Health Literacy in the 50 States


At Health IQ we’re committed to making the 21st century the health literacy century. Just as reading literacy led to breathtaking advances in the last century, health literacy can dramatically improve individual lives in this century.

As our report shows, states with higher health literacy scores had lower rates of diabetes, obesity and high blood pressure. Our report also showed a strong correlation between health literacy and health care costs, which are a serious challenge for individuals, families and society as a whole.

At Health IQ we’ve identified a new asset class we call health equity. Just as homeowners can build equity over time, focusing on diet, exercise, and improving one’s Health IQ or health literacy can build health equity. Studies show that the average retiree will need $280,000 just to pay for medical expenses. However, those with more health equity – and higher health literacy – will need less.

With health care and prescription drug costs rising, we also call on policymakers on all sides to be champions of health literacy in their states and communities.

Health literacy is not a liberal or conservative idea. It’s a true idea rooted in data and science that can dramatically improve people’s lives while strengthening our safety net. Medicare spending is expected to double over the next decade and will become insolvent in 2026, just seven years from now. Policymakers will need every tool at their disposal to confront rising health costs. Few will be more effective than health literacy.

Our nation’s health care and insurance challenges are daunting but the opportunities ahead are exciting. In this century we’ll see breakthroughs and advances we can’t imagine. Today, we’re seeing the growth of wearable technology and health management innovations like FitBit and Apple Health. These innovations have led to new interest and insights around what it means to be healthy. Yet, mere technology is not enough. Rates of chronic illnesses like obesity and diabetes continue to rise. We need to merge technology with education. What we might learn is exciting to contemplate but what we already know can transform lives. That’s why health literacy is so important.

About this report

This report sets out to establish health literacy as the cornerstone of an individual’s personal health equity.

Health IQ launched its Health Literacy Quiz and daily health quiz app in 2014. With over 10.2 million Health IQ Quizzes taken in the United States, our research supports that a high Health IQ score is correlated to lower rates of diabetes, obesity and high blood pressure. Improving health literacy can translate to healthier people and lower healthcare costs.

Where It Matters

Higher Health IQ correlates to better health outcomes

Median Health IQ by State

Hover over a state to see it’s median Health IQ


Lower Health IQ correlates to higher Medicare Rx costs

Tennessee Highest Cost

Health IQ Score: 134

Medicare Rx cost (per capita 65+): $3,911

Possible influencer: Tennessee is a state highly affected by the recent national opioid epidemic. As a public health concern, dealing with opioid addiction and its health issues comes at a cost, which may be a contributing factor to higher Medicare Rx costs.

North Dakota Lowest Cost

Health IQ Score: 153

Medicare Rx cost (per capita 65+): $1,412

Possible influencer: High Health IQ score may reflect smarter medication management and avoiding unnecessary prescription costs. Also, historically, North Dakota law has required pharmacies be locally owned; less pharmacy access may encourage out-of-state purchase, lowering North Dakota’s own Rx costs.


Higher Health IQ correlates to lower rates of high blood pressure


Health IQ Score: 114

High blood press. rate: 41.9%


Health IQ Score: 114

High blood press. rate: 39.0%


Health IQ Score: 110

High blood press. rate: 40.8%

Alabama, Louisiana, and Mississippi all fit the trend line of low Health IQ’s and high rates of blood pressure, demonstrating how closely aligned the lowest Health IQ scores are with the highest rates of high blood pressure. These states are also part of the “Stroke Belt” a region with higher incidence of stroke and death from stroke.


Higher Health IQ correlates to lower obesity rates

Iowa Highest Obesity, High IQ

Health IQ Score: 146 (above median)

Obesity Rate: 36.4% (4th highest)

Possible influencer: This score mismatch speaks to the possibility of a potential specific environmental factor. For example, in this highly agricultural state, researchers are considering the many health impacts of pesticide exposure, including obesity.

Hawaii Low Health IQ, Low Obesity

Health IQ Score: 136 (below median)

Obesity Rate: 23.8% (2nd lowest)

Possible influencer: Hawaii’s low rate of obesity may be due to heavy investment in island-wide health initiatives. These include programs to decrease smoking rates, increase physical activity and promote healthy eating.


Higher Health IQ correlates to lower diabetes rates

Alaska Low Diabetes, Low IQ

Health IQ Score: 142 (below median)

Diabetes Rate: 7.4% (lowest)

Possible influencer: Diabetes % is the number of adults who report being diagnosed by a health professional. However, a high percentage of adults in AK reported having not seen or talked to a doctor in the last 12 months possibly contributing to a lower rate of diagnosis.

Mississippi, Alabama, Louisiana, West Virginia, South Carolina

Health IQ Score: 110-128

Diabetes Rate: 13.4-14.2%

Possible influencer: MS, LA, AL, and WV also have the highest rates of obesity. MS, AL, LA, and SC are also states within the “Stroke Belt” – a region with higher incidence of stroke and death from stroke.

Created by the Best

Developed & verified by health experts

Health IQ assembled a team of the nation’s leading medical, health, and fitness experts to create this cutting edge assessment.

Health IQ Experts

Kevin Knopf, MD
Dir., Hematology / Oncology, St. Luke’s Hospital
Jeffrey Popma, MD
Director Interventional Cardiology, Beth Israel
Greg Camarillo
Ex-National Football League (NFL) Player
Dathan Ritzenhein
Olympian, Professional Athlete, Coach
Dorothy L. Espelage, PhD
Authored White House Brief on Bullying
Candy Tsourounis, PharmD
Professor Clinical Pharmacy, UCSF
Shadi Hosseini, DDS
Dental Health Expert, Good Morning America
Gail M. Whitelaw, PhD, MHA
Audiologist / Professor, Doctor of Audiology
Paul Nussbaum, PhD
President & Founder Brain Health Center
Bridget Swinney
Award-Winning Author MS, RDN
Susie Garcia
Registered Dietitian Nutritionist & Author
Glenn Mills
GoSwim co-founder, coach & Olympian
Prajakta Ranade, MS RD CDE
Clinical Dietitian, Stanford Health Care
Chris Carmichael
Pro-Cyclist, Olympic Coach, CEO & Author
Gilly Lane
Head Men’s Squash Coach, UPENN. National Pan Am Team Coach and Gold Medalist.
Matthew Ruscigno
Registered Dietitian, Vegan and Endurance Athlete, Author
Kyle McFarland
Nationally and Internationally Competitive Climber and Route Setter
Ariane Hundt
Clinical Nutritionist & Fitness Expert
Melanie R. Silverman
Pediatric Registered Dietitian Nutritionist
Brooke Alpert
Nutrition Expert & Author MS, RD, CDN
Sarah Ballantyne, PhD
Award-Winning Blogger, The Paleo Mom
James Colbert, MD
Internal Medicine, Harvard Med School Faculty
Josh Rohr
USA Powerlifting Senior International Coach 3X USA Powerlifting National Champion
Tamara Duker Freuman
Registered & Certified Dietitian, Nutritionist
Vance Newgard
Head Olympic Weightlifting Coach United States —Olympic Training Site, Northern Michigan University
Jill Brown
Group Fitness Expert & Master Trainer
Chris Kidawski
CrossFit Level 1 Coach & Elite Athlete Trainer
Donna Boden
Registered & Licensed Dietitian Dana Farber
Barry J. Jacobs
Psychologist, Family Therapist, Author
Andy Powell
Associate Head Coach, Univ. of Oregon.
Kristen McGee
Celebrity Yoga and Pilates Instructor
Danielle Omar
Registered Dietitian / Nutritionist, Author
Dylan Bosch
Olympic Swimmer, Team Captain - Div I NCAA Athlete. 14-time NCAA All-American.
Nicole F. Holovach
Registered & Licensed Dietitian, Organic Farmer
Ashley Turner
Yoga–Meditation Instructor, Psychotherapist
Stefano Profumo
Elite Category 1 Cyclist and Masters Category Champion
Ole-Petter R. Hamnvik, MBBCh, BAO, MM
Endocrinologist, Brigham and Women’s Hospital
Scott Hacker, MD
Team Orthopedic Surgeon, US Olympic Team
Abbie Smith-Ryan, PhD
Asst. Prof. Exercise & Sports Science, UNC
Liza Makowski, PhD
Assistant Professor, Nutrition, UNC
Espen D. Kateraas
Accomplished Endurance Athlete
Hina Chaudhry, MD
Assoc. Prof. of Medicine, Mt. Sinai
Cate Shanahan, MD
Science Director, LA Lakers PRO Nutrition
Adam Campbell
Record Holding World Class Ultrarunner
Randolph W. Evans, MD
Neurologist, Clinical Professor, & Editor
Ashish Bhatia, MD
Assoc. Prof. Clinical Dermatology, Northwestern

What's in the Quiz

Over 30,000 questions covering integrative health concepts

To arrive at these conclusions Health IQ analyzed its proprietary quiz data in contrast with published reports from both the public and private sector.


  • Portion Control Hacks
  • Choosing Nutrient-Dense Foods
  • Nutrition for Vegetarians


  • Running & Memory
  • HIIT & Metabolism
  • Yoga & Digestion


  • Side Effects of Statins
  • Anti-inflammatory Foods
  • Cinnamon & Diabetes

Supporting Data

Health IQ Source Material

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