Rural, High-Performing Rankings

Measuring health and wellness in similar communities

(George Rose/Getty Images)

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.

People who live in rural communities are more likely to own their homes and live in the state where they were born than those in urban areas, according to the U.S. Census Bureau. And while access to care and transportation barriers can pose challenges, residents of rural communities with high-performing economies typically live in healthier natural environments and fare better in terms of housing than their urban counterparts.

Below are the 2019 rankings of the top 100 rural, high-performing 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	Teton County, Wyoming	86.9	50.6	74	80	50.1	76.8	90.7	62.9	69.8	94.3
2	Chaffee County, Colorado	83.8	61.7	42.7	56.1	67.9	82	96.8	81.9	82.6	73.6
3	Morgan County, Utah	89.4	48.5	65.3	81.2	59.3	65.7	81.5	77.8	79.5	66.4
4	Routt County, Colorado	89.2	54.3	55.4	72.7	54.3	72.4	88.6	77.5	70.5	87.9
5	Jefferson County, Montana	76.8	62.1	44.2	66.1	75.9	86.2	76.7	74.7	84.8	73.3
6	San Miguel County, Colorado	90.9	57.7	59.8	68.7	29.6	95.2	91.9	74	68.3	81.2
7	Pitkin County, Colorado	91.4	42.7	57.5	74	41.5	78.4	97.9	83.3	68.9	84.8
8	Sioux County, Iowa	86.2	62.2	57	64.9	80.2	53.8	76.4	72.5	66.4	81.5
9	Hardin County, Iowa	74.7	70	62.6	57.5	81.8	58.1	79	76.1	60.7	79.1
10	Lincoln County, Wyoming	73.7	71.6	54.1	68.4	67.3	66.6	87.4	81.9	66.9	54.9
11	Grand County, Colorado	80.1	56.8	35.3	67	54.6	86.8	89.5	88.8	66.7	75.6
12	Elbert County, Colorado	76.4	79.4	34.5	77.2	61.1	65.9	74.9	81.6	91.5	34.4
13	Summit County, Utah	89.5	23.2	57.2	79.3	63.7	69	72.6	81.6	74	78.3
14	San Juan County, Washington	92.6	59.5	51.4	56.4	26.9	100	66.1	72.6	84.3	73
15	Winneshiek County, Iowa	86.5	60.1	65.5	61.5	76.1	53.9	76.1	63	64.9	76.1
16	Winnebago County, Iowa	73.8	71.7	61.6	48.7	76.6	58.2	80.3	72.3	61.4	91
17	Sublette County, Wyoming	74	44.2	56	70.2	85.2	76.2	88.2	69	69.1	55.6
18	Madison County, Montana	88	75.3	33.2	51.1	48.3	92.4	76.3	67.7	84.2	58.1
19	O'Brien County, Iowa	83	64	54.7	55.6	82.7	62.4	79.9	69.9	58.7	70.1
20	Addison County, Vermont	85	64.5	68.2	63.1	56	75.9	62.4	69.3	60.6	64.3
21	Mitchell County, Iowa	81.5	74.5	35.6	56.5	70	65.1	72.1	72	66.8	82.9
22	Hamilton County, Nebraska	80.3	63.8	52.3	64.9	79.6	39.8	69.4	68.9	76.9	70.3
23	Lewis and Clark County, Montana	75.5	71.2	44.6	58.5	67.7	65.4	80.5	61.6	68.5	78
24	Lyon County, Iowa	72.4	61.1	40.6	60.8	91.2	58.5	73.6	72.6	70.8	71.2
25	Cheyenne County, Nebraska	78.9	72.3	50.2	69.4	80.2	52.8	67.8	61.8	56.4	73.5

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 are 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, high-performing communities in America, ranging from No. 1 Teton County, Wyoming, to No. 100 Clay County, Nebraska. 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. Those designated as “high-performing” scored in the top half of the economy category out of all rural places assessed for the overall Healthiest Communities rankings.

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).