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Massachusetts ranked healthiest state in the US for second year in a row

Runners along the Charles River in Cambridge during a morning sun rise over the Boston downtown skyline in the background.David L. Ryan/Globe Staff/file

Massachusetts was rated the healthiest state in the country according to a study released last month by Boston University’s School of Public Health and the digital health company Sharecare, scoring highest in the areas of health care access, and housing and transportation.

Massachusetts maintained the number one spot in 2021 for the second year in a row, followed by Hawaii, New Jersey, Maryland, and New York. Mississippi remains at the bottom of the list for the third year running, joined in the bottom five by Arkansas, West Virginia, Kentucky, and Alabama.

The annual study aims to give an overview of the country’s health and well-being by assessing people’s individual health — their physical, social, and financial well-being — and combining that data with information about community health, including economic security, home values, public transit use, and access to food, health care, and public amenities.

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The 2021 study surveyed about 500,000 people in more than 3,100 US counties to determine where people are thriving and struggling.

The Sharecare Community Well-Being Index is based on over 4 million surveys collected since 2008. It is the third year Sharecare partnered with BU on the study, which now places more emphasis on community well-being and the interplay between individual health and community health, according to Kimberly Dukes, executive director of the Boston University School of Public Health Biostatistics & Epidemiology Data Analytics Center.

“We wanted to add in the context in which you live, work, and play,” Dukes said.

She and a team of 15 are behind the multi-year study, which she said they plan to expand for 2022 and beyond by integrating additional measures like climate change and Medicare/Medicaid data. “This is a long-term commitment,” Dukes said of the partnership between BU and Sharecare.

Massachusetts scored the highest in the domains of health care access, and housing and transportation — which looks at home values, the ratio of home value to income, and public transit use. The study shows that people in the Bay State are about 12 times more likely to use public transportation than residents in bottom-quantile states. This may sound surprising, given the recent flurry of malfunctions on the MBTA, but Dukes explained that it’s all about infrastructure.

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“Massachusetts has really great infrastructure, and that’s why it continues to do so well,” Dukes said, adding that changing and improving access to infrastructure, such as building hospitals or public transportation systems, “takes a very long time.”

The state’s next highest scores were in purpose well-being, defined as “liking what you do each day and feeling motivated to achieve your goals,” and financial well-being, followed by physical, social, community, and food access.

Massachusetts scored lowest in the areas of economic security and in resource access. Economic security is determined by examining rates of employment, labor force participation, individuals with health insurance coverage, and household income above poverty level. Resource access, meanwhile, is defined as the “quantity of libraries and religious institutions per 10,000 residents, employment rates for people over 65, and presence of grocery stores within 20 miles,” according to the study.

The analysis of the bottom five states showed the lowest scores in community well-being, which measures how much people like where they live and have pride in their community. These states also scored low in the area of purpose well-being.

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The 2021 study also aimed to examine how nationwide well-being was affected by COVID-19 and the rollout of vaccines. Scores measuring community and social bonds increased with the rollout of vaccines as people gathered more and returned to in-person work.

In the category of financial well-being, scores also increased to pre-pandemic levels — reversing a year-over-year decline measured between 2019 and 2020, the study said.

Dukes added that the 2021 data showed that people living in vulnerable populations found more purpose, community, and social bonds than people living in non-vulnerable populations.

“I was really happy to see that for people in more vulnerable populations,” Dukes said. “People came together to help one another out during the pandemic — to help community well being. They felt more of a sense of purpose and community than in non-vulnerable populations, and I think that’s a really important finding.”

Read the full report and learn more about the project’s methodology at wellbeingindex.sharecare.com/reports.


Brittany Bowker can be reached at brittany.bowker@globe.com. Follow her on Twitter @brittbowker and on Instagram @brittbowker.