One of the strengths of the United States is its diverse economy, which comprises many industries that contribute to overall economic development and greater stability. Total U.S. economic output topped $16 trillion in 2015, and each state’s contribution to overall GDP was unique, both in terms of size and industrial composition.

For example, California, New York, and Texas each generated over $1 trillion in economic output in 2015. Combined, these three states accounted for 31% of the nation’s total economic output. Each state’s unique economic landscape is shaped by a range of factors, from legal regulations to the presence natural resources. For example, with the nation’s largest oil reserves, oil and gas extraction drives Texas’s economy. Meanwhile, since removing certain banking restrictions, credit intermediation drives the South Dakota economy

42. Tennessee
> Largest industry: Ambulatory health care services
> Industry GDP contribution: $14.0 billion
> Industry output as pct. of GDP: 5.0%
> Industry workforce: 288,028

Some industries are more susceptible to changing consumer tastes and spending habits. However, society’s need for medical care is nearly constant, regardless of the economy. In fact, as the baby boom generation continues to age, need for outpatient care will continue to rise. The economic output of Tennessee’s ambulatory health care services, which includes clinic and doctor visits, has increased by 14.8% in the past five years. The largest industry in the state, ambulatory health care accounts for 5.0% of Tennessee’s GDP.

Real estate is by far the largest industry in the United States and the largest contributor to GDP in most states. But since housing is a universal need irrespective of geography, it fails to illuminate regional economic differences. In order to capture the unique economic features of each state, 24/7 Wall St. reviewed the largest industry in each state by GDP contribution — excluding real estate.

Click here to see the largest industry in each state.
Click here to see our detailed findings and methodology.