While some states are making significant gains in various health measures, the nation's overall health is on the decline, according to the United Health Foundation's (UHF) latest health rankings report released Tuesday.
UHF's 2017 America's Health Rankings report considers 35 health care measures that together cover:
- Behaviors, including drug overdose deaths, alcohol misuse, and physical inactivity;
- Clinical care, including preventable hospitalizations among Medicare beneficiaries, the number of primary care physicians, and the number of dentists;
- Community and environment, including air pollution, childhood poverty levels, and infectious disease cases;
- Policy, including those related to immunizations and public health funding; and
- Outcomes, including cancer deaths, cardiovascular deaths, and health disparities.
The report is based on data from CDC, the U.S. Census Bureau, and other federal agencies.
The United Health Foundation is one of UnitedHealth Group's philanthropic foundations. Daily Briefing is published by Advisory Board, a division of Optum, which is a wholly owned subsidiary of UnitedHealth Group.
The report for the first time ranked Massachusetts as the healthiest state in the country, ending Hawaii's five-year reign in the top spot. The next healthiest states included:
- Hawaii, which ranked second;
- Vermont, which ranked third;
- Utah, which ranked fourth; and
- Connecticut, which ranked fifth.
According to the rankings, the five least healthy states in the United States were:
- West Virginia, which ranked 46th;
- Alabama, which ranked 47th;
- Arkansas, which ranked 48th;
- Louisiana, which ranked 49th; and
- Mississippi, which ranked 50th.
According to the report, Florida and Utah experienced the largest improvements in overall rank, each rising four slots: Florida to No. 32 and Utah to No. 4. Florida's ranking reflected improvements in the number of children living in poverty and frequent mental distress since last year, while Utah's performance reflected improvements in air pollution levels, rates of immunization among children, and other measures, the report found.
Overall, the "nation is facing serious public health challenges," the report said.
For instance, according to the report, the nation's mortality trends are "concerning." The rate of premature death increased for the seventh year in a row, totaling 7,214 years lost before age 75 for every 100,000 people. Further, the rates of cardiovascular and drug-related deaths increased by 2% and 7%, respectively, since 2015, with marked increases in some of the "healthiest" states: New Hampshire's rate of drug-related deaths increased by 118% since 2016, for instance, while Massachusetts' rate increased by 69% since 2016.
Ultimately, the report found that the United States ranked 27th for life expectancy when compared with 35 other nations, CNN reports.
The report also found that the concentration of health care providers varied widely between states. For instance, Massachusetts reported 547.3 mental health care providers for every 100,000 people, the highest concentration of mental health care providers in the nation, while Alabama had only 85 mental health care providers per 100,000 population, giving it the lowest concentration. According the report, states reported similar variation in the concentration of primary care physicians and dentists.
According to Georges Benjamin—executive director of the American Public Health Association, which was not involved in the report—said the findings reflect the nation's lack of a "system with everybody in." He added, "We're failing in our fundamental task to be a healthier nation."
Separately, Tom Frieden—former CDC director and current president and CEO of Resolve to Save Lives—said the nation can reverse the increasing trends of cardiovascular and drug-related mortality, but only through "concerted action by government, health systems, communities, and individuals" (Thielking, "Morning Rounds," STAT News, 12/12; 2017 America's Health Rankings, December 2017; 2017 America's Health Rankings Executive Summary, December 2017; Ramsey, Business Insider, 12/12; Cohen, CNN, 12/12).
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