I travel to the US midwest for work a lot, and it's amazing just how not only unfit and heavy everyone is, but also super sickly and injured. The amount of people walking around with a limp or a cane or those motorized wheelchairs is hardcore. I've never seen anything like it.

I know this is entirely anecdotal, but I'd bet so much money that healthcare expenditure is way higher than similar-sized cities on the West Coast.