Here are grim tidings. New Jersey has five of the top 15 most unhealthy cities in the United States, according to a Quote.com study. Camden, Trenton, Passaic, Newark, and Paterson are the unlucky five, with Camden coming second overall. The study ranked Gary, Indiana as the least healthy city of all in the country.

Quote.com says it recruited 12 medical experts to identify the most critical health metrics, using data from the CDC and the Robert Wood Johnson Foundation’s 500 Cities Project. On the negative side, they focused on issues such as obesity, heart disease, cancer, and diabetes; on the positive side, they looked at preventive behaviors like regular mammograms, cancer screenings, and health insurance coverage.

Ohio joined the Garden State for having five cities ranked among the least healthy. And, between them, Indiana, New Jersey, and Ohio accounted for 70 percent of the least healthy cities. As Quote.com put it, “Many of the unhealthiest cities have dealt with, or are currently experiencing, major economic or social issues. These findings concur with a 15-year study by the medical journal JAMA, which found a direct link between poverty and health. That study’s authors even estimated a life expectancy difference of 10 to 15 years between the poorest and richest people.”

Newton, MA ranked as the healthiest city; seven cities in California made it into the top 20 healthiest.