At 78.5 years, life expectancy in the United States, while trailing several dozen other countries, has continuously risen in the past century. Leading this upward trajectory are the 25 healthiest U.S. cities. These cities span 14 states and are located across multiple regions, from the Northeast to the Southwest — yet most share several common factors.

In order to determine the healthiest cities in the United States, 24/7 Wall St. examined more than two dozen measures of health factors and health outcomes from the County Health Rankings and Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Based primarily on measures intended to capture quality and length of life, Rochester, Minnesota is the healthiest U.S. metropolitan area.

Premature death is the most important measure in determining the health of a city. In each of the 25 healthiest U.S. cities, residents are far less likely to die before the age of 75 than the typical American. Though healthy behaviors and social and economic conditions vary among the healthiest cities, in every case, there are multiple identifiable causes for residents’ good health.

In an interview with 24/7 Wall St., Amanda Jovaag, data lead at County Health Rankings, explained that, in general, “as income and wealth increase … so does health.” People and families that are financially secure are more likely to be able to afford necessary medical treatment and healthy food on a regular basis. Median household incomes exceed the national median in a majority of the healthiest cities in the country. In the San Jose, California metro area, one of the healthiest in the country, the typical household earns $92,960 a year, more than in any other U.S. city.

48. San Diego-Carlsbad, CA

> Premature death rate: 255.0 (per 100,000)
> Adult obesity rate: 20.2%
> Pct. adults without health insurance: 12.3%
> Median household income: $63,996

In addition to sufficient income, health insurance coverage is a crucial component in ensuring individuals get necessary medical treatment and preventative screening. “The uninsured are much less likely to have primary care providers and a source for regular care than the insured,” Jovaag said. Ultimately, “those without insurance are often diagnosed at later, less treatable disease stages than those with insurance and, overall, have worse health outcomes, lower quality of life, and higher mortality rates.” Nationwide, 11.7% of people ineligible for Medicare are uninsured. Uninsured rates in the healthiest U.S. cities are all lower than the national rate, ranging from 3.9% in Mankato, Minnesota, to 10.8% in the Provo-Orem, Utah metro area.

While insurance coverage and income are important, so too are healthy behaviors. Certain behavioral factors and indicators, such as smoking and obesity, can increase the risk of a number of severe conditions and diseases and can significantly detract from quality of life. As a result, obesity and smoking rates were heavily weighted in the ranking of cities by health. Nationwide, 17% of adults identify as smokers, and 27% of adults are obese. The vast majority of the healthiest cities are home to a smaller share of obese residents and smokers than the country as a whole.

24/7 Wall St. created an index modeled after analysis conducted by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. To identify the 25 healthiest cities, 24/7 Wall St. reviewed all U.S. metropolitan statistical areas. The index rankings are based on overall health outcomes, a weighted composite of length of life, quality of life, and overall health factors. The health factors component is itself a weighted composite of healthy behaviors, clinical care, social and economic factors, and physical environment measures. Data on life expectancy came from the Institute for Health Metrics and Evaluation, a global health research center affiliated with the University of Washington.

Click here to see the 25 healthiest cities in America.