From 24/7 Wall St.: The United States is far from being the healthiest country in the world. The country struggles with obesity and heart disease, and life expectancy is worse than in countries such as Slovenia and Chile.
However, according to one study, the country’s state of health may be turning around. In this year’s edition of America’s Health Rankings, the country improved in more than two-thirds of the health measures considered by the report.
The United Health Foundation’s America’s Health Rankings report examined factors such as healthy behaviors, quality of health care, health policy, the presence of diseases and deaths from illnesses across the nation. The differences in health on a state level vary considerably. This year, Hawaii is the healthiest state in the country, while Mississippi is the least healthy state.
Most of the nation’s least healthy states suffer from the worst rates of diabetes, deaths from cancer and deaths from cardiovascular disease. In healthier states, such outcomes are far less common. For instance, eight of the 10 healthiest states also had among the 10 fewest cardiovascular deaths per 100,000 people.
The toll of poor health can cost, or significantly shorten, people’s lives. The Centers for Disease Control tracked premature death, which measures the number of years lost when people do not live to age 75. In the healthiest states, this number is quite low, with nearly all states in the bottom 15 nationwide. In America’s least healthy states, this number is far higher, with all but one state among the 10 worst nationwide. In the nation’s least healthy state, Mississippi, there were 10,821 years lost per 100,000 people, nearly twice the number of the country’s third healthiest state, Minnesota.
Behavior plays a major role in determining whether people stay healthy. In an interview with 24/7 Wall St., Dr. Reed Tuckson, external clinical advisor to United Health Foundation’s America’s Health Rankings, explained, “At the end of the day you’re not going to be able to turn around the diseases if you don’t deal with the risk factors.”
Nine of the 10 least healthy states in the nation had among the 10 worst obesity rates in the country. Similarly, nine of the 10 least healthy states had among the worst levels of physical inactivity. Smoking was also more common in the least healthy states.
Money also clearly plays a role in determining health. The healthiest states are often among the nation’s wealthiest, and each had a median household income well-above the national median. At the other end, nearly all of the nation’s least healthy states had among the lowest incomes. The three least healthy states — Mississippi, Arkansas and Louisiana — were also the nation’s three poorest by median income. Residents’ ability to pay for health care, as well as the ability to afford a good education, which can affect good health decisions, are possible reasons for this relationship.
Tuckson added that the relationship between wealth and health could also be the result of lack of optimism poorer people may have. “When you do not have great hope for the future, when you’re living a life that is not as optimistic, people are generally not as inclined to take charge of their overall health. ‘What’s the point,’ people will say. ‘If my life is miserable anyway, why would I do something to make myself live longer?’”
Access to quality care is also crucial. In states where residents are most likely to be healthy, there are usually high numbers of physicians and doctors. The opposite is true in the nation’s least healthy states. In places with limited access to quality care, residents are more likely to have children with low birth weight, and preventable hospitalizations are also more common. Hawaii, America’s healthiest state, had the lowest rate of preventable hospitalizations among Medicare recipients.
The relationship between good health and good policy, however, is hardly straightforward. While some healthy states provide a considerable amount of health funding, others do not. Hawaii spent more than any other state on health care at $225 per person from 2011 through 2012. However, Minnesota, the third healthiest state, spent less than $47 per person. According to Tuckson, the lack of correlation between health spending and overall health is likely because it is difficult to measure consistently. “Funding for public health is a complicated statistic, and it can be captured differently from state to state, dependent on how their budgets are oriented.”
Based on data provided by United Health Foundation’s America’s Health Rankings, 24/7 Wall St. examined the 10 states with each the highest and lowest overall scores. These scores are based on a number of measures that fall into two separate categories: determinants and outcomes. Determinants are further divided into behaviors, such as smoking; community and environmental factors, such as children living in poverty; policy factors, such as public health funding and immunization rates; and clinical care factors, such as the availability of dentists and doctors. Additionally, we also reviewed supplementary data provided by America’s Health Rankings, including economic factors such as median household income. All data referenced are the most recent available data.
These are America’s most and least healthy states, according to 24/7 Wall St.:
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