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2020: These Cities Are the Healthiest and Unhealthiest in Texas

Our research team dives deep into the latest government data to rank the healthiest and least healthy cities in Texas.

Last Updated: Mar 11, 2020
Heatmap of texas health

Innerbody.com has carefully evaluated the data and identified the top 10 healthiest Texas cities, as well as the 10 least healthy cities in the state.

Innerbody.com’s research team closely examined the latest government data from the Centers for Disease Control, the Environmental Protection Agency and the Economic Research Service, among others, in order to evaluate Texas’ 30 largest cities (from Odessa to Houston).

Since everything is bigger in Texas, we pored over extensive data sets, analyzing 20 different factors across the following four key dimensions in order to determine our Health Rankings:

  • Clinical Care & Prevention
  • Disease & Health Outcomes
  • Health Behaviors
  • Physical Environment

Among the 20 factors were residents’ access to health care and health insurance; cancer and obesity rates; air quality and lead exposure; and even how much sleep an average resident gets.

Plano takes the top spot this year as the healthiest large city in Texas for 2020, moving up one spot from last year’s rankings. Plano has the highest overall Health Score (78.8) by a decent margin over Frisco, ranked 2nd (73.7), while Austin (69.6) rounds out the top 3.

Plano ranked an impressive #1 or #2 in each of our four dimensions. With outstanding clinical care and prevention, low disease rates, healthy behavioral habits, and a great physical environment, Plano will be tough to beat in the years to come.

Meanwhile, the least healthy large city in Texas for 2020 is Waco (30.2), with Brownsville (33.9) and Laredo (35.4) most narrowly escaping that distinction.

Here are all 20 factors that we used for this study:

Healthfactors

Top 10 Healthiest Cities in Texas

Without further ado, here are the Top 10 Healthiest Cities in the Lone Star State for 2020:

#1

Plano

Plano
  • Overall Health Score

    78.8

  • Population

    259,841

  • Care & Prevention

    Ranked # 2 (out of 30)

  • Health Behaviors

    Ranked # 2 (out of 30)

  • Disease Outcomes

    Ranked # 1 (out of 30)

  • Environment

    Ranked # 1 (out of 30)

#2

Frisco

Frisco
  • Overall Health Score

    73.7

  • Population

    116,989

  • Care & Prevention

    Ranked # 1 (out of 30)

  • Health Behaviors

    Ranked # 1 (out of 30)

  • Disease Outcomes

    Ranked # 2 (out of 30)

  • Environment

    Ranked # 23 (out of 30)

#3

Austin

Austin
  • Overall Health Score

    69.6

  • Population

    790,390

  • Care & Prevention

    Ranked # 4 (out of 30)

  • Health Behaviors

    Ranked # 3 (out of 30)

  • Disease Outcomes

    Ranked # 3 (out of 30)

  • Environment

    Ranked # 8 (out of 30)

#4

McKinney

McKinney
  • Overall Health Score

    62.8

  • Population

    195,342

  • Care & Prevention

    Ranked # 3 (out of 30)

  • Health Behaviors

    Ranked # 4 (out of 30)

  • Disease Outcomes

    Ranked # 4 (out of 30)

  • Environment

    Ranked # 20 (out of 30)

#5

Carrollton

Carrollton
  • Overall Health Score

    62.4

  • Population

    119,097

  • Care & Prevention

    Ranked # 5 (out of 30)

  • Health Behaviors

    Ranked # 5 (out of 30)

  • Disease Outcomes

    Ranked # 5 (out of 30)

  • Environment

    Ranked # 16 (out of 30)

#6

Irving

Irving
  • Overall Health Score

    59.4

  • Population

    216,290

  • Care & Prevention

    Ranked # 14 (out of 30)

  • Health Behaviors

    Ranked # 6 (out of 30)

  • Disease Outcomes

    Ranked # 9 (out of 30)

  • Environment

    Ranked # 2 (out of 30)

#7

Midland

Midland
  • Overall Health Score

    58.4

  • Population

    111,147

  • Care & Prevention

    Ranked # 13 (out of 30)

  • Health Behaviors

    Ranked # 11 (out of 30)

  • Disease Outcomes

    Ranked # 6 (out of 30)

  • Environment

    Ranked # 3 (out of 30)

#8

El Paso

El Paso
  • Overall Health Score

    54.3

  • Population

    649,121

  • Care & Prevention

    Ranked # 17 (out of 30)

  • Health Behaviors

    Ranked # 12 (out of 30)

  • Disease Outcomes

    Ranked # 7 (out of 30)

  • Environment

    Ranked # 14 (out of 30)

#9

Arlington

Arlington
  • Overall Health Score

    53.2

  • Population

    365,438

  • Care & Prevention

    Ranked # 9 (out of 30)

  • Health Behaviors

    Ranked # 13 (out of 30)

  • Disease Outcomes

    Ranked # 14 (out of 30)

  • Environment

    Ranked # 9 (out of 30)

#10

Garland

Garland
  • Overall Health Score

    51.3

  • Population

    226,876

  • Care & Prevention

    Ranked # 18 (out of 30)

  • Health Behaviors

    Ranked # 10 (out of 30)

  • Disease Outcomes

    Ranked # 18 (out of 30)

  • Environment

    Ranked # 5 (out of 30)

Bottom 10 Least Healthy Cities in Texas

Below are cities #30 - #21, the least healthy cities in Texas:

#30

Waco

Waco
  • Overall Health Score

    30.2

  • Population

    124,805

  • Care & Prevention

    Ranked # 23 (out of 30)

  • Health Behaviors

    Ranked # 28 (out of 30)

  • Disease Outcomes

    Ranked # 27 (out of 30)

  • Environment

    Ranked # 30 (out of 30)

#29

Brownsville

Brownsville
  • Overall Health Score

    33.9

  • Population

    175,023

  • Care & Prevention

    Ranked # 29 (out of 30)

  • Health Behaviors

    Ranked # 20 (out of 30)

  • Disease Outcomes

    Ranked # 29 (out of 30)

  • Environment

    Ranked # 24 (out of 30)

#28

Laredo

Laredo
  • Overall Health Score

    35.4

  • Population

    236,091

  • Care & Prevention

    Ranked # 30 (out of 30)

  • Health Behaviors

    Ranked # 26 (out of 30)

  • Disease Outcomes

    Ranked # 30 (out of 30)

  • Environment

    Ranked # 15 (out of 30)

#27

Beaumont

Beaumont
  • Overall Health Score

    36.1

  • Population

    118,296

  • Care & Prevention

    Ranked # 8 (out of 30)

  • Health Behaviors

    Ranked # 29 (out of 30)

  • Disease Outcomes

    Ranked # 28 (out of 30)

  • Environment

    Ranked # 28 (out of 30)

#26

Wichita Falls

Wichita Falls
  • Overall Health Score

    37.9

  • Population

    104,553

  • Care & Prevention

    Ranked # 10 (out of 30)

  • Health Behaviors

    Ranked # 30 (out of 30)

  • Disease Outcomes

    Ranked # 23 (out of 30)

  • Environment

    Ranked # 27 (out of 30)

#25

Abilene

Abilene
  • Overall Health Score

    40.1

  • Population

    117,063

  • Care & Prevention

    Ranked # 21 (out of 30)

  • Health Behaviors

    Ranked # 25 (out of 30)

  • Disease Outcomes

    Ranked # 22 (out of 30)

  • Environment

    Ranked # 25 (out of 30)

#24

Killeen

Killeen
  • Overall Health Score

    40.9

  • Population

    127,921

  • Care & Prevention

    Ranked # 6 (out of 30)

  • Health Behaviors

    Ranked # 27 (out of 30)

  • Disease Outcomes

    Ranked # 26 (out of 30)

  • Environment

    Ranked # 29 (out of 30)

#23

Mesquite

Mesquite
  • Overall Health Score

    45.1

  • Population

    139,824

  • Care & Prevention

    Ranked # 16 (out of 30)

  • Health Behaviors

    Ranked # 16 (out of 30)

  • Disease Outcomes

    Ranked # 24 (out of 30)

  • Environment

    Ranked # 18 (out of 30)

#22

Fort Worth

Fort Worth
  • Overall Health Score

    45.2

  • Population

    741,206

  • Care & Prevention

    Ranked # 15 (out of 30)

  • Health Behaviors

    Ranked # 19 (out of 30)

  • Disease Outcomes

    Ranked # 21 (out of 30)

  • Environment

    Ranked # 17 (out of 30)

#21

Pasadena

Pasadena
  • Overall Health Score

    45.3

  • Population

    149,043

  • Care & Prevention

    Ranked # 27 (out of 30)

  • Health Behaviors

    Ranked # 23 (out of 30)

  • Disease Outcomes

    Ranked # 25 (out of 30)

  • Environment

    Ranked # 12 (out of 30)

Best and Worst in Select Ranking Factors

Here are how some of the cities fared in select factors:

Lowest Obesity Rates

  • 1. Austin
  • 2. Plano
  • 3. Frisco
  • 4. Carrollton
  • 5. McKinney

Highest Obesity Rates

  • 30. Laredo
  • 29. McAllen
  • 28. Brownsville
  • 27. Waco
  • 26. Wichita Falls

Ratings based on obesity rates among adults aged ≥18 years.

Lowest Air Pollution

  • 1. Amarillo
  • 2. Midland
  • 3. Odessa
  • 4. Abilene
  • 5. Lubbock

Highest Air Pollution

  • 30. Houston
  • 29. Pasadena
  • 28. Plano
  • 27. Irving
  • 26. Carrollton

Ratings based on average daily concentration of fine particulate matter in the air.

High Access to Health Insurance

  • 1. Frisco
  • 2. Plano
  • 3. Austin
  • 4. McKinney
  • 5. Denton

Low Access to Health Insurance

  • 30. Laredo
  • 29. Brownsville
  • 28. McAllen
  • 27. Pasadena
  • 26. Paso

Ratings based on current lack of health insurance among adults.

Most Hours of Sleep

  • 1. Austin
  • 2. Frisco
  • 3. Denton
  • 4. Carrollton
  • 5. Plano

Least Hours of Sleep

  • 30. Killeen
  • 29. Wichita Falls
  • 28. Beaumont
  • 27. El Paso
  • 26. Fort Worth

Ratings based on the percentage of adults sleeping less than 7 hours per day.

Best Flu Shot Rates

  • 1. Plano
  • 2. Frisco
  • 3. Arlington (tied)
  • 4. McKinney (tied)
  • 5. Denton

Worst Flu Shot Rates

  • 30. Laredo
  • 29. Brownsville
  • 28. Odessa
  • 27. El Paso
  • 26. McAllen

Ratings based on percentage of older adults who are up to date on influenza vaccinations.

Least Amount of Binge Drinking

  • 1. Plano
  • 2. Frisco
  • 3. Midland
  • 4. Denton
  • 5. McKinney

Most Amount of Binge Drinking

  • 30. Brownsville
  • 29. Laredo
  • 28. McAllen
  • 27. Waco
  • 26. Beaumont

Ratings based on percentage of adults who engage in binge drinking.

How All Texan Cities Fared -- All Rankings

Below is how each of the largest 30 cities in Texas was ranked overall, along with how each was ranked in each of our four key dimensions: Care & Prevention, Disease Outcomes, Health Behaviors, and Physical Environment:

Overall Health Rank City Population Overall Health Score Care & Prevention Disease Outcomes Health Behaviors Physical Environment
1 Plano 259,841 78.8 2 1 2 1
2 Frisco 116,989 73.7 1 2 1 23
3 Austin 790,390 69.6 4 3 3 8
4 McKinney 195,342 62.8 3 4 4 20
5 Carrollton 119,097 62.4 5 5 5 16
6 Irving 216,290 59.4 14 9 6 2
7 Midland 111,147 58.4 13 6 11 3
8 El Paso 649,121 54.3 17 7 12 14
9 Arlington 365,438 53.2 9 14 13 9
10 Garland 226,876 51.3 18 18 10 5
11 Denton 113,383 50.6 7 8 7 26
12 Grand Prairie 175,396 50.3 11 13 9 21
13 Corpus Christi 305,215 49.6 22 11 22 7
14 McAllen 129,877 48.7 26 10 8 19
15 Houston 2,099,451 47.9 25 20 15 13
16 Dallas 1,197,816 47.5 20 17 14 6
17 San Antonio 1,327,407 47.4 12 12 21 22
18 Odessa 99,940 47.0 28 19 17 4
19 Amarillo 190,695 46.4 19 16 24 10
20 Lubbock 229,573 46.2 24 15 18 11
21 Pasadena 149,043 45.3 27 25 23 12
22 Fort Worth 741,206 45.2 15 21 19 17
23 Mesquite 139,824 45.1 16 24 16 18
24 Killeen 127,921 40.9 6 26 27 29
25 Abilene 117,063 40.1 21 22 25 25
26 Wichita Falls 104,553 37.9 10 23 30 27
27 Beaumont 118,296 36.1 8 28 29 28
28 Laredo 236,091 35.4 30 30 26 15
29 Brownsville 175,023 33.9 29 29 20 24
30 Waco 124,805 30.2 23 27 28 30

How We Collected Data and Developed Our Rankings

We examined the 30 largest cities in Texas (from Houston to Odessa) based on the latest U.S. Census Bureau statistics across four key dimensions: Clinical Care & Prevention, Disease & Health Outcomes, Health Behaviors, and Physical Environment. We analyzed 5 metrics within each dimension.

Therefore, for each city we looked at no less than 20 different health factors in total. We graded each metric on a 100-point scale, with a score of 100 always representing the healthiest, most favorable conditions.

More detailed information about each metric - including definition, source, and weighting - is as follows:

Clinical Care & Prevention: 25% total weight

Insurance Access: 5% weight

  • Measures: Current lack of health insurance among adults aged 18–64 years
  • Source: Centers for Disease Control and Prevention

Routine Checkups: 5% weight

  • Measures: Visits to doctor for routine checkup within the past year among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Dental Visits: 5% weight

  • Measures: Visits to dentist or dental clinic among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Influenza Vaccination: 5% weight

  • Measures: Older adults aged ≥65 years who are up to date on a core set of clinical preventive services (influenza or pneumococcal vaccination)
  • Source: Centers for Disease Control and Prevention

Cholesterol Screening: 5% weight

  • Measures: Cholesterol screening among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Disease & Health Outcomes: 25% total weight

Cancer: 5% weight

  • Measures: Cancer (excluding skin cancer) among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

High Blood Pressure: 5% weight

  • Measures: High blood pressure among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Diabetes: 5% weight

  • Measures: Diagnosed diabetes among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Coronary Heart Disease: 5% weight

  • Measures: Coronary heart disease among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Asthma: 5% weight

  • Measures: Current asthma prevalence among adults aged ≥18 Years
  • Source: Centers for Disease Control and Prevention

Unhealthy Behaviors: 25% total weight

Smoking: 5% weight

  • Measures: Current smoking among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Obesity: 5% weight

  • Measures: Obesity among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Lack of Physical Activity: 5% weight

  • Measures: No leisure-time physical activity among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Lack of Sleep: 5% weight

  • Measures: Sleeping less than 7 hours among adults aged ≥18 years
  • Source: Centers for Disease Control and Prevention

Binge Drinking: 5% weight

  • Measures: Binge drinking among adults aged ≥ 18 years
  • Source: Centers for Disease Control and Prevention

Physical Environment: 25% total weight

Air Pollution: 5% weight

  • Measures: Average daily concentration of fine particulate matter (PM2.5) per cubic meter (average)
  • Source: US Environmental Protection Agency

Healthy Food Access: 5% weight

  • Measures: Population living more than ½ mile from the nearest supermarket, supercenter, or large grocery store (%)
  • Source: Economic Research Service

Lead Exposure Risk: 5% weight

  • Measures: Poverty-adjusted risk of housing-based lead exposure (index)
  • Source: American Community Survey

Park Access: 5% weight

  • Measures: Population living within a 10 minute walk of green space (%)
  • Source: ParkServe®

Walkability: 5% weight

  • Measures: Neighborhood amenities accessible by walking as calculated by Walk Score® (index)
  • Source: Walk Score®

Sources

  • Centers for Disease Control and Prevention
  • US Environmental Protection Agency
  • Economic Research Service
  • American Community Survey
  • ParkServe®
  • Walk Score®
  • Innerbody.com Research

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