America’s Fittest States Revealed in New Nationwide Ranking
Vermont ranks as the fittest state in the U.S., while Louisiana finishes last, highlighting a dramatic divide shaped by geography, lifestyle habits, and access to outdoor spaces.
A new analysis from Nursa, a per diem healthcare staffing platform, evaluated all 50 states across 10 health and lifestyle indicators to create its Fittest States Index. Vermont claimed the top spot with a score of 8.97 out of 10, while Louisiana placed last with 4.25. The contrast between the two states illustrates how environmental factors and daily habits can influence the health of entire populations.
Fitness gaps have consequences that extend beyond individual wellness. Preventable illnesses linked to inactivity and poor diet place a growing burden on healthcare systems nationwide. Identifying where states succeed—or struggle—offers insight into the conditions that help people maintain healthier lifestyles.
What Put Vermont at the Top
Vermont’s first-place ranking reflects strong performance across nearly every metric measured.
Sleep played a significant role. Only 29.6% of Vermont residents reported getting fewer than seven hours of sleep per night, the best rate in the country. By comparison, Hawaii had the highest share of short sleepers at 45.6%. Although sleep is often overlooked in fitness discussions, it is closely tied to recovery, metabolism, and overall health.
Diet also stood out. About 12.9% of Vermont adults reported eating at least two servings of fruit and three servings of vegetables daily. That rate is 3.4 times higher than Oklahoma, where only 3.8% of adults meet the same guideline, the lowest figure nationwide.
Physical activity levels are also strong. Only 16% of Vermont residents are considered inactive outside of work, the second-lowest rate in the country. Mississippi recorded the highest inactivity rate at 30.6%.
Infrastructure also supports an active lifestyle. Vermont has 13.1 gyms per 100,000 residents and 31 walking or hiking routes per 100,000 people. Fast food access is relatively limited, with 19.4 locations per 100,000 residents, well below the national average of 24.1.
The state’s broader health indicators also reflect these advantages. Life expectancy is 78.4 years, and 13.2% of adults smoke, compared with a national smoking rate of 16.3%.
The Other Top Fitness States
Massachusetts ranked second with a score of 8.73. Its 27% obesity rate sits seven points below the national average of 34%, and 11.7% of residents smoke, the second-lowest rate in the country. Massachusetts also leads the nation in exercise participation, with 68.1% of residents getting at least 150 minutes of moderate aerobic activity each week.
Washington placed third (8.69), largely due to its strong outdoor infrastructure. The state has 73.6 walking, running, and hiking routes per 100,000 residents, the highest in the nation, along with 15.3 gyms per 100,000 people. Only 17.4% of residents are inactive outside of work.
Colorado finished fourth (8.44) and stands out as an unusual case. Despite having the highest fast food density in the country at 37.1 locations per 100,000 residents, the state maintains the lowest obesity rate nationwide at 25% and the lowest inactivity rate at 15.6%. Colorado also leads in gym access with 16.5 gyms per 100,000 residents. Its strong outdoor culture and access to exercise opportunities may help offset the high fast food presence.
Why Some States Continue to Lag
At the bottom of the ranking, Louisiana scored 4.25, the lowest in the nation. The state has just 2.8 gyms per 100,000 residents, the lowest rate in the country. It also faces an adult obesity rate of 39.2% and a 21% smoking rate, both among the nation’s highest. Nearly 28% of residents are inactive outside of work, and only 42.8% achieve the recommended 150 minutes of weekly aerobic exercise.
Mississippi (4.36) and West Virginia (4.91) followed closely behind. West Virginia has the highest adult obesity rate in the U.S. at 41.4%, and more than 41% of residents report sleeping fewer than seven hours each night.
Alabama (4.99) and Nevada (5.11) complete the bottom five. These states share several challenges, including limited gym availability, higher inactivity rates, and elevated levels of smoking and obesity.
Oklahoma also received a notable distinction despite ranking eighth from the bottom (5.65) overall. It recorded the poorest diet in the nation, with only 3.8% of adults meeting daily fruit and vegetable intake guidelines.
Geographically, the least fit states are concentrated in the Southern U.S. Louisiana, Mississippi, West Virginia, Alabama, Tennessee, and Kentucky all fall within the bottom ten. These states also tend to have fewer parks and walking routes, lower gym availability, and higher rates of food insecurity and smoking.
How the Index Was Calculated
Nursa researchers compiled data from multiple sources to create the rankings.
Obesity and smoking rates came from the Centers for Disease Control and Prevention, while sleep, inactivity, and diet statistics were drawn from America’s Health Rankings, including 2021 data on fruit and vegetable consumption.
Exercise participation figures were sourced from the Apple Heart & Movement Study, which measured the share of residents achieving 150 minutes or more of moderate aerobic activity each week. Alcohol consumption data came from World Population Review’s 2023 per-capita dataset.
Researchers also analyzed OpenStreetMap data to measure gym availability, walking and hiking routes, and fast food restaurant density across all 50 states.
Each state was evaluated across all ten indicators, with a percentrank scoring method used to generate a composite score out of 10. All data used in the analysis was finalized on February 19, 2026.
The index does not claim to capture every factor influencing health. Variables such as income levels, healthcare access, and local food environments also play major roles. However, as a snapshot of how Americans eat, move, sleep, and smoke, the results paint a clear picture.
Vermont’s top ranking reflects what happens when outdoor access, healthier sleep patterns, lower smoking rates, and active residents align. Louisiana’s last-place finish reflects the opposite: limited fitness infrastructure, higher inactivity, and some of the nation’s worst diet and smoking statistics.
The gap between the two states is significant—and it extends well beyond a single fitness score.
