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.
Rural areas make up the majority of U.S. land, but are home to only about a fifth of the population. 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 2018 rankings of the top 100 rural, up-and-coming communities and their scores across 10 categories that drive health outcomes, on a scale of zero to 100.
Rank | County | Population Health | Equity | Education | Economy | Housing | Food & Nutrition | Environment | Public Safety | Community Vitality | Infrastructure | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Jefferson County, Washington | 80.4 | 64.4 | 33.6 | 42.3 | 48.4 | 78.2 | 84.0 | 64.8 | 87.1 | 73.1 | |||||||||||
| 2 | Lincoln County, Washington | 70.2 | 72.4 | 41.7 | 40.2 | 53.4 | 69.6 | 63.1 | 80.0 | 71.8 | 78.6 | |||||||||||
| 3 | Dolores County, Colorado | 67.6 | 51.4 | 22.7 | 35.7 | 76.8 | 87.1 | 88.2 | 71.5 | 78.8 | 48.3 | |||||||||||
| 4 | Emery County, Utah | 62.0 | 88.6 | 34.2 | 40.7 | 65.6 | 53.3 | 67.0 | 85.7 | 49.6 | 73.2 | |||||||||||
| 5 | Keweenaw County, Michigan | 62.6 | 46.5 | 45.7 | 39.8 | 56.4 | 56.3 | 85.0 | 82.3 | 87.5 | 42.1 | |||||||||||
| 6 | Tillamook County, Oregon | 67.6 | 71.1 | 29.6 | 42.7 | 38.3 | 61.8 | 74.0 | 79.7 | 65.2 | 72.2 | |||||||||||
| 7 | Wallowa County, Oregon | 74.7 | 56.8 | 31.1 | 39.1 | 41.2 | 78.3 | 65.6 | 76.7 | 71.7 | 62.1 | |||||||||||
| 8 | Big Stone County, Minnesota | 87.9 | 55.8 | 50.4 | 40.6 | 39.6 | 65.1 | 58.0 | 63.6 | 65.5 | 56.1 | |||||||||||
| 9 | Garfield County, Washington | 75.4 | 55.5 | 39.5 | 39.1 | 76.0 | 54.9 | 49.7 | 74.6 | 62.4 | 73.8 | |||||||||||
| 10 | Lexington city, Virginia | 60.2 | 68.8 | 75.9 | 38.0 | 31.5 | 67.4 | 53.7 | 77.8 | 34.9 | 83.2 | |||||||||||
| 11 | Boise County, Idaho | 71.0 | 67.4 | 27.7 | 42.5 | 60.7 | 77.5 | 73.7 | 70.8 | 72.1 | 26.7 | |||||||||||
| 12 | Idaho County, Idaho | 79.6 | 70.0 | 31.2 | 37.6 | 60.4 | 66.6 | 64.1 | 66.7 | 65.7 | 45.8 | |||||||||||
| 13 | Yancey County, North Carolina | 51.6 | 76.5 | 39.8 | 41.3 | 65.9 | 56.5 | 92.4 | 74.6 | 61.9 | 41.1 | |||||||||||
| 14 | Iron County, Wisconsin | 73.9 | 60.7 | 45.7 | 40.6 | 39.0 | 62.0 | 69.4 | 66.1 | 65.0 | 56.5 | |||||||||||
| 15 | Catron County, New Mexico | 72.3 | 70.8 | 23.0 | 20.6 | 55.0 | 73.4 | 73.0 | 40.8 | 93.1 | 61.7 | |||||||||||
| 16 | Real County, Texas | 51.7 | 66.2 | 42.2 | 35.7 | 85.5 | 63.9 | 54.9 | 55.5 | 80.9 | 47.0 | |||||||||||
| 17 | Grant County, Oregon | 70.8 | 58.1 | 23.0 | 34.8 | 70.0 | 71.3 | 54.3 | 85.3 | 66.1 | 57.5 | |||||||||||
| 18 | Curry County, Oregon | 70.0 | 66.3 | 21.2 | 31.1 | 27.7 | 67.2 | 89.0 | 71.0 | 65.8 | 84.9 | |||||||||||
| 19 | Custer County, Idaho | 61.8 | 61.4 | 21.7 | 36.9 | 76.2 | 80.1 | 59.8 | 66.2 | 72.3 | 49.9 | |||||||||||
| 20 | Grant County, New Mexico | 68.0 | 64.1 | 40.0 | 36.8 | 58.9 | 69.5 | 74.8 | 48.3 | 53.7 | 68.8 | |||||||||||
| 21 | Fall River County, South Dakota | 79.3 | 67.2 | 32.0 | 38.8 | 56.4 | 60.7 | 69.6 | 41.9 | 65.4 | 62.9 | |||||||||||
| 22 | Sanders County, Montana | 65.7 | 70.2 | 12.2 | 29.4 | 76.2 | 76.1 | 75.6 | 60.9 | 74.3 | 49.1 | |||||||||||
| 23 | Sheridan County, Nebraska | 79.0 | 59.3 | 50.2 | 42.6 | 37.4 | 70.0 | 74.4 | 37.6 | 58.3 | 54.9 | |||||||||||
| 24 | Itasca County, Minnesota | 71.6 | 65.0 | 39.5 | 42.4 | 42.2 | 62.8 | 53.6 | 63.1 | 66.4 | 61.6 | |||||||||||
| 25 | Lincoln County, New Mexico | 65.6 | 52.9 | 37.4 | 38.5 | 42.0 | 82.0 | 79.9 | 51.9 | 61.9 | 65.7 |
The remaining 3,000 counties are unranked. To see more information on your county, search here:
The 2018 Healthiest Communities rankings were created in collaboration with the Aetna Foundation and are based on an examination of nearly 3,000 communities across 80 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 Jefferson County, Washington, to No. 100 Alamosa County, Colorado. 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 did not score in the top 50 percent of economies nationwide, although the communities in these rankings did outperform others of similar economic status in the overall Healthiest Communities analysis. “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.
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
CATEGORIES
WEIGHT
Population Health
14.1 %
Equity
12.2 %
Education
12.2 %
Economy
11.1 %
Housing
9.5 %
Food & Nutrition
8.8 %
Environment
8.6 %
Public Safety
8.5 %
Community Vitality
7.6 %
Infrastructure
7.5 %
U.S. News divided communities into four peer groups to allow for fair comparisons between them. See the top 500 overall rankings and the top 100 communities in the other three peer groups:
- Overall Rankings
- Urban, High-Performing Rankings
- Urban, Up-and-Coming Rankings
- Rural, High-Performing Rankings
An Honor Roll also highlights top-performing communities within each of the four peer groups in each of the nine U.S. Census regional divisions: East North Central, East South Central, Middle Atlantic, Mountain, New England, Pacific, South Atlantic, West North Central and West South Central.