Most Heart-Healthy States in the U.S.

Despite the emergence of COVID-19, heart disease remained the most common cause of death in the U.S. in 2020. According to 2020 data from the National Center for Health Statistics (NCHS), death certificates indicated that heart disease killed close to 700,000 Americans that year.

Separate survey results from the NCHS in 2019 showed that 4.6% of American adults have received a coronary heart disease diagnosis. Coronary heart disease, also called coronary artery disease or ischemic heart disease, is the most common type of heart disease in the U.S. In 2019, nearly 361,000 Americans died due to this type of cardiovascular disease.

Overall, the deaths caused by heart disease and heart disease-related complications are numerous. Out of 100,000 American adults 35 and older:

Source: Centers for Disease Control and Prevention (CDC). Interactive Atlas of Heart Disease and Stroke. Accessed on Jan. 14, 2022.

Many American adults also have risk factors that put them at high risk for developing heart disease, including:

In addition to potential lifestyle changes, Americans can lower some heart disease risk factors with proper medication. However, many aren’t taking advantage of this assistance. For example, just 54.5% of people who would benefit from cholesterol-lowering drugs are taking them.

West Virginia has the highest rate of coronary heart disease in the country, even after considering the state’s older population. Nearly a quarter of the state’s adults are older than 65. The state still comes in as the least heart-healthy state with a 6.3% age-weighted score.

Aside from the age of its population, other challenges contribute to the Mountain State’s heart-health struggles. West Virginia’s Department of Health & Human Resources cites the prevalence of obesity (highest in the nation at 37.7%, based on 2018 data), lack of health care access — though lower than the U.S. average — tobacco use and low physical activity levels as some of the risk factors affecting the health of the state’s residents.

Minnesota is tied for the seventh most heart-healthy state in the nation. However, even though it didn’t factor into the heart-healthy rankings above, the state has notable statistics worth discussing.

Among U.S. adults between the ages of 45 and 64, the North Star State has the lowest rate of heart disease deaths per 100,000 adults. Minnesota reports 71.5 deaths from heart disease per 100,000 adults in this age range. In contrast, Mississippi, which holds a spot in the bottom 10 heart-healthy states, reports 216.7 heart disease deaths per 100,000 adults.

Only four other states beyond Minnesota had fewer than 80 deaths per 100,000 people:

At the other end of the spectrum, four states and the District of Columbia had more than 200 deaths from heart disease per 100,000 people ages 45 to 64:

The District of Columbia figures are notable since the district simultaneously holds the No. 2 spot among the most heart-healthy states.

States with the lowest rates of heart disease deaths among middle-age adults

With heart disease being the leading cause of death in the U.S. — and so many American adults struggling with heart disease — it’s critical to do everything you can to protect your health, your finances and your family.

No. 1: Focus on risk factors that you can control

Older adults have a higher risk of developing heart disease. And while you can’t control your age or your family medical history, you can take steps to reduce heart disease risks in other ways.

Making healthy food choices, maintaining a healthy weight, exercising and controlling blood pressure and cholesterol levels are examples of factors you may be able to control. Other actions that could benefit you include managing stress levels, avoiding smoking and limiting alcohol consumption.

No. 2: Make health care a priority

Routine health care screenings can help you detect heart disease risk factors. These warning signs might include high blood pressure and high cholesterol.

When left unchecked and unmedicated, these conditions may lead to heart and blood vessel damage. However, a trusted health care provider may be able to recommend lifestyle adjustments and medications that could help you manage such issues.

No. 3: Secure health insurance

Having ample health insurance puts you in a better position to care for your heart health. Yet, according to the American Heart Association, about 7.3 million Americans with cardiovascular disease don’t have health insurance. This lack of coverage makes the uninsured less likely to receive necessary medical care, often leading to worse medical outcomes and higher death rates.

Robin Townsend, a ValuePenguin technical writer whose focus is health and life insurance, notes that under the Affordable Care Act (ACA), ACA-compliant health plans (issued after March 23, 2010) won’t deny you coverage or charge you more based on preexisting health conditions or increased risk factors.

"This is true for individual and group health insurance," Townsend says. "Once a person is enrolled, the plan can’t deny coverage or raise rates based solely on health."

No. 4: Consider life insurance

Having adequate life insurance coverage in place can offer financial protection for your loved ones if something happens to you. Yet Townsend notes that because life insurance companies can consider health, an insurer can deny you coverage or charge you more if you’re an at-risk consumer.

On a positive note, life insurance companies offer multiple types of coverage, even for people with preexisting medical conditions. Just because you can’t qualify for one policy doesn’t mean there aren’t life insurance options available to you.

"Some life companies might reduce rates for existing customers who show they’re making lifestyle changes and lowering their heart health risks," Townsend says.

ValuePenguin analysts used the latest available data from the Centers for Disease Control and Prevention and the American Heart Association to determine the prevalence of various heart conditions and health behaviors in the 50 states and the District of Columbia. Analysts further used population data from the U.S. Census Bureau to weight some of these results to account for states with older populations.