Residents of a certain southern state may find themselves in luck this flu season, as data shows people living there are the least likely to get sick.
Researchers at Marian University in Indiana ranked 100 cities in America where people are most and least likely to come down with the common cold – and three cities in North Carolina made the top 10, including one that ranked first.
The team ranked the cities by analyzing and assigning scores to a variety of factors known to cause winter illnesses, such as cold temperatures, air quality, population, and the number of children – who have weaker immune systems and are more likely to pass germs around.
All of those scores were then added together and each city was given a cumulative score, with a lower score indicating what the researchers estimate is a healthier city and a higher score pointing to a city more likely to be prone to sickness.
Wilmington, North Carolina was the least illness-prone city on the list with a score of 28.
With 122,000 residents, the researchers said the low population density and balmy weather could help ward off germs.
Madison, Wisconsin and Honolulu, Hawaii followed close behind with respective scores of 34 and 36. Raleigh, North Carolina and San Jose, California rounded out the top five, both scoring 37.
On the flip side, Bakersfield, California was the germiest city in the country, which experts blamed on low flu vaccination rates, poor air quality, and a high population of adults with weak immune systems.
The researchers wrote: ‘Simple practices like getting vaccinated, maintaining good nutrition, and staying active can make a big difference in protecting yourself from seasonal illnesses.’
Researchers at Marian University in Indiana ranked 100 cities in America where people are most and least likely to come down with a cold or the flu this season (stock image)
![Wilmington, North Carolina was deemed the city where you're least likely to catch a cold based on high humidity and healthy air quality](https://i.dailymail.co.uk/1s/2025/01/31/17/94703005-14343719-image-a-18_1738343082293.jpg)
Wilmington, North Carolina was deemed the city where you’re least likely to catch a cold based on high humidity and healthy air quality
Your browser does not support iframes.
The rankings come as respiratory illnesses, including the flu, Covid, and respiratory syncytial virus (RSV), plague the US.
Forty-four states are experiencing high or very high respiratory activity.
According to the latest CDC data, the flu is hitting Americans the hardest. Influenza test positivity increased 30 percent in the last week and hospitalizations rose to 38,250.
During the week of January 18, the flu accounted for 5.4 percent of hospital visits. The following week, that rose to seven percent.
The number of doctor visits for respiratory illnesses increased from 5.7 percent the week of January 18 to seven percent the week after.
The researchers said Wilmington, North Carolina earned the spot for healthiest city for its low population density – the amount of people within a specific area.
Having a low population density means there are fewer people in close contact with each other, reducing the spread of airborne illnesses like Covid and the flu.
Wilmington also has high rates of humidity, which keeps nasal passages moist by increasing mucus production.
Without enough mucus, the nasal passages become irritated and inflamed, leaving the body prone to respiratory infections like sinusitis.
The researchers also pointed to the city’s clean air. According to the American Lung Association, Wilmington has the lowest levels in the country of particle matter (PM2.5) pollution, microscopic contaminants that irritate the lungs.
Your browser does not support iframes.
Madison, Wisconsin was the second healthiest city with a score of 33.7.
The researchers pointed to the city’s 69 percent flu vaccination rate among older residents, an improvement over the national average of 58 percent in this population.
Additionally, just 3.5 percent of the city’s population is uninsured compared to eight percent in the US overall, meaning they have more access to preventative care.
Honolulu ranked third for its warm climate, which helps the nose filter out germs by increasing mucus production to trap pathogens and encourages residents to spend less time in close quarters.
Raleigh, North Carolina and San Jose, California rounded out the top five.
The researchers cited the southern city’s low percentage of adults reporting overall poor health and San Jose’s abundant access to healthy foods as reasons why residents of these cities may be able to avoid illnesses.
On the other end of the spectrum, Bakersfield, California was crowned the sickest city in the analysis, scoring 71.7.
The researchers cited the 413,000-resident city’s poor air quality and dry air as primary reasons for the ranking.
According to the American Lung Association, Bakersfield was the worst city for particulate matter and pollution out of more than 200 metropolitan areas.
![Bakersfield, California was the city most likely to result in a cold based on poor air quality and dry weather](https://i.dailymail.co.uk/1s/2025/01/31/17/94703839-14343719-image-a-19_1738343082461.jpg)
Bakersfield, California was the city most likely to result in a cold based on poor air quality and dry weather
The researchers wrote: ‘The city also has a high number of adults reporting poor or fair health and frequent physical distress, both of which can be indicators of weakened immune systems and higher vulnerability to infections.’
McAllen, Texas, came in second-worst place, with a score of 70.9.
Sitting on the southern border with Mexico, McAllen has a high percentage of adults without insurance.
According to a recent analysis, one in four adults in the area were uninsured in 2023. This could be due to the fact that one in five adults in the city live in poverty, limiting their ability to pay for insurance that would cover regular checkups.
Living uninsured may keep them from seeing a doctor out of fear of incurring large medical bills, and if they have any underlying conditions, they could have a higher risk of getting sick.
El Paso, another border town in southwestern Texas, was close behind McAllen with a score of 69.7. Like McAllen, one in four adults in El Paso are uninsured.
Philadelphia, Pennsylvania and Las Vegas, Nevada rounded out the top five cities most likely to cause a cold. The experts cited low humidity levels, dry temperatures, and high population density for both areas.