America's Healthiest And Unhealthiest States

[Mrs. Sharon B. Hodge]

Your Health
America's Healthiest And Unhealthiest States
David Sutton,

Twenty spots where factors such as binge drinking, pollution and disease are most and least harmful to one's health.

America's health is failing. And no one likely knows that better than those in Louisiana.

It lands at the bottom of a list measuring the health of the nation's 50 states. Joining it at the bottom are Mississippi, South Carolina, Tennessee and Texas.

Vermont was crowned the healthiest state for the second consecutive year. Hawaii, New Hampshire, Minnesota and Utah round out the top five, according to a study published yesterday.

Behind the Numbers

The report, America's Health Rankings, compiled and analyzed 22 health measures, both determinants and outcomes. The study is a collaboration between United Health Foundation, American Public Health Association and Partnership for Prevention. Data for the study was provided by Centers for Disease Control and Prevention, National Center for Health Statistics, Census Bureau, Bureau of Economic Analysis, National Center for Education Statistics, Bureau of Labor Statistics, Environmental Protection Agency, American Medical Association, Dartmouth Atlas Project and Trust for America's Health.

It focuses on four key areas: personal behaviors, community and environment, public and health policy, and clinical care. It is meant to highlight the successes and failures of each state and the nation so Americans can live longer, healthier lives.

Northern Exposure
Residents of Vermont have a pretty good shot at that.

"Vermont ranks higher for health determinants than for health outcomes, indicating that overall healthiness should remain high over time," the study says.

Vermont isn't perfect though; the state has a high rate of binge drinking at 21.9%, and a low immunization rate for children 19- to 35-months-old at 79.8%.

"The ranking reflects investments the state has made in health care delivery. We will continue to improve access and quality, and hopefully impact the cost by doing the right thing," says Wendy Davis, Vermont's commissioner of health. "Our Blueprint for Health program puts the responsibility on communities and individuals to build a better system."

Below Par
Louisiana has a low binge-drinking rate at 13.3% and saw an increase in the state's public health spending this year to $95 per person, from $69 per person, but the throngs of uninsured (20.2%) and the high rate of preventable hospitalizations (111.9 discharges per 1,000 Medicare enrollees) drag it down.

Alan Levine, Louisiana secretary of health and hospitals, acknowledges that the state finishes near the bottom in many health care studies.

"We must realize there are people behind these numbers," he says. "After two months in office we have already passed sweeping reforms, but the system won't be fixed overnight. We need to improve the trajectory."

Levine remains optimistic that conditions in the state will improve. He hopes a new teaching hospital in New Orleans will help increase access to health care.

But poor health isn't limited to the country's southernmost states. America's health overall failed to improve for the fourth year in a row. Four years of stagnation stands in contrast to the 1990s when Americans' health climbed at an average rate of 1.5%. Obesity is one culprit. It has skyrocketed 127% since the 1990s, from 11.6% of the population to 26.3%, according to the study. Obesity increases the risk for diseases such as heart disease, stroke, high blood pressure, diabetes and cancer.

Worrisome still, is the growing number of uninsured Americans. Today, 45.7 million Americans are uninsured, an increase of 16% over 1990 levels.

When expanded internationally, the outlook becomes even grimmer. American's life expectancy of 69 years lags behind 27 other developed nations. Not surprisingly, Japan remains the leader at 75 years.

HEALTHIEST TOP 10

Washington: 10
Change: +2

Prevalence of Obesity (percent of population): 23

Air Pollution (micrograms of fine particles per cubic meter): 18

Lack of Health Insurance (percent without health insurance): 16

Immunization Coverage (percent of children ages 19 to 35 months): 48

Primary Care Physicians (number per 100,000 population): 13

Poor Mental Health Days (days in previous 30 days): 19

Cardiovascular Deaths (deaths per 100,000 population): 13

Cancer Deaths (deaths per 100,000 population): 17

Maine: 9
Change: -2

Prevalence of Obesity (percent of population): 17

Air Pollution (micrograms of fine particles per cubic meter): 16

Lack of Health Insurance (percent without health insurance): 5

Immunization Coverage (percent of children ages 19 to 35 months): 40

Primary Care Physicians (number per 100,000 population): 12

Poor Mental Health Days (days in previous 30 days): 32

Cardiovascular Deaths (deaths per 100,000 population): 18

Cancer Deaths (deaths per 100,000 population): 44

Idaho: 8
Change: +7

Prevalence of Obesity (percent of population): 14

Air Pollution (micrograms of fine particles per cubic meter): 7

Lack of Health Insurance (percent without health insurance): 31

Immunization Coverage (percent of children ages 19 to 35 months): 45

Primary Care Physicians (number per 100,000 population): 50

Poor Mental Health Days (days in previous 30 days): 19

Cardiovascular Deaths (deaths per 100,000 population): 21

Cancer Deaths (deaths per 100,000 population): 8

Connecticut: 7
Change: -2

Prevalence of Obesity (percent of population): 2

Air Pollution (micrograms of fine particles per cubic meter): 26

Lack of Health Insurance (percent without health insurance): 6

Immunization Coverage (percent of children ages 19 to 35 months): 3

Primary Care Physicians (number per 100,000 population): 6

Poor Mental Health Days (days in previous 30 days): 8

Cardiovascular Deaths (deaths per 100,000 population): 11

Cancer Deaths (deaths per 100,000 population): 19

Massachusetts: 6
Change: +3

Prevalence of Obesity (percent of population): 2

Air Pollution (micrograms of fine particles per cubic meter): 19

Lack of Health Insurance (percent without health insurance): 1

Immunization Coverage (percent of children ages 19 to 35 months): 8

Primary Care Physicians (number per 100,000 population): 1

Poor Mental Health Days (days in previous 30 days): 19

Cardiovascular Deaths (deaths per 100,000 population): 9

Cancer Deaths (deaths per 100,000 population): 25

Utah: 5
Change: +1

Prevalence of Obesity (percent of population):7

Air Pollution (micrograms of fine particles per cubic meter): 25

Lack of Health Insurance (percent without health insurance): 32

Immunization Coverage (percent of children ages 19 to 35 months): 37

Primary Care Physicians (number per 100,000 population): 45

Poor Mental Health Days (days in previous 30 days): 8

Cardiovascular Deaths (deaths per 100,000 population): 3

Cancer Deaths (deaths per 100,000 population): 1

Minnesota: 4
Change: -2

Prevalence of Obesity (percent of population): 24

Air Pollution (micrograms of fine particles per cubic meter): 17

Lack of Health Insurance (percent without health insurance): 4

Immunization Coverage (percent of children ages 19 to 35 months): 7

Primary Care Physicians (number per 100,000 population): 9

Poor Mental Health Days (days in previous 30 days): 3

Cardiovascular Deaths (deaths per 100,000 population): 1

Cancer Deaths (deaths per 100,000 population): 11

New Hampshire: 3
Change: +1

Prevalence of Obesity (percent of population): 14

Air Pollution (micrograms of fine particles per cubic meter): 10

Lack of Health Insurance (percent without health insurance): 11

Immunization Coverage (percent of children ages 19 to 35 months): 1

Primary Care Physicians (number per 100,000 population): 16

Poor Mental Health Days (days in previous 30 days): 32

Cardiovascular Deaths (deaths per 100,000 population): 19

Cancer Deaths (deaths per 100,000 population): 28

Hawaii: 2
Change: +1

Prevalence of Obesity (percent of population): 2

Air Pollution (micrograms of fine particles per cubic meter): 2

Lack of Health Insurance (percent without health insurance): 2

Immunization Coverage (percent of children ages 19 to 35 months): 4

Primary Care Physicians (number per 100,000 population): 7

Poor Mental Health Days (days in previous 30 days): 7

Cardiovascular Deaths (deaths per 100,000 population): 2

Cancer Deaths (deaths per 100,000 population): 1

Vermont: 1
Change: no change

Prevalence of Obesity (percent of population): 6

Air Pollution (micrograms of fine particles per cubic meter): 10

Lack of Health Insurance (percent without health insurance): 10

Immunization Coverage (percent of children ages 19 to 35 months): 29

Primary Care Physicians (number per 100,000 population): 5

Poor Mental Health Days (days in previous 30 days): 14

Cardiovascular Deaths (deaths per 100,000 population): 10

Cancer Deaths (deaths per 100,000 population): 13


UNHEALTHIEST BOTTOM 10

Georgia: 41
Change: -1

Prevalence of Obesity (percent of population): 40

Air Pollution (micrograms of fine particles per cubic meter): 50

Lack of Health Insurance (percent without health insurance): 41

Immunization Coverage (percent of children ages 19 to 35 months): 19

Primary Care Physicians (number per 100,000 population): 38

Poor Mental Health Days (days in previous 30 days): 38

Cardiovascular Deaths (deaths per 100,000 population): 40

Cancer Deaths (deaths per 100,000 population): 26

Nevada: 42
Change: -3

Prevalence of Obesity (percent of population): 13

Air Pollution (micrograms of fine particles per cubic meter): 14

Lack of Health Insurance (percent without health insurance): 43

Immunization Coverage (percent of children ages 19 to 35 months): 50

Primary Care Physicians (number per 100,000 population): 46

Poor Mental Health Days (days in previous 30 days): 45

Cardiovascular Deaths (deaths per 100,000 population): 38

Cancer Deaths (deaths per 100,000 population): 32

Arkansas: 43
Change: +5

Prevalence of Obesity (percent of population): 45

Air Pollution (micrograms of fine particles per cubic meter): 32

Lack of Health Insurance (percent without health insurance): 40

Immunization Coverage (percent of children ages 19 to 35 months): 46

Primary Care Physicians (number per 100,000 population): 41

Poor Mental Health Days (days in previous 30 days): 32

Cardiovascular Deaths (deaths per 100,000 population): 43

Cancer Deaths (deaths per 100,000 population): 45

Oklahoma: 44
Change: +4

Prevalence of Obesity (percent of population): 43

Air Pollution (micrograms of fine particles per cubic meter): 23

Lack of Health Insurance (percent without health insurance): 42

Immunization Coverage (percent of children ages 19 to 35 months): 25

Primary Care Physicians (number per 100,000 population): 49

Poor Mental Health Days (days in previous 30 days): 47

Cardiovascular Deaths (deaths per 100,000 population): 49

Cancer Deaths (deaths per 100,000 population): 36

Florida: 45
Change: -4

Prevalence of Obesity (percent of population): 10

Air Pollution (micrograms of fine particles per cubic meter): 13

Lack of Health Insurance (percent without health insurance): 48

Immunization Coverage (percent of children ages 19 to 35 months): 10

Primary Care Physicians (number per 100,000 population): 33

Poor Mental Health Days (days in previous 30 days): 19

Cardiovascular Deaths (deaths per 100,000 population): 15

Cancer Deaths (deaths per 100,000 population): 14

Texas: 46
Change: -9

Prevalence of Obesity (percent of population): 39

Air Pollution (micrograms of fine particles per cubic meter): 33

Lack of Health Insurance (percent without health insurance): 50

Immunization Coverage (percent of children ages 19 to 35 months): 38

Primary Care Physicians (number per 100,000 population): 42

Poor Mental Health Days (days in previous 30 days): 32

Cardiovascular Deaths (deaths per 100,000 population): 30

Cancer Deaths (deaths per 100,000 population): 15

Tennessee: 47
Change: -1

Prevalence of Obesity (percent of population): 47

Air Pollution (micrograms of fine particles per cubic meter): 41

Lack of Health Insurance (percent without health insurance): 27

Immunization Coverage (percent of children ages 19 to 35 months): 22

Primary Care Physicians (number per 100,000 population): 17

Poor Mental Health Days (days in previous 30 days): 19

Cardiovascular Deaths (deaths per 100,000 population): 47

Cancer Deaths (deaths per 100,000 population): 47

South Carolina: 48
Change: -6

Prevalence of Obesity (percent of population): 44

Air Pollution (micrograms of fine particles per cubic meter): 37

Lack of Health Insurance (percent without health insurance): 34

Immunization Coverage (percent of children ages 19 to 35 months): 17

Primary Care Physicians (number per 100,000 population): 34

Poor Mental Health Days (days in previous 30 days): 38

Cardiovascular Deaths (deaths per 100,000 population): 36

Cancer Deaths (deaths per 100,000 population): 38

Mississippi: 49
Change: +1

Prevalence of Obesity (percent of population): 50

Air Pollution (micrograms of fine particles per cubic meter): 29

Lack of Health Insurance (percent without health insurance): 46

Immunization Coverage (percent of children ages 19 to 35 months): 34

Primary Care Physicians (number per 100,000 population): 48

Poor Mental Health Days (days in previous 30 days): 49

Cardiovascular Deaths (deaths per 100,000 population): 50

Cancer Deaths (deaths per 100,000 population): 46

Louisiana: 50
Change: -1

Prevalence of Obesity (percent of population): 47

Air Pollution (micrograms of fine particles per cubic meter): 35

Lack of Health Insurance (percent without health insurance): 47

Immunization Coverage (percent of children ages 19 to 35 months): 39

Primary Care Physicians (number per 100,000 population): 20

Poor Mental Health Days (days in previous 30 days): 8

Cardiovascular Deaths (deaths per 100,000 population): 45

Cancer Deaths (deaths per 100,000 population): 49