Washington, D.C., December 5, 2006 – Americans as a whole are only 0.3 percent healthier than they were at this time last year, according to the 17th annual edition of America’s Health Rankings: A Call to Action for People & Their Communities™, released today. This increase is significantly lower than the nation’s average annual improvement of 1.5 percent documented between 1990 and 2000, and only keeps pace with the 0.3 percent average annual national improvement since 2000. The report also observes that the United States continues to trail other nations in important statistics such as healthy life expectancy and infant mortality.
The report, which is produced by United Health Foundation in partnership with the American Public Health Association and Partnership for Prevention, is a yearly assessment of the relative healthiness of the nation, based upon analysis of comprehensive determining factors such as personal behaviors, the environment in which people live and work, the decisions made by public and elected officials and the quality of medical care delivered by health professionals.
This year, the report ranks Minnesota as the healthiest state in the nation for the fourth year in a row. Vermont comes in second, followed by New Hampshire, Hawaii and Connecticut. Louisiana is ranked as the least-healthy state, while Mississippi (49), South Carolina (48), Tennessee (47) and Arkansas (46) complete the bottom five.
“We as a nation are blessed with unparalleled resources and assets and as such it is troubling that we are not making more significant progress in overall health improvements,” said Reed Tuckson, M.D., senior vice president of United Health Foundation. “This report is a call to action for all of us – as individuals, members of families, participants in community life, health professionals and political and policy leaders – to intensify our efforts toward a healthier America. We can do better and our children deserve better.”
A National Health Analysis
Since America’s Health Rankings™ began in 1990, the nation’s overall health has improved by 18.7 percent. This national success can be attributed mostly to the reduction of several health determinants, such as infectious diseases, smoking, cardiovascular deaths, motor vehicle deaths and violent crime. In addition, there are slightly fewer children living in poverty, and more ninth graders are graduating high school within four years than in 1990. Each of these factors contributed positively to the nation’s overall health status.
Since 2000, however, the rate of improvement in the nation’s health status has essentially stagnated. Key reasons for this are the persistence of tobacco use and our nation’s relatively high infant mortality rate. This stagnation is compounded by the increasing prevalence of obesity in America. Obesity, which is up from 11.6 percent of the population in 1990 to nearly 25 percent today, is a precursor to many other diseases and plays a large role in hindering the nation’s ability to improve its overall health status.
Finally, the report makes special note of the increase in the percentage of uninsured people, which has increased from 13.4 percent in 1990 to 15.9 percent of the population today. The increasing number of uninsured Americans has significant effects on the ability to prevent disease, in addition to impeding necessary medical care delivery.
The United States Compared to Other Nations
The report also notes that the potential for optimal healthiness in the United States has not yet been achieved. Compared with other nations, the United States lags behind in several important indicators of overall health. For example, a baby girl born today in the United States can expect to live 71 healthy, active years; while a baby girl born today in Japan can expect to live 78 healthy, active years.
Particularly troubling is the report’s observation that 35 other nations have infant survival rates that are better than or equal to that of the United States. Our rate of 6.6 deaths per 1,000 live births is double that of Japan, Sweden, Finland, Monaco and San Marino. Countries such as the Czech Republic, France, Germany and Spain also have better rates of infant survival.
“Nowhere is the failure of prevention of more concern than in its impact on the nation’s children,” said Marian Wright Edelman, president and founder of the Children’s Defense Fund. “And, as I observed in my commentary in this year’s report, health insurance that assures medically necessary services for all children must be the top priority for our nation now.”
A State-by-State Analysis
The report’s state-by-state analysis shows Illinois with the highest overall health improvement since last year (a 2.8 percent increase). Next are Ohio, with a 2.6 percent jump; Wisconsin, with a 2.3 percent increase; and Kansas, with a 2.1 percent rise. States with the greatest decline in overall health include New Mexico, which dropped 4.2 percent; Idaho, which declined by 3.9 percent; and West Virginia, which dropped 3.5 percent. But, regardless of where an individual state ranks, each state has its own set of successes and challenges.
“The rankings are a vital tool for every state to find opportunities to help citizens further improve their health,” said John M. Clymer, president of Partnership for Prevention. “America’s Health Rankings™ is more than a report; it is a call to action for states to implement healthful policies, since health is a critical factor in both quality of life and economic vitality.”
Health Disparities among Minority Populations
The report also documents the persistence of differences in health outcomes among racial and ethnic groups in America. In his commentary on eliminating health disparities, Admiral John Agwunobi, M.D., assistant secretary for health with the U.S. Department of Health and Human Services, notes that Latinos in particular have the lowest rates of health insurance coverage and regular sources of health care, and are actually experiencing an overall increase in health disparities. In addition, data from the National Fetal and Infant Mortality Review Program shows that the rate of pre-term births among African-American women is about four times higher than among non-Hispanic white women. It also shows that infant mortality rates vary greatly across racial and ethnic groups. The highest levels of infant deaths due to Sudden Infant Death Syndrome (SIDS) in the nation occur within the Native American community, and its rate is 2.4 times higher than that of non-Hispanic white infants.
“The consequences of disparities in health status have plagued our nation for far too long,” said Georges Benjamin, M.D., executive director of the American Public Health Association. “If we are to achieve the healthiest possible America, we must intensify our efforts to implement targeted and effective strategies that are appropriate for each American community.”
Information about Quality of Health Care Services Included in Report for the First Time
This year, America’s Health RankingsTM includes a state-level analysis of the quality and cost effectiveness of medical care to provide a more complete and comprehensive assessment of American health. This analysis, completed by the prestigious Dartmouth Atlas Project, shows that the quality of medical care and the cost of that care vary widely among the states.
One of the most outstanding conclusions in the analysis is that offering and rendering more services does not necessarily lead to better-quality care. In fact, in some states, the greater use of services is associated with poorer quality and lower satisfaction with care.
The Dartmouth Atlas Project also found that the treatment of patients with chronic illnesses varies widely among the states. For example, the average number of days spent in the hospital by seriously ill Medicare beneficiaries during their last six months of life varies from 7.3 days in Utah to 15.2 days in New Jersey and 16.3 days in New York. As a result, Medicare spending per patient varied nearly two-fold. The reasons for this, according to Elliott S. Fisher, M.D., professor of medicine at Dartmouth Medical School, are factors such as the amount of time similarly ill patients spend in the hospital, how often they see physicians, the number of specialists involved in their care and how many tests and procedures they have.
“The goal of the health and medical care system should be to utilize its resources effectively to produce optimal health outcomes,” said Fisher. “We hope that our data will stimulate policymakers, patients and health professionals to focus on how best to achieve accountability for costs, quality and outcomes of care striving to make
evidence-based decisions where possible and to improve the evidence base where it is currently lacking.”
About America’s Health Rankings™
The purpose of America’s Health Rankings™ is to stimulate public conversation that leads to activities that enhance the health of our nation, states and communities. The report is premised on the foundation that people will translate reliable information into effective action.
This year’s report benefits from the perspectives of thoughtful and experienced experts, such as Michael O. Leavitt, Secretary of Health and Human Services, The Texas Medical Association, the University of Wisconsin Population Health Institute and The Washington Health Foundation.
America’s Health Rankings™ combines 12 individual measures classified within four determinants of health and six measures classified as health outcomes into one comprehensive view of the health of all 50 states, separately and collectively. It employs a unique methodology that weights the contributions of various factors, such as smoking, preventable disease, high school graduation rates, children in poverty and others, to a community’s health.
The report’s methodology was developed and is periodically reviewed by a panel of top public health scholars, led by the School of Public Health at the University of North Carolina at Chapel Hill. The report is based on data from the U.S. Departments of Health and Human Services, Commerce, Education and Labor, the National Safety Council and the National Association of State Budget Officers.
To view the entire report, please visit www.americashealthrankings.org or www.unitedhealthfoundation.org.
About United Health Foundation
United Health Foundation is an independent, not-for-profit foundation funded solely by UnitedHealth Group. The foundation is dedicated to providing information in support of the health and medical decisions made by physicians and health professionals, individuals and community leaders. For more information about United Health Foundation and its work, please visit www.unitedhealthfoundation.org.
About the American Public Health Association
Founded in 1872, the American Public Health Association is the oldest, largest and most diverse organization of public health professionals in the world. The association aims to protect all Americans and their communities from preventable, serious health threats and strives to assure community-based health promotion and disease prevention activities and preventive health services are universally accessible in the United States. More information is available at www.apha.org.
About Partnership for Prevention
Partnership for Prevention is a membership organization of businesses, nonprofit organizations and government agencies advancing policies and practices to prevent disease and improve the health of all Americans. The organization seeks to increase investment in preventing disease, promoting health and making prevention a national priority among both the public and private sectors. For additional information, visit www.prevent.org.