
  2. Shreveport, LA (173)
  3. Laredo, TX (172)
  4. Augusta, GA (171)
  5. Gulfport, MS (170)
  6. Montgomery, AL (169)
  7. Winston-Salem, NC (168)
  8. Las Cruces, NM (167)
  9. Fayetteville, NC (166)
  10. Lubbock, TX (165)

Physically Active Adults

Drilling down into additional WalletHub reports reveals additional interesting data. Seattle, Irvine, Portland, Huntington Beach, and Overland Park, KS, have the highest percentage of adults who are physically active. The cities with the lowest percentage of physically active adults are Brownsville and Laredo, TX, Miami, Newark, NJ, and Hialeah, FL.

Getting more specific about physical activity, the states that boast the lowest percentage of adults who aren’t exercising are Washington (50), Colorado (49), California (48), Alaska (47), and Oregon (46). Their counterparts are the states that have the highest percentage of adults who aren’t exercising: Kentucky (1), Mississippi (2), Texas (3), Arkansas (4), and Oklahoma (5).

Another interesting way to determine how fit or active adults are in various cities is to look at fitness club memberships, walking trails, and running trails. The cities that enjoy the lowest costs for fitness club memberships are Amarillo, TX, Garden Grove, CA, Nashua, NH, Stockton, CA, and El Paso, TX.

One way to interpret the list above is that gym memberships are very affordable and therefore appealing to the population. However, low membership costs could also reflect low interest in joining a fitness club or a population experiencing financial struggles.

Washington, DC, Laredo, Anchorage, AK, Oakland, New York, and San Francisco, CA, are the cities with the highest fitness club memberships. Perhaps unsurprisingly, a number of those cities also known for having high rent, mortgages, and other costs of living. One interpretation is that the people in these cities are simply used to paying more for goods and services, including dining and nights out.

San Francisco, Washington, DC, Tallahassee, Seattle, and Santa Clarita, CA, have the most walking trails per capita, and Washington, DC, San Francisco, Seattle, Chicago, and Austin have the most running trails. The cities with the fewest walking trails are Pembroke Pines, FL, Cincinnati, Brownsville, Hialeah, and El Paso. Stockton, El Paso, Newark, San Bernadino, CA, and Hialeah have the fewest number of running trails.

Again, it’s important to seek context when interpreting such data. Median population age, size of city, employment rates, weather, and other factors should be applied when analyzing activity and green spaces.

Restaurant Opportunities

“Which cities have the most restaurants?” is an important question for anyone considering opening a new restaurant. WalletHub has an answer: Out of 182 cities, New York (1), San Francisco (2), Miami (3), Las Vegas (4), and Orlando (5) have the most restaurants per capita. Two follow-up questions are, “Do these cities need another restaurant?”, and, “Is my concept different enough to stand out in a city loaded with restaurants?”

The cities with the fewest restaurants per capita are South Burlington (178), West Valley City (179), Lewiston, ME (180), Pearl City (181), and Peoria, AZ (182). In this case, crucial questions are, “Are there enough people to support my restaurant and make it profitable?”, and, “Is this market interested in a new restaurant opening?”

Portland, New York, Austin, San Francisco, and Orlando have largest number of healthy restaurants per capita. Orlando doesn’t appear on WalletHub’s healthiest cities ranking unless the food metric is applied, in which case it claims the 19th spot. The cities with the fewest healthy restaurants per capita are Garland, TX, Aurora, IL, North Las Vegas, NV, and Corpus Christi and Laredo in Texas.

The cities with lowest percentage of adults who aren’t consuming enough fruits and vegetables each day are Portland, ME, Burlington, VT, and California cities San Jose, San Francisco, Oakland and Fremont. Adults in Corpus Christi, TX, Huntington, WV, Little Rock, AR, Augusta, GA, and Gulfport, MS, aren’t eating enough fruits and vegetables per day.

WalletHub’s ranking of the top 20 vegetarian-friendly and vegan-friendly cities—a list of 100 cities—is as follows:

  1. Portland, OR
  2. Los Angeles, CA
  3. Orlando, Fl
  4. Seattle, WA
  5. Austin, TX
  6. Atlanta, GA
  7. New York, NY (number 3 for restaurants serving vegetarian options, number 4 for vegan)
  8. San Francisco, CA
  9. San Diego, CA
  10. Tampa, FL
  11. Scottsdale, AZ (number 1 for restaurants serving vegetarian and vegan options)
  12. Anaheim, CA
  13. Chicago, IL
  14. Madison, WI (number 5 for restaurants serving vegan options)
  15. Milwaukee, WI
  16. Washington, DC (number 2 for restaurants serving vegetarian and vegan options)
  17. Las Vegas, NV
  18. Pittsburgh, PA
  19. Houston, TX
  20. Charlotte, NC

On the other hand, El Paso, TX (100), San Bernadino (99), Greensboro, NC (98), North Las Vegas (97), and Baton Rouge, LA (96) are the least vegetarian- and vegan-friendly cities in the United States. Santa Ana, CA (96), Newark, NJ (97). Stockton, CA (98), North Las Vegas, NV (99), and Laredo, TX (100) are the cities with the lowest percentage of restaurants that serve vegetarian options. The cities with the lowest percentage of restaurants serving vegan options are Laredo (96), North Las Vegas (97), Stockton (98), Hialeah (99), and Newark (100).

The WalletHub list of best foodie cities, which includes 182 cities, matches up rather intriguingly with their list of most vegetarian- and vegan-friendly cities. The rankings may be different, but 13 cities show up on both lists (shown in bold):

  1. Portland, OR
  2. New York, NY
  3. Miami, Fl
  4. San Francisco, CA
  5. Los Angeles, CA
  6. Las Vegas, NV
  7. San Diego, CA
  8. Seattle, WA
  9. Chicago, IL
  10. Austin, TX
  11. Orlando, FL
  12. Sacramento, CA
  13. Tampa, FL
  14. Atlanta, GA
  15. Denver, CO
  16. Charleston, SC
  17. Washington, DC
  18. Honolulu, HI
  19. Philadelphia, PA
  20. Oakland, CA

The lowest-ranked foodie cities are 182 Pearl City, HI (182), Juneau, AK (181), Jackson, MS (180), Augusta, GA (179), West Valley City, UT (178), Moreno Valley, CA (177), Fremont, CA (176), Montgomery, AL (175), Nampa, ID (174), and Columbus, GA (173).

It’s tempting to dismiss the cities that ranked lowest among food cities as disinterested in trying new cuisine and food items. However, it’s possible that these cities are hungry to try new things, providing an opportunity for operators. Savvy business owners in all industries have created profitable brands by filling needs and desires in underserved—or essentially unserved—markets.

Take, for instance, the cities that are ranked the least friendly for vegetarians and vegans. Operators with concepts centered on vegetarian and/or vegan cuisine can cross them off their lists of potential locations. But they can also decide to do more research, find out why these cities aren’t considered great for vegetarians and vegans, and determine if their concept may succeed by filling a dietary need.

The founder of Invictus Hospitality, Michael Tipps, sometimes gauges the dedication to a concept by asking a simple but powerful question: “Would you be willing to move to another city to make your idea a reality?” While that’s not the answer for every operator looking to open a new concept or expand operations, it does work for some.

Other Considerations

It’s up to every operator to understand as much as they can about the market they’re going to serve. Investigating a location and its surrounding areas is important not just on the business side but because upon opening doors, an operator is a member of a particular community.

If one doesn’t understand who they’re serving, how can one expect long-term success?

Before settling on a market, an operator must research it. What’s size of the city and its population size? What are the commercial real estate costs? What’s the median age? The median income? How financially healthy is the city? What does the labor pool look like? How many people are employed? Unemployed? Retired? What are the violent and non-violent crime rates?

Speaking to that last metric, the following are the states with most thefts per capita, according to WalletHub: New Mexico (1), Alaska (2), Louisiana (3), South Carolina (4), Washington (5). The states with the fewest are New York (46), Maine (47), Massachusetts (48), Vermont (49), and New Hampshire (50). These are important rankings when considering the risk of break and enters.

What can you expect for cost per square foot? Annual sales per square foot? Sales per seat? What does the dining scene look like? The night-out and nightlife scene (Las Vegas, NYC, Orlando, Miami and Atlanta are WalletHub’s top five nightlife cities)? What types of venues are most popular and most profitable?

What about fun? The hospitality industry isn’t just about hospitality and treating guests as one would treat them in their own home—fun is a factor. Eatertainment’s rise in popularity, outshining traditional nightclubs, is proof that people desire fun from the guest experience and their nights out.

America’s most fun cities (out of 182 total), according to WalletHub and based on entertainment, recreation, nightlife, parties and costs, are:

  1. Las Vegas, NV
  2. Orlando, FL
  3. New York, NY
  4. Miami, FL
  5. Chicago, IL
  6. Atlanta, GA
  7. San Francisco, CA
  8. Portland, OR
  9. San Diego, CA
  10. Los Angeles, CA
  11. Austin, TX
  12. New Orleans, LA
  13. Honolulu, HI
  14. Denver, CO
  15. Washington, DC
  16. Tampa, FL
  17. Seattle, WA
  18. St. Louis, MO
  19. Houston, TX
  20. Philadelphia, PA

The least fun—again, according to WalletHub, so don’t shoot the messenger—are Pearl City (182), Oxnard, CA (181), Yonkers (180), Santa Rosa (179), Bridgeport (178), Brownsville, TX (177), South Burlington (176), New Haven, CT (175), Aurora (174), and Lewiston (173).

Interestingly, WalletHub’s list of happiest states doesn’t align with their most fun cities perfectly. Their top five happiest states are Hawaii, Utah, Minnesota, California and New Jersey. With the exception of California, these states don’t claim rankings for the top 20 most fun cities. Of course, neither do the least happy states—West Virginia (50), Arkansas (49), Alaska (48), Mississippi (47), and Louisiana (46)—with the exception of Louisiana claiming the number 12 most fun city, New Olreans.

Operators must decide whether a city has been ranked among the least fun because they’re not interested in having fun or because they’re being offered enough places for a fun night out. Is there an opportunity in those cities?

One metric that may seem morbid to some is death rate. A city with a high premature death rate, as dark as some may find it, can potentially limit the age groups and visits of customers. This metric also impacts the age ranges of the labor pool available to an operator. Healthcare costs, access to medical and mental health professionals, crime rates, and financial health can all be factors.

The cities with the highest premature death rate, according to WalletHub data, are Detroit (1), Charleston, WV (2), Augusta (3), Huntington, WV (4), St. Louis (5), and Baltimore (6). The cities with the lowest premature death rate are almost exclusively in California, with the exception of Yonkers in New York: San Jose (1), Yonkers (2), Anaheim, (3), Santa Ana (4), Irvine (5), and Huntington Beach (6).

Being the first and only to serve a market with a particular type of concept, cuisine and drinks can be risky. But this entire industry is built on risk, calculated and otherwise. Seeking out the fittest or least healthy cities to open a restaurant, eatertainment venue or bar is a risky proposition. Making an informed decision can also make it profitable.

WalletHub Methodology

Food Metrics (25 points)

  • Inadequate Fruit & Vegetable Consumption: Double Weight (~5.00 Points)
    Note: This metric measures the percentage of adults consuming fewer than one serving of fruits or vegetables per day.
  • Farmer's Markets per Capita: Full Weight (~2.50 Points)
  • Gourmet Specialty-Food Stores per Capita: Full Weight (~2.50 Points)
  • Healthy Restaurants per Capita: Full Weight (~2.50 Points)
    Note: “Healthy Restaurants” refers to vegetarian, vegan and gluten-free establishments.
  • Dietitians & Nutritionists per Capita: Full Weight (~2.50 Points)
  • Share of Residents Who Say They Eat Healthy: Full Weight (~2.50 Points)
    Note: This metric is based on Gallup and Sharecare's 2016 Community Rankings for Healthy Eating report which examines healthy eating across the nation.
  • Google Search Interest for “Healthy Eating”: Full Weight (~2.50 Points)
    Note: This metric measures the search interest for “healthy food near me”, “healthy dinner ideas”, “healthy snacks”, “health food stores”, “healthy recipes”, “healthy grocery list”.
  • Share of Obese Residents: Full Weight (~2.50 Points)
  • Limited Access to Healthy Foods: Full Weight (~2.50 Points)
    Note: This metric measures the percentage of the population who earn a low income and do not live within a reasonable distance to a grocery store.

Fitness Metrics (25 points)

  • Share of Adults Who Engage in Any Physical Activity: Double Weight (~6.25 Points)
  • Well-Being “Physical” Rank: Full Weight (~3.13 Points)
    Note: This metric refers to the city’s rank in the “Physical” section of the Gallup-Sharecare State of American Well-Being rankings. “Physical” refers to having good health and enough energy to get things done daily.
  • Fitness & Instruction Centers per Capita: Full Weight (~3.13 Points)
  • Average Cost of Fitness-Club Membership: Full Weight (~3.13 Points)
  • Intramural Leagues per Capita: Full Weight (~3.13 Points)
  • Weight-Loss Centers per Capita: Full Weight (~3.13 Points)
  • Fitness Trainers & Aerobics Instructors per Capita: Full Weight (~3.13 Points)


McCann, Adam. “Healthiest & Unhealthiest Cities in America.” WalletHub. February 11, 2019.

McCann, Adam. “Best & Worst Cities for Recreation.” WalletHub. July 2, 2019.

McCann, Adam. “Happiest States in America.” WalletHub. September 9, 2019.

McCann, Adam. “Most Fun Cities in America.” September 16, 2019.

McCann, Adam. “2019’s Best Cities for Vegans & Vegetarians.” WalletHub. September 30, 2019.

McCann, Adam. “2019’s Best Foodie Cities in America.” WalletHub. October 7, 2019.

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