December 26, 2018
Where you live may make a difference in how healthy you are.
America’s Health Rankings Annual Report by the United Health Foundation for 2018 examined 35 markers of health in every state in the United States and found that Hawaii is the healthiest state in the nation, followed by Massachusetts, Connecticut, Vermont, and Utah.
The states facing the most health challenges were Arkansas, Oklahoma, Alabama, Mississippi, and Louisiana, which ranked last on the list.
In evaluating the nation’s health as a whole, the assessment found that obesity rates hit an all-time high, surpassing 30 percent of the population for the first time in the report’s 29-year history. On the positive side, the childhood poverty rate decreased by 6 percent over last year and by 19 percent over the past five years.
Personal Behaviors Can Make a Difference
“The report should be a call to action,” says Rhonda Randall, DO, chief medical officer of UnitedHealthcare National Market and an adviser to America’s Health Rankings. “Our personal behaviors have a really significant impact on our health because they ultimately have a significant impact on our outcomes.”
Dr. Randall stresses that factors such as obesity, smoking, and physical inactivity are linked to negative outcomes, such as cardiovascular disease, cancer, and premature death.
“Obesity rates are really concerning to us,” she says. “They continue to go in the wrong direction.”
Still, individuals may improve their health no matter where they live by adopting healthy behaviors.
“The states that tend to be in the top 10 are states where individuals are making healthy choices in their own lives,” says Randall.
Hawaii, for example, had a low prevalence of obesity, with 23.8 percent self-reporting a BMI (body mass index) greater than 30 compared with the national obesity rate of 31.3 percent. (BMI is a measure of body fat based on weight and height.) Also, 12.8 percent of adults in Hawaii indicated that they were smokers compared with 17.1 percent nationwide.
Hawaii also had relatively low rates of preventable hospitalization, cancer death, frequent mental distress, and physical inactivity, according to Randall.
Other Nationwide Health Concerns
On the negative side, the report highlighted that premature deaths have been rising, increasing by 3 percent over last year. The suicide rate has also increased 16 percent since 2012.
More American were reporting frequent mental distress, climbing 7 percent over the past two years, as well as poorer physical health with frequent physical distress rising 5 percent over two years.
Some Silver Linings, Such as a Drop in Childhood Poverty
“The good news on a national level is that childhood poverty has decreased quite significantly,” says Randall.
In the past year alone, poverty decreased 6 percent; and over the past five years, it dropped 19 percent. Randall stresses that a person’s socio-economic status growing up can establish their health for the rest of their lives.
While the report doesn’t tell why this poverty rate has gone down, Randall says that there may be a correlation with the national economy, which has been improving over the past five years.
Another positive highlight has been an increase in the number of mental health providers nationwide (up 8 percent over last year) and the number of primary care physicians (up 5 percent over last year).
“As a nation, we have a primary care physician shortage,” says Randall. “So seeing it go up in the past year is a good indication that we’re starting to turn that around and make some headway.”
A Call for Community Action
The United Health Foundation encourages health professionals, public health officials, and elected leaders to use the findings to support the health of people in their communities.
“Policymakers can use the report in greater detail at a state level to see where they are doing very well and where they are most challenged,” says Randall.
“This is a community effort,” adds Sharon Zarabi, RD, CDN, bariatric program director at Lenox Hill Hospital in New York City, who was not involved in the report. “States that promote healthy living and healthy policy will result in healthy residents. We must take charge of our health.”