Sleep is a key component of a healthy lifestyle. The Centers for Disease Control and Prevention recommends that adults get at least seven hours of sleep each night — and falling short of this target carries a number of risks. Still, nearly 90 million American adults are not getting enough sleep.
Americans who do not get enough sleep are at increased risk of making mistakes in their day-to-day lives — and mistakes at work or while driving can have serious consequences. Insufficient sleep is also linked to chronic diseases, including type 2 diabetes, heart disease, obesity, and depression.
Using data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program, 24/7 Tempo identified the least sleep deprived metro area in every state. Four states — Delaware, New Hampshire, Rhode Island, and Vermont — have only one metro area. As a result, these areas rank as the least sleep deprived in the state by default only.
Though each metro area on this list has the lowest sleep deprivation rate in its state, the share of adults sleeping less than seven hours per night varies considerably — from 40.8% down to 26.6%. Nationwide, 35.2% of adults are not getting enough sleep.
Research has shown that sleep duration is linked to both regulation of blood sugar as well as metabolic changes — and that adults who regularly sleep less than seven hours a night are at increased risk of diabetes and obesity. In the majority of metro areas on this list, rates of both diabetes and obesity are lower than they are across the state as a whole. Here is a look at what happens to your body when you don’t get enough sleep.
To improve sleep habits, the CDC recommends developing a routine of going to bed at the same time each night and waking up at the same time every day. The CDC also advises regular exercise and avoiding caffeine, large meals, and alcohol before bed time. Removing electronic devices, such as TVs and computers, from the bedroom can also help improve sleep habits. Here is a list of 19 secrets to sleep better at night.
Click here to see the least sleep deprived metro area in every state
Click here to see our detailed methodology
Alabama: Daphne-Fairhope-Foley
> Adults reporting insufficient sleep (<7 hours): 36.4% (Alabama: 39.6%)
> Adults reporting poor or fair health: 16.5% (Alabama: 21.4%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Alabama: 4.9)
> Adult obesity rate: 30.0% (Alabama: 36.1%)
> Adults with diabetes: 10.3% (Alabama: 14.5%)
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Alaska: Fairbanks
> Adults reporting insufficient sleep (<7 hours): 32.8% (Alaska: 33.3%)
> Adults reporting poor or fair health: 14.0% (Alaska: 15.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.1 (Alaska: 3.7)
> Adult obesity rate: 31.0% (Alaska: 31.9%)
> Adults with diabetes: 7.1% (Alaska: 8.3%)
Arizona: Flagstaff
> Adults reporting insufficient sleep (<7 hours): 32.6% (Arizona: 34.9%)
> Adults reporting poor or fair health: 17.9% (Arizona: 18.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Arizona: 4.0)
> Adult obesity rate: 24.5% (Arizona: 27.9%)
> Adults with diabetes: 7.7% (Arizona: 9.6%)
Arkansas: Fayetteville-Springdale-Rogers
> Adults reporting insufficient sleep (<7 hours): 33.3% (Arkansas: 37.2%)
> Adults reporting poor or fair health: 21.8% (Arkansas: 23.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Arkansas: 5.3)
> Adult obesity rate: 31.6% (Arkansas: 35.0%)
> Adults with diabetes: 9.6% (Arkansas: 13.5%)
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California: Santa Rosa-Petaluma
> Adults reporting insufficient sleep (<7 hours): 30.0% (California: 34.5%)
> Adults reporting poor or fair health: 15.1% (California: 17.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.3 (California: 3.7)
> Adult obesity rate: 23.9% (California: 24.3%)
> Adults with diabetes: 8.3% (California: 8.8%)
Colorado: Boulder
> Adults reporting insufficient sleep (<7 hours): 26.6% (Colorado: 30.0%)
> Adults reporting poor or fair health: 11.2% (Colorado: 13.8%)
> Avg. number of mentally unhealthy days reported in past month: 3.6 (Colorado: 3.7)
> Adult obesity rate: 14.3% (Colorado: 22.4%)
> Adults with diabetes: 5.5% (Colorado: 6.6%)
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Connecticut: Bridgeport-Stamford-Norwalk
> Adults reporting insufficient sleep (<7 hours): 33.1% (Connecticut: 33.8%)
> Adults reporting poor or fair health: 11.9% (Connecticut: 13.0%)
> Avg. number of mentally unhealthy days reported in past month: 3.6 (Connecticut: 3.8)
> Adult obesity rate: 21.2% (Connecticut: 26.3%)
> Adults with diabetes: 7.3% (Connecticut: 9.2%)
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Delaware: Dover*
> Adults reporting insufficient sleep (<7 hours): 39.3% (Delaware: 36.5%)
> Adults reporting poor or fair health: 21.0% (Delaware: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Delaware: 4.2)
> Adult obesity rate: 38.4% (Delaware: 32.4%)
> Adults with diabetes: 13.9% (Delaware: 11.8%)
*Because Dover is the only eligible metro in Delaware, it is the least sleep deprived metro by default.
Florida: Naples-Marco Island
> Adults reporting insufficient sleep (<7 hours): 34.1% (Florida: 37.3%)
> Adults reporting poor or fair health: 18.3% (Florida: 19.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.1 (Florida: 4.2)
> Adult obesity rate: 21.9% (Florida: 27.2%)
> Adults with diabetes: 9.1% (Florida: 10.8%)
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Georgia: Gainesville
> Adults reporting insufficient sleep (<7 hours): 35.0% (Georgia: 38.3%)
> Adults reporting poor or fair health: 20.6% (Georgia: 18.4%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (Georgia: 4.2)
> Adult obesity rate: 32.0% (Georgia: 32.3%)
> Adults with diabetes: 11.5% (Georgia: 12.0%)
Hawaii: Kahului-Wailuku-Lahaina
> Adults reporting insufficient sleep (<7 hours): 39.5% (Hawaii: 43.2%)
> Adults reporting poor or fair health: 14.7% (Hawaii: 15.4%)
> Avg. number of mentally unhealthy days reported in past month: 3.7 (Hawaii: 3.4)
> Adult obesity rate: 24.6% (Hawaii: 24.6%)
> Adults with diabetes: 10.3% (Hawaii: 11.1%)
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Idaho: Lewiston
> Adults reporting insufficient sleep (<7 hours): 33.7% (Idaho: 33.4%)
> Adults reporting poor or fair health: 17.4% (Idaho: 15.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Idaho: 4.0)
> Adult obesity rate: 31.0% (Idaho: 29.0%)
> Adults with diabetes: 11.3% (Idaho: 9.3%)
Illinois: Bloomington
> Adults reporting insufficient sleep (<7 hours): 33.4% (Illinois: 33.5%)
> Adults reporting poor or fair health: 14.5% (Illinois: 15.9%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Illinois: 3.8)
> Adult obesity rate: 31.1% (Illinois: 29.7%)
> Adults with diabetes: 10.9% (Illinois: 9.9%)
Indiana: Columbus
> Adults reporting insufficient sleep (<7 hours): 35.4% (Indiana: 38.0%)
> Adults reporting poor or fair health: 17.4% (Indiana: 18.2%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (Indiana: 4.7)
> Adult obesity rate: 31.8% (Indiana: 33.9%)
> Adults with diabetes: 11.6% (Indiana: 12.1%)
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Iowa: Iowa City
> Adults reporting insufficient sleep (<7 hours): 30.0% (Iowa: 33.1%)
> Adults reporting poor or fair health: 12.9% (Iowa: 13.5%)
> Avg. number of mentally unhealthy days reported in past month: 3.6 (Iowa: 3.5)
> Adult obesity rate: 27.7% (Iowa: 34.3%)
> Adults with diabetes: 7.0% (Iowa: 9.9%)
Kansas: Manhattan
> Adults reporting insufficient sleep (<7 hours): 32.4% (Kansas: 34.0%)
> Adults reporting poor or fair health: 15.7% (Kansas: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.1 (Kansas: 4.1)
> Adult obesity rate: 28.1% (Kansas: 33.0%)
> Adults with diabetes: 6.6% (Kansas: 10.5%)
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Kentucky: Louisville/Jefferson County
> Adults reporting insufficient sleep (<7 hours): 39.5% (Kentucky: 42.1%)
> Adults reporting poor or fair health: 20.1% (Kentucky: 21.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Kentucky: 5.0)
> Adult obesity rate: 32.7% (Kentucky: 34.6%)
> Adults with diabetes: 12.4% (Kentucky: 12.7%)
Louisiana: Houma-Thibodaux
> Adults reporting insufficient sleep (<7 hours): 36.9% (Louisiana: 38.0%)
> Adults reporting poor or fair health: 23.7% (Louisiana: 21.4%)
> Avg. number of mentally unhealthy days reported in past month: 5.3 (Louisiana: 5.0)
> Adult obesity rate: 39.7% (Louisiana: 36.3%)
> Adults with diabetes: 12.8% (Louisiana: 13.0%)
Maine: Portland-South Portland
> Adults reporting insufficient sleep (<7 hours): 31.7% (Maine: 34.5%)
> Adults reporting poor or fair health: 13.2% (Maine: 17.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.3 (Maine: 5.0)
> Adult obesity rate: 25.9% (Maine: 29.8%)
> Adults with diabetes: 8.9% (Maine: 10.4%)
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Maryland: Salisbury
> Adults reporting insufficient sleep (<7 hours): 36.7% (Maryland: 37.7%)
> Adults reporting poor or fair health: 18.6% (Maryland: 15.2%)
> Avg. number of mentally unhealthy days reported in past month: 4.4 (Maryland: 3.7)
> Adult obesity rate: 34.9% (Maryland: 31.6%)
> Adults with diabetes: 13.1% (Maryland: 11.1%)
Massachusetts: Barnstable Town
> Adults reporting insufficient sleep (<7 hours): 32.7% (Massachusetts: 34.3%)
> Adults reporting poor or fair health: 12.7% (Massachusetts: 13.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (Massachusetts: 4.3)
> Adult obesity rate: 22.5% (Massachusetts: 25.0%)
> Adults with diabetes: 10.1% (Massachusetts: 8.7%)
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Michigan: Grand Rapids-Kentwood
> Adults reporting insufficient sleep (<7 hours): 36.1% (Michigan: 40.4%)
> Adults reporting poor or fair health: 16.8% (Michigan: 18.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Michigan: 4.7)
> Adult obesity rate: 30.2% (Michigan: 32.4%)
> Adults with diabetes: 9.5% (Michigan: 11.0%)
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Minnesota: Rochester
> Adults reporting insufficient sleep (<7 hours): 29.0% (Minnesota: 29.1%)
> Adults reporting poor or fair health: 11.9% (Minnesota: 12.9%)
> Avg. number of mentally unhealthy days reported in past month: 3.3 (Minnesota: 3.5)
> Adult obesity rate: 29.9% (Minnesota: 29.0%)
> Adults with diabetes: 8.1% (Minnesota: 8.5%)
Mississippi: Hattiesburg
> Adults reporting insufficient sleep (<7 hours): 37.3% (Mississippi: 37.8%)
> Adults reporting poor or fair health: 20.9% (Mississippi: 22.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (Mississippi: 4.8)
> Adult obesity rate: 35.5% (Mississippi: 39.1%)
> Adults with diabetes: 12.1% (Mississippi: 14.6%)
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Missouri: Columbia
> Adults reporting insufficient sleep (<7 hours): 32.4% (Missouri: 35.2%)
> Adults reporting poor or fair health: 17.0% (Missouri: 19.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (Missouri: 4.5)
> Adult obesity rate: 28.1% (Missouri: 32.5%)
> Adults with diabetes: 7.2% (Missouri: 11.4%)
Montana: Billings
> Adults reporting insufficient sleep (<7 hours): 31.8% (Montana: 30.9%)
> Adults reporting poor or fair health: 14.5% (Montana: 14.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.3 (Montana: 3.9)
> Adult obesity rate: 27.9% (Montana: 27.1%)
> Adults with diabetes: 8.6% (Montana: 8.9%)
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Nebraska: Grand Island
> Adults reporting insufficient sleep (<7 hours): 31.0% (Nebraska: 32.3%)
> Adults reporting poor or fair health: 16.0% (Nebraska: 13.8%)
> Avg. number of mentally unhealthy days reported in past month: 3.8 (Nebraska: 3.6)
> Adult obesity rate: 37.4% (Nebraska: 33.4%)
> Adults with diabetes: 11.5% (Nebraska: 10.0%)
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Nevada: Reno
> Adults reporting insufficient sleep (<7 hours): 35.2% (Nevada: 37.3%)
> Adults reporting poor or fair health: 18.1% (Nevada: 19.1%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Nevada: 4.0)
> Adult obesity rate: 23.7% (Nevada: 27.1%)
> Adults with diabetes: 7.9% (Nevada: 10.5%)
New Hampshire: Manchester-Nashua*
> Adults reporting insufficient sleep (<7 hours): 36.3% (New Hampshire: 35.3%)
> Adults reporting poor or fair health: 12.2% (New Hampshire: 12.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.2 (New Hampshire: 4.6)
> Adult obesity rate: 28.5% (New Hampshire: 28.6%)
> Adults with diabetes: 9.7% (New Hampshire: 9.6%)
*Because Manchester-Nashua is the only eligible metro in New Hampshire, it is the least sleep deprived metro by default.
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New Jersey: Ocean City
> Adults reporting insufficient sleep (<7 hours): 38.6% (New Jersey: 37.5%)
> Adults reporting poor or fair health: 15.5% (New Jersey: 15.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (New Jersey: 3.8)
> Adult obesity rate: 28.3% (New Jersey: 27.0%)
> Adults with diabetes: 11.6% (New Jersey: 9.9%)
New Mexico: Santa Fe
> Adults reporting insufficient sleep (<7 hours): 28.6% (New Mexico: 33.1%)
> Adults reporting poor or fair health: 17.8% (New Mexico: 20.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (New Mexico: 4.5)
> Adult obesity rate: 16.1% (New Mexico: 27.3%)
> Adults with diabetes: 6.1% (New Mexico: 9.5%)
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New York: Ithaca
> Adults reporting insufficient sleep (<7 hours): 32.8% (New York: 38.9%)
> Adults reporting poor or fair health: 13.5% (New York: 16.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.4 (New York: 3.6)
> Adult obesity rate: 23.0% (New York: 26.4%)
> Adults with diabetes: 6.5% (New York: 10.1%)
North Carolina: Raleigh-Cary
> Adults reporting insufficient sleep (<7 hours): 32.7% (North Carolina: 36.1%)
> Adults reporting poor or fair health: 14.9% (North Carolina: 18.0%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (North Carolina: 4.1)
> Adult obesity rate: 29.3% (North Carolina: 32.3%)
> Adults with diabetes: 9.3% (North Carolina: 11.5%)
North Dakota: Fargo
> Adults reporting insufficient sleep (<7 hours): 31.1% (North Dakota: 32.8%)
> Adults reporting poor or fair health: 12.6% (North Dakota: 13.6%)
> Avg. number of mentally unhealthy days reported in past month: 3.6 (North Dakota: 3.8)
> Adult obesity rate: 31.9% (North Dakota: 33.9%)
> Adults with diabetes: 7.6% (North Dakota: 9.4%)
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Ohio: Cincinnati
> Adults reporting insufficient sleep (<7 hours): 37.5% (Ohio: 40.6%)
> Adults reporting poor or fair health: 17.4% (Ohio: 17.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.7 (Ohio: 4.8)
> Adult obesity rate: 32.4% (Ohio: 33.5%)
> Adults with diabetes: 11.8% (Ohio: 12.2%)
Oklahoma: Tulsa
> Adults reporting insufficient sleep (<7 hours): 36.2% (Oklahoma: 37.5%)
> Adults reporting poor or fair health: 19.9% (Oklahoma: 20.9%)
> Avg. number of mentally unhealthy days reported in past month: 4.9 (Oklahoma: 4.8)
> Adult obesity rate: 32.6% (Oklahoma: 34.5%)
> Adults with diabetes: 11.8% (Oklahoma: 12.3%)
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Oregon: Portland-Vancouver-Hillsboro
> Adults reporting insufficient sleep (<7 hours): 31.6% (Oregon: 32.8%)
> Adults reporting poor or fair health: 15.8% (Oregon: 18.2%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Oregon: 4.8)
> Adult obesity rate: 28.0% (Oregon: 29.3%)
> Adults with diabetes: 9.0% (Oregon: 9.7%)
Pennsylvania: Reading
> Adults reporting insufficient sleep (<7 hours): 36.3% (Pennsylvania: 38.6%)
> Adults reporting poor or fair health: 19.2% (Pennsylvania: 17.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Pennsylvania: 4.7)
> Adult obesity rate: 34.2% (Pennsylvania: 30.8%)
> Adults with diabetes: 10.4% (Pennsylvania: 11.0%)
Rhode Island: Providence-Warwick*
> Adults reporting insufficient sleep (<7 hours): 37.2% (Rhode Island: 36.7%)
> Adults reporting poor or fair health: 16.8% (Rhode Island: 16.5%)
> Avg. number of mentally unhealthy days reported in past month: 4.6 (Rhode Island: 4.2)
> Adult obesity rate: 28.6% (Rhode Island: 28.5%)
> Adults with diabetes: 10.1% (Rhode Island: 10.1%)
*Because Providence-Warwick is the only eligible metro in Rhode Island, it is the least sleep deprived metro by default.
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South Carolina: Myrtle Beach-Conway-North Myrtle Beach
> Adults reporting insufficient sleep (<7 hours): 34.5% (South Carolina: 38.8%)
> Adults reporting poor or fair health: 18.0% (South Carolina: 17.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.8 (South Carolina: 4.7)
> Adult obesity rate: 32.2% (South Carolina: 34.0%)
> Adults with diabetes: 13.3% (South Carolina: 13.3%)
South Dakota: Sioux Falls
> Adults reporting insufficient sleep (<7 hours): 29.5% (South Dakota: 30.1%)
> Adults reporting poor or fair health: 12.3% (South Dakota: 13.4%)
> Avg. number of mentally unhealthy days reported in past month: 3.0 (South Dakota: 3.3)
> Adult obesity rate: 31.4% (South Dakota: 32.4%)
> Adults with diabetes: 8.8% (South Dakota: 10.1%)
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Tennessee: Chattanooga
> Adults reporting insufficient sleep (<7 hours): 39.1% (Tennessee: 40.8%)
> Adults reporting poor or fair health: 19.7% (Tennessee: 21.2%)
> Avg. number of mentally unhealthy days reported in past month: 5.1 (Tennessee: 5.2)
> Adult obesity rate: 32.3% (Tennessee: 33.3%)
> Adults with diabetes: 14.2% (Tennessee: 12.5%)
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Texas: Austin-Round Rock-Georgetown
> Adults reporting insufficient sleep (<7 hours): 33.1% (Texas: 34.4%)
> Adults reporting poor or fair health: 16.3% (Texas: 18.7%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Texas: 3.8)
> Adult obesity rate: 26.9% (Texas: 31.4%)
> Adults with diabetes: 7.9% (Texas: 10.2%)
Utah: Provo-Orem
> Adults reporting insufficient sleep (<7 hours): 30.9% (Utah: 31.2%)
> Adults reporting poor or fair health: 13.3% (Utah: 14.8%)
> Avg. number of mentally unhealthy days reported in past month: 3.9 (Utah: 3.9)
> Adult obesity rate: 25.8% (Utah: 27.0%)
> Adults with diabetes: 6.2% (Utah: 7.5%)
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Vermont: Burlington-South Burlington*
> Adults reporting insufficient sleep (<7 hours): 30.6% (Vermont: 30.1%)
> Adults reporting poor or fair health: 11.8% (Vermont: 12.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.1 (Vermont: 4.2)
> Adult obesity rate: 25.4% (Vermont: 27.0%)
> Adults with diabetes: 7.7% (Vermont: 8.8%)
*Because Burlington-South Burlington is the only eligible metro in Vermont, it is the least sleep deprived metro by default.
Virginia: Charlottesville
> Adults reporting insufficient sleep (<7 hours): 36.1% (Virginia: 38.6%)
> Adults reporting poor or fair health: 16.4% (Virginia: 16.6%)
> Avg. number of mentally unhealthy days reported in past month: 4.3 (Virginia: 4.0)
> Adult obesity rate: 28.8% (Virginia: 30.5%)
> Adults with diabetes: 10.2% (Virginia: 10.7%)
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Washington: Bellingham
> Adults reporting insufficient sleep (<7 hours): 29.2% (Washington: 31.8%)
> Adults reporting poor or fair health: 15.0% (Washington: 15.0%)
> Avg. number of mentally unhealthy days reported in past month: 4.5 (Washington: 4.0)
> Adult obesity rate: 28.0% (Washington: 28.6%)
> Adults with diabetes: 7.9% (Washington: 9.3%)
West Virginia: Wheeling
> Adults reporting insufficient sleep (<7 hours): 40.8% (West Virginia: 42.5%)
> Adults reporting poor or fair health: 19.9% (West Virginia: 23.6%)
> Avg. number of mentally unhealthy days reported in past month: 5.4 (West Virginia: 5.8)
> Adult obesity rate: 35.6% (West Virginia: 37.8%)
> Adults with diabetes: 14.6% (West Virginia: 15.1%)
Wisconsin: La Crosse-Onalaska
> Adults reporting insufficient sleep (<7 hours): 29.6% (Wisconsin: 32.7%)
> Adults reporting poor or fair health: 13.8% (Wisconsin: 14.8%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Wisconsin: 4.0)
> Adult obesity rate: 27.2% (Wisconsin: 31.7%)
> Adults with diabetes: 7.0% (Wisconsin: 9.5%)
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Wyoming: Casper
> Adults reporting insufficient sleep (<7 hours): 33.7% (Wyoming: 33.8%)
> Adults reporting poor or fair health: 15.6% (Wyoming: 15.3%)
> Avg. number of mentally unhealthy days reported in past month: 4.0 (Wyoming: 4.0)
> Adult obesity rate: 31.2% (Wyoming: 29.2%)
> Adults with diabetes: 9.1% (Wyoming: 9.0%)
Methodology
To determine the least sleep deprived metro in every state, 24/7 Tempo reviewed the share of adults reporting fewer than seven hours of sleep on average from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report. While the CHR report is from 2021, insufficient sleep figures published in the report are from 2018.
We used the 384 metropolitan statistical areas as delineated by the United States Office of Management and Budget and used by the Census Bureau as our definition of metros.
Metros were ranked within their state based on the share of adults reporting insufficient sleep. Since many metros cross state lines, the metro was assigned to the state of its first-listed principal city. Thus, the Washington-Arlington-Alexandria, DC-VA-MD-WV, metro area was excluded as it is principally in the District of Columbia.
Additional information on the share of adults reporting poor or fair health, the average number of mentally unhealthy days reported in the past 30 days, adults 20 years and older who report a body mass index of 30 kg/m2 or higher (adult obesity rate), and the share of adults 20 years and older with diagnosed diabetes are also from the 2021 CHR.
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