Where you live in the United States can affect your health and your access to health care.

A new report suggests that some cities in California, Washington, Oregon and Utah are home to the healthiest people, while some cities in southern states rank among the unhealthiest.

The 180 most populous cities in the United States were assessed across 43 key indicators of good health by the personal finance site WalletHub. These measures have been divided into four categories: health care, food, fitness and green spaces. Each metric was scored by WalletHub analysts on a 100-point scale, with a score of 100 representing the most favorable conditions for a healthy lifestyle.

The data collected includes the cost of a medical visit, consumption of fruits and vegetables and the number of cases of COVID-19. Data was collected over the course of a month.

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“The data comes from trusted, primarily government sources, such as the Census Bureau, Council for Community and Economic Research, Bureau of Labor Statistics, and CDC,” WalletHub analyst Jill Gonzalez said in a statement to USA TODAY. .

San Francisco, Calif., ranked No. 1 because of the mental and physical health of its residents, health insurance coverage and because 83% of its population is vaccinated, according to Gonzalez.

Brownsville, Texas ranked last due to a lack of health care providers and healthy food restaurants. Brownsville also has the highest share of obese residents, according to Gonzalez.

“Brownsville ranks dead last due to the low proportion of adults who engage in physical activity, about 61%, and the low Physical Wellness Score,” Gonzalez said.

Fermont, California has the lowest share of physically unhealthy adults at 8%, 2.5 times less than Huntington, West Virginia, the city with the highest at 19.60%.

Laredo, Texas has the lowest cost per doctor visit, $56, which is 3.9 times cheaper than Juneau, Alaska, the city with the highest price at $219.

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Two cities in Vermont, Burlington and South Burlington, have the lowest proportion of adults eating fruit less than once a day at 30.40%, 1.7 times lower than Gulfport, Mississippi, the highest city at 51.80%.

Glendale, Arizona and Lewiston, Maine have the lowest average monthly cost for a fitness club membership, $15.00, which is 7.2 times cheaper than New York, the city with the highest price at $108.26.

Healthiest Cities

1. San Francisco, California

2.Seattle, Washington

3. San Diego, California

4. Portland, Oregon

5. Salt Lake City, Utah

6. Honolulu, Hawaii

7.Austin, Texas

8.Denver, Colorado

9. South Burlington, Vermont

10.Washington, D.C.

The least healthy cities

173. Montgomery, Alabama

174. Columbus, Georgia

175. Augusta, Georgia

176. Shreveport, Louisiana

177. Charleston, West Virginia

178. Jackson, Mississippi

179. Memphis, TN

180. Laredo, TX

181. Gulfport, Mississippi

182. Brownville, TX

“People should consider the healthiest places to live because living in a city that promotes well-being and provides access to healthy food and recreational facilities can significantly improve their quality of life,” said Gonzalez in a statement.