The Healthy Living Score is anchored to the composite measure from America's Health Rankings, the longest-running state-by-state health assessment in the country, first published in 1990 and now in its 36th edition. Its 2025 report pulls together roughly 99 measures from more than 30 data sources to size up the health of each state. Because it leans on large federal systems rather than proprietary numbers, it is widely treated as a trustworthy backbone for exactly this kind of comparison.
That composite folds into five dimensions, and we use the same framework. Health Behaviors covers everyday patterns like smoking, obesity, physical activity, drinking, nutrition, and sleep. Health Outcomes looks at the results, including life expectancy, diabetes, and cardiovascular deaths. Clinical Care reflects access to primary and preventive care, insurance coverage, and avoidable hospital stays. Social and Economic Factors weigh in with education, income, and community conditions. And Physical Environment accounts for things like air quality and housing, a dimension you can explore further in our look at America's cleanest-air cities.
Many of these measures come from the Behavioral Risk Factor Surveillance System, the CDC's long-running state telephone survey that tracks self-reported behaviors and conditions. America's Health Rankings standardizes each measure into a z-score, weights it (individual measures typically carry between 2.5 and 7.5 percent of the total), and adds the weighted scores together to produce one composite figure per state.
We take that composite and rescale it into a friendlier 0-to-100 form with a fixed, reproducible formula: Score equals 60 plus 30 times the state's composite z-score, rounded to the nearest whole number. A perfectly average state lands at 60, stronger states climb above it, and states facing more headwinds fall below. Because the rounding is gentle, a few states share the same score while holding slightly different ranks; in those cases, the underlying z-score breaks the tie. One honest note on provenance: America's Health Rankings does not publish a 0-to-100 scale of its own, so the Healthy Living Score is our rescaling of its data, not an official figure from the source.
To keep the reading simple, here is how the bands translate. A score of 80 or above is exceptional, 70 to 79 is strong, 60 to 69 is solid and near the national middle, 45 to 59 is below average, and anything under 45 signals significant challenges across several dimensions at once.
