Which U.S. state is the healthiest? The answer might surprise you—and one coast fares better than the other

That’s according to a new survey released Tuesday by the Boston University School of Public Health (BUSPH) and Sharecare, a digital health company.

The duo used a proprietary process to assess the well-being of nearly a half million Americans surveyed from all 50 states in 2022 in a variety of domains, including physical, social, community, purpose, and financial. Researchers also assessed how each state ranked when it came to social determinants of health, like access to health care, food, resources, housing, and transportation, as well as economic security.

As a whole, the U.S. scored a 60.7 on a scale of 100—similar to scores it received before the pandemic. The national rating was nearly identical to the year prior’s: 60.9. Compared to the year before, physical health, social and community bonds, and sense of purpose in daily life all experienced statistically significant increases. 

But financial well-being saw a substantial decrease. The trend reveals “an undercurrent of economic insecurity possibly linked to inflation and ongoing economic uncertainty, reminiscent of pre-pandemic times,” Michael Winter, associate director of statistical programming at the Biostatistics & Epidemiology Data Analytics Center of BUSPH, said in a news release on the results.

“This year’s report highlights the importance of addressing all aspects of well-being, which extends beyond physical health to include financial stability and socioeconomic factors.”

For those who enjoy a friendly battle between coasts, the East Coast won this one, with five of its states making the list, compared to only two on the West Coast. The top 10 states, according to the list:

The short list of superlative states is nearly identical to 2021’s. The only difference: Connecticut, No. 8 in 2021, and Washington, No. 9 in 2021, swapped places in 2022.

In case you’re curious, these 10 states scored the lowest:

The list of lowest-ranking states in 2022 is identical to 2021’s list. The same 10 states have been at the bottom of the list since 2020, though their positions have changed somewhat. 

Mississippi has held the bottom spot on the list for the past four years, according to the report. Contributing factors include bottom quintile scores in each category, and having the lowest scores nationwide when it comes to financial security, community, and food access.

What’s so special about Massachusetts?

Massachusetts has held the top spot on the list for the past three years due to high scores in both individual health measures and social determinants of health. It ranked in the top 10 in eight of 10 measured domains, including healthcare access (No. 1), housing and transportation (No. 2), purpose (No. 7), financial (No. 3), physical (No. 7), social (No. 9), community (No. 7), and food access (No. 8).

Perhaps not so ironically, Massachusetts—Cambridge, to be exact—was named Fortune’s No. 1 best place to live for families this year. Among factors contributing to the rank: the state’s excellent reputation in higher education, a high median household income, low crime rates, and quality public schools.

Another overlap: Maryland was ranked No. 4 on Sharecare’s list—and Silver Spring, Md., No. 3 on Fortune’s list, thanks to its proximity to the Washington, D.C., metro and the culture that accompanies it, above-average high school graduation rates, and good quality of living for seniors.

Other overlapping top 10 states include California and New York.

There were commonalities in both lists’ bottom 10 locations, too, with Indiana, Arkansas, Oklahoma, Alabama, Tennessee, Louisiana, and New Mexico appearing on both.