Although there is substantial agreement how microeconomic forces—income, risk aversion—shape public health outcomes, there is substantial disagreement about the relationship between macroeconomic forces—market liberalization and economic freedom—on public health. In this paper, we investigate the relationship between public health, economic freedom, and wealth using a large sample of metropolitan‐level data from the United States. We find that economic freedom does have a statistically significant and positive impact on general, physical, and mental health, but the overall results are small in magnitude. When we disaggregate the three areas of economic freedom, we find that areas with lower government spending and freer labor markets have the strongest positive effect on physical and mental health. However, our results are strongest for the richest group of respondents, suggesting that the economic freedom‐health relationship is perhaps indirect, and shown through income.