10 Healthiest and Safest Metro Areas Revealed

A metropolitan area in Michigan tops the list of cities providing residents with basic needs in health care, safety, and other essentials, according to a Gallup and Healthways survey announced today.

Holland-Grand Haven, Mich., ranks first, followed closely behind by two Iowa metro areas. McAllen-Edinburg-Mission, Texas, ranks last. Five of 10 worst metro areas for meeting residents' basic needs are in California, and these are clustered together primarily in the middle of the state.

Those areas that scored highest on basic needs also had the lowest crime rates.

The survey included 187 metro areas, and was based on responses from 353,000 American adults interviewed by telephone in 2009. Residents were asked about their access to 13 basic necessities, such as safe places to exercise, easy access to fresh fruits and vegetables, money for food and shelter, access to clean water and to health care.

City scores from the responses were used to calculate the Basic Access Index. The national average for 2009 was 82.2 out of 100 points, down from 83.6 in 2008.

Here's who filled out the top and bottom 10, along with Basic Access Index scores:

Top 10:

1. Holland-Grand Haven, Mich. – 89.3
2. Madison, Wis. – 88.0
3. Des Moines-West Des Moines, Iowa – 87.7
4. Cedar Rapids, Iowa – 87.3
5. Portland-South Portland-Biddeford, Maine – 87.0
6. Minneapolis-St. Paul-Bloomington, Minn.-Wis. – 86.7
7. Lancaster, Pa. – 86.7
8. Boston-Cambridge-Quincy, Mass.-N.H.
9. Honolulu, Hawaii – 86.4
10. Hartford-West Hartford-East Hartford, Conn. – 86.4

Bottom 10:

1. McAllen-Edinburg-Mission, Texas – 72.2
2. Visalia-Porterville, Calif. – 73.8
3. Bakersfield, Calif. – 75.3
4. Modesto, Calif. – 75.5
5. Lake Havasu City-Kingman, Ariz. – 76.4
6. Stockton, Calif. – 76.4
7. Huntington, Ashland, W. Va.-Ky-Ohio – 76.8
8. Salinas, Calif. – 76.8
9. El Paso, Texas – 77.0
10. Las Vegas-Paradise, Nev. – 77.1

Food, shelter, health care

Not only does McAllen-Edinburg-Mission, Texas, rank at the bottom of American metro areas, in terms of residents' reports of basic needs being met, but it also does the worst on six of the 13 individual items within the Basic Access Index: having enough money for food, shelter and health care; having health insurance; having a personal doctor; and having visited a dentist in the past year.

These issues will likely continue to receive low ratings in McAllen-Edinburg-Mission throughout 2010, because the area also currently has the highest jobless rate in Texas. However, despite the current poor conditions, or perhaps because of them, this area's residents are the most optimistic in the country about their area getting better as a place to live.

Worcester, Mass., residents are the most likely to have health insurance and a personal doctor. Americans living in Cedar Rapids, Iowa, top the list in having enough money for health care and having visited a dentist in the last 12 months, and Holland-Grand Haven leads in the area of safety.

Basic needs met means lower crime

The survey researchers also compared the most recent FBI crime statistics available, from 2008, with the Basic Access Index data from the same year. Results showed metro areas that topped the list for basic needs being met consistently had lower violent crime and property crime rates than those with higher scores.

This pattern held even after researchers accounted for average household income by sorting the metro areas into high-income ($63,000 per year or more), middle-income ($57,000 to $62,999), and low-income (less than $57,000 per year) categories.

For example, "middle income" metro areas with bottom-third basic access scores had 77 percent higher violent crime rates and 41 percent higher property crime rates than similarly wealthy metro areas that scored in the top-third for basic needs. Additionally, the lowest-income metro areas with high Basic Access Index scores had lower rates of violent and property crime per 100,000 residents than did the highest-income metro areas that have low basic access scores.

The relationship between basic access and crime documents the extent to which providing for residents' basic needs can have an impact beyond more obvious improvements in health, nutrition and shelter, the study researchers say.