Rural, Up-and-Coming Rankings

Measuring health and wellness in similar communities

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Understanding the cultures of communities around the U.S. and how they can overcome obstacles to health and wellness is a key driver behind the U.S. News Healthiest Communities rankings, which allow residents to compare their communities with others across the nation of similar geographic status and economic strength.

Living in far-flung counties may pose challenges for residents' health, but the comparably higher scores of these rural communities with up-and-coming economies show that all types of communities can experience success and serve as models for one another.

Below are the 2019 rankings of the top 100 rural, up-and-coming communities and their scores across 10 categories that drive overall community health, on a scale of zero to 100.

Rank	County	Population Health	Equity	Education	Economy	Housing	Food & Nutrition	Environment	Public Safety	Community Vitality	Infrastructure

1	Wallowa County, Oregon	85.6	54.3	51.7	36.4	38.9	80.9	69.8	76.9	75.9	63.5
2	Lincoln County, Washington	77.5	76.9	41.1	34.4	51.4	53.6	58	80.9	71.3	78.7
3	Calhoun County, Iowa	73.9	55.4	54.4	39.7	54.1	68.6	72.4	72.3	54.5	70.6
4	Iron County, Wisconsin	67.3	65.1	48.4	37.2	45.9	64.2	71.9	77.9	69.1	58.5
5	Baylor County, Texas	54.9	54.8	73.2	37.5	59.2	59.3	59.5	62.7	49.9	90.4
6	Grant County, Oregon	78.9	63.8	33	32.4	33.9	65.2	63.8	84.1	68.5	63.1
7	Curry County, Oregon	64.1	69.4	28.3	36.7	28.4	79.2	68.2	74.9	62.2	82.5
8	Yancey County, North Carolina	52.3	76.4	43	33	56.9	64.3	85.3	76.1	62.4	40.7
9	Rio Grande County, Colorado	64.9	64.4	38.9	31.5	56.7	83.4	89.2	57.4	48.1	56.5
10	Walworth County, South Dakota	76.3	62.7	53.1	39.5	60.2	32.3	76.3	39.1	55.7	84.4
11	Lexington city, Virginia	66.7	45.9	85.4	34.3	61.2	56.7	65.9	77.4	28.3	70.1
12	Wahkiakum County, Washington	65.2	85.6	22	29.1	59.4	60.5	61.5	78	81.1	33.8
13	Mitchell County, North Carolina	56	69	34.4	37.1	76.6	52.9	88.3	66.6	55.1	52.1
14	Powell County, Montana	59.2	52.2	26.3	39.2	77.5	76.5	74.6	75.8	50.8	60.6
15	Richland County, Illinois	68.1	60	46.7	39.1	68.2	65.3	67.6	47.4	53.2	63
16	Musselshell County, Montana	53.7	97.8	29.3	39.6	44.3	68.9	73.2	51.6	76.1	35.4
17	Wadena County, Minnesota	64.7	68.2	46.6	35.9	52.1	55.4	69	67.9	62.9	54.8
18	Washington County, Idaho	59.8	74.4	25.2	32.6	57	71.1	62.4	85.4	54.1	61.3
19	Alger County, Michigan	72.1	71.3	25.8	30.5	60.7	53.4	71.1	73.2	59.7	59.6
20	Chouteau County, Montana	60.9	37.5	32.5	28.9	82.4	65.4	71.3	67.9	62	76.1
21	Union County, Illinois	64.4	73.4	50.9	35.7	60.7	50.6	60.9	73	53.5	44.8
22	Sanders County, Montana	64.7	72.1	23.5	31.8	44.9	79.3	71.2	61.5	72.2	48.4
23	Iron County, Michigan	60.8	72.7	31.4	33.9	59.3	59.2	71.9	64.8	66	49.1
24	Essex County, Vermont	62.6	79.6	58.7	36.4	53.1	37.5	66.6	69	53.6	47.4
25	Tillamook County, Oregon	70	52.1	29.1	40	34.1	66.6	68.5	79.9	63.2	70.7

The 2019 Healthiest Communities rankings were created in collaboration with the Aetna Foundation and are based on an examination of nearly 3,000 communities across 81 metrics in the 10 health-related categories. Population health and equity were the most heavily weighted categories, based on the assessments of more than a dozen leading experts on what matters most to a community’s health.

These rankings identify the top 100 rural, up-and-coming communities in America, ranging from No. 1 Wallowa County, Oregon, to No. 100 Sullivan County, Missouri. Communities classified as “rural” were not metropolitan or micropolitan – areas with substantial central populations and integrated adjacent communities – or were home to fewer than 20 people per square mile. Up-and-coming” applies to communities that scored in the bottom half in the economy category out of all rural communities assessed in the Healthiest Communities rankings. “Up-and-coming” also is meant to designate communities that have more room to build and strengthen their economies.

Beyond the rankings, the Healthiest Communities platform offers data and insight on each of the nearly 3,000 communities evaluated. Users can dive into the data with our interactive Data Explorer.

14.15%

Population Health

12.23%

Equity

12.15%

Education

11.08%

Economy

9.46%

Housing

8.77%

Food & Nutrition

8.62%

Environment

8.46%

Public Safety

7.62%

Community Vitality

7.46%

Infrastructure

Healthiest Communities

in collaboration with

Healthiest Communities is an interactive destination for consumers and policymakers, developed by U.S. News & World Report in collaboration with the Aetna Foundation, an independent charitable and philanthropic affiliate of CVS Health. Backed by in-depth research and accompanied by news and analysis, the site features comprehensive rankings drawn from an examination of nearly 3,000 counties and county equivalents on 81 metrics across 10 categories, informing residents, health care leaders and officials about local policies and practices that drive better health outcomes for all. Data were gathered and analyzed by the University of Missouri Center for Applied Research and Engagement Systems (CARES).