How Healthy Is Your State And Our Nation?

Mike Magee

The wire release of America’s Health Rankings®, a state by state assessment compiled by the American Public Health Association and supported by the United HealthCare Foundation, summed it up this way: “Overall Healthiness Slightly Improved, but Obesity, Children in Poverty, and Diabetes Worrisome for States’ Health….reductions in smoking, preventable hospitalizations and infectious disease were offset by continued increases in obesity, children in poverty, and lack of health insurance. Clearly obesity is taking its toll with a 19% increase in the diagnosis just in the last 5 years.”

Reed Tuckson MD, executive vice president at UnitedHealth Group said, “We know with certainty that many people will suffer consequences of preventable disease unless we strengthen individual healthiness, community by community across America. The persistent year after year increase in obesity, physical inactivity, diabetes, and other risk factors combined with a still unacceptably high use of tobacco means an increased burden of chronic illness, including diabetes, with medical care costs that will be unaffordable for any state, private employer, or individual in the days to come.” Georges Benjamin, executive director of the American Public Health Association, added, ““Obesity and tobacco use are top contributors to a variety of diseases, including heart disease, cancer, stroke, diabetes and other leading causes of premature death and disability. We cannot avoid these critical public and personal health battles.”

Here are some specifics:

OBESITY

Up 132 percent from 11.6 percent to 26.9 percent in the past 10 years; more than one in four Americans are considered obese.

SMOKING

Smoking decreased from 18.3 percent to 17.9 percent of the adult population in the past year, down from 29.5 percent in the 1990. Still tobacco leads to one out of five deaths, that’s 443,000 deaths this year. Four states are role models for success – Utah, California, Massachusetts and Washington. Their smoking rates are below 15 percent.

CHILDHOOD POVERTY

The number of children in poverty has increased for the last four years from 17.4 percent of children in 2007 to 20.7 percent of children in the 2010.

LACK OF INSURANCE

51 million are uninsured, an increase from 13.9 percent in 2001 to 15.3 percent in the 2009 to 16.0 percent in the 2010.

DIABETES

8.3 percent of American adults have been told by a physician that they have diabetes. CDC estimates that by 2050, 1 in 3 to 1 in 5 will be affected. Large numbers of people are unaware they have the disease. UnitedHealth Center for Health Reform & Modernization says more than 50 percent of Americans could have diabetes and/or pre-diabetes by 2020 at a cost of $3.35 trillion over the next decade – for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion – up from an estimated $194 billion this year.

What states are healthiest according to the release? “Vermont tops the list of healthiest states for the last four years of published reports. Vermont has had a steady climb in the Rankings for the last twelve years from a ranking of 17th in the 1997 and 1998 Editions. Massachusetts is ranked second, an improvement from third last year. Massachusetts has ranked in the top ten for almost 20 years. New Hampshire is ranked third, followed by Connecticut and Hawaii.” And many states have made some progress in the past 20 years. Maryland dropped its smoking rates from 29.7 to 15.1 percent of the population. Louisiana’s children in poverty rate declined from 38.5 to 19.5 percent. Washington’s infant mortality rate was cut in half (from 9.7 to 4.8 deaths per 1,000 live births). And Vermont decreased cardiovascular deaths from 401.7 to 241.1 per 100,000 population.

But compared to the rest of the world, we are collectively behind. How far?

30 out of 37 other countries have better life expectancies then we do. Japan leads all countries with an average expectancy of age 76.

Our’s is the highest mortality rate from treatable chronic conditions when compared to 19 other industrialized countries.

We’re third to last in the rate of infant mortality among 37 developed nations. (United States had seven deaths per 1,000 live births, compared to three deaths or fewer in Italy, Japan, Finland, France and Greece.)

And we rank 29th in homicide rates when compared to 31 other industrialized countries.

How is your state doing? Check the map.

As for solutions, that will take cooperation. Leaders of the study explain:

“This report looks at the four groups of health determinants that can be affected:

1. Behaviors include the everyday activities we do that affect our personal health. It includes habits and practices we develop as individuals and families that have an effect on our personal health and on our utilization of health resources. These behaviors are modifiable with effort by the individual supported by community, policy and clinical interventions.

2. Community and environment reflects the reality that the daily conditions in which we live our lives have a great effect on achieving optimal individual health.

3. Public and health policies are indicative of the availability of resources to encourage and maintain health and the extent that public and health programs reach into the general population.

4. Clinical care reflects the quality, appropriateness and cost of the care we receive at doctors’ offices, clinics and hospitals.

“All health determinants are intertwined and must work together to be optimally effective. For example, an initiative that addresses tobacco cessation requires not only efforts on the part of the individual but also support from the community in the form of public and health policies that promote non-smoking and the availability of effective counseling and care at clinics. Similarly sound prenatal care requires individual effort, access to and availability of prenatal care coupled with high quality health care services. Addressing obesity, which is a health epidemic now facing this country, requires coordination among almost all sectors of the economy including food producers, distributors, restaurants, grocery and convenience stores, exercise facilities, parks, urban and transportation design, building design, educational institutions, community organizations, social groups, health care delivery and insurance to complement and augment individual actions.”