Hawaii named healthiest state, Louisiana ranks last in new report

As the new year approaches, many people focus on improving their health -- but how does where you live rank when it comes to health?Hawaii now ranks a...

Posted: Dec 20, 2018 7:32 AM

As the new year approaches, many people focus on improving their health -- but how does where you live rank when it comes to health?

Hawaii now ranks as the healthiest state in America, beating out Massachusetts to return to the top spot in a new report by the United Health Foundation, a nonprofit division of UnitedHealth Group, which also owns the insurance company United Healthcare and Optum.

Hawaii, Massachusetts, Connecticut, Vermont and Utah are the five healthiest states of the year, while the five least healthy are Arkansas, Oklahoma, Alabama, Mississippi and, coming in last, Louisiana, according to the annual America's Health Rankings report, released last week.

The report has been conducted annually for the past 29 years.

"A rank means that you overall are healthier than the states below you in the rank and are overall less healthy than the states above you in the rank," said Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets and a senior adviser to the America's Health Rankings report.

"The report provides a benchmark of how the health of each state's population has changed year over year, by comparison to other states, and insights into challenges and successes. The states that are in the top five on the list have areas where they could improve. The states that are in the bottom five have areas that they have done well," she said. "So every state has some areas where they're challenged and some areas where they have some really strong measures around their health."

Last year, the five healthiest states were the same but in different order: Massachusetts, Hawaii, Vermont, Utah and Connecticut. The least healthy last year were West Virginia, Alabama, Arkansas, Louisiana and Mississippi. Previously, Hawaii had a five-year reign as healthiest state.

'Obesity has hit an all-time high'

To create the rankings, the report takes into account 35 health factors and examines them by state.

Those 35 measures fall into categories: "the behaviors that we are choosing in our lifestyle; the community and environment where we live; the public policy that happens at a state level; and the clinical care that we receive when we go to the doctor and the hospital ultimately influence the outcomes around our health," Randall said.

"A scientific advisory committee looks at each one of those measures and determines, based on scientific evidence, how much of an impact that measure has on the overall health of a population," she said. "Then, the states get a ranking for each individual measure, and then they get an overall ranking."

The data in the report also provided a snapshot of the nation's overall health, which Randall said revealed both concerning and encouraging trends.

"Starting with the thing that concerned us the most, obesity has hit an all-time high. The obesity rate in America for the adult population, for the first time in the history of producing this report, is up 5% in the past year. It hit 31.3% for 2018," Randall said.

In other words, nearly one in three US adults is obese.

Obesity rates also appeared to be high in many of the states ranked as least healthy. For instance, the prevalence of obesity in West Virginia is 38.1%, nearly double the prevalence in Colorado, where it is 22.6%, according to the report.

"Another thing that concerns us that we found in this report was that premature death increased 3% in the past year. That means years of life lost before people are reaching the age of 75," Randall said.

"That often has correlation with a number of factors -- things like our lifestyle choices, living with more chronic diseases," she said. "We also know that the suicide rate has increased as well, and that would contribute to the increase in premature death rate, along with other causes."

The report measured the suicide rate as the number of deaths due to intentional self-harm per 100,000 deaths recorded on death certificates, and the data showed that America's suicide rate has increased 16% since 2012.

The report wasn't all doom and gloom; it also had some positive findings.

"Childhood poverty has decreased," Randall said.

"That's a key indicator of somebody's socioeconomic status and a good predictor of how their overall health is going to be for the rest of their life. That childhood poverty measure decreased 6% since the prior year," she said.

"We're also seeing there are more mental health providers available than in prior years," she said. "That measure looks at mental health providers of all degrees, so it looks at psychiatrists, psychologists, mental health professionals, marriage and family therapists as examples, and so that number has increased nationally."

What's behind the state-by-state differences

Some of the state-by-state differences in the rankings could be explained by social determinants of health, said Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the new report.

The US Centers for Disease Control and Prevention defines social determinants as the complex social structures and economic systems that can drive most health inequities, such as access to health care or education.

"If you think about the things that cause premature death -- heart disease, perinatal deaths, tobacco-related diseases -- in many ways, those are spurred by social determinants," Benjamin said.

For instance, "Mississippi, Alabama, Louisiana continue to be at the bottom, and that kind of carries up to the Arkansas and Tennessee region. When you look at some of the challenges they have, it's still around tobacco use and poverty and, to some degree, physical inactivity," he said. "Those are the things that we know result in fundamentally poor health outcomes. What we would like to see is all states improving."

Hopes for better health in the new year

As the nation looks toward 2019, Randall said, she has some hopes for public health.

"What I hope we will see next year is that some of these trends really start to go in a better direction. As an example, the smoking trend in the United States has come down consistently over the 29 years of this report. That encourages me," Randall said.

"Now, if we focus our attention to other lifestyle choices -- like physical inactivity, like obesity -- and find out as individuals what motivates us, what are the small changes that we can make that we'll stick with," she said.

"Whatever that is -- whether that's wearing something that's tracking your activity and it's encouraging you to just add a little bit more walking in your daily life; whether it is having a buddy who you're going to get up and take the dog for a walk together with -- whatever that is that's going to motivate you, it's going to be something that can help you stick with it."

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 915942

Reported Deaths: 9606
CountyCasesDeaths
Hennepin1786832038
Ramsey739711046
Dakota67683587
Anoka64112577
Washington40545359
Stearns33631279
St. Louis29591409
Scott25994186
Wright25957217
Olmsted22339130
Sherburne19000127
Carver1670669
Clay12104105
Blue Earth1147970
Rice11451138
Crow Wing11213123
Chisago995379
Kandiyohi9815108
Otter Tail9813127
Benton9033125
Beltrami816997
Goodhue811798
Douglas7875101
Itasca772299
Mower733449
McLeod713084
Winona710258
Isanti700783
Steele685731
Morrison672879
Becker628574
Polk603187
Freeborn561246
Carlton546974
Mille Lacs532479
Lyon528461
Nobles525054
Nicollet522460
Pine515043
Cass501253
Todd492843
Brown470759
Le Sueur459734
Meeker433458
Martin386544
Wabasha375510
Waseca374333
Dodge361112
Hubbard355249
Roseau316231
Fillmore305315
Wadena302940
Redwood281445
Houston272017
Renville268451
Faribault258233
Sibley252317
Pennington252130
Kanabec250136
Cottonwood230132
Aitkin222450
Chippewa220542
Pope207410
Watonwan198020
Yellow Medicine188023
Rock177729
Koochiching176725
Swift173123
Stevens167511
Jackson161016
Clearwater158020
Marshall153522
Murray151811
Pipestone149729
Lake132924
Lac qui Parle123025
Wilkin121116
Mahnomen106014
Norman10509
Grant101510
Big Stone9485
Lincoln8805
Kittson73223
Red Lake71410
Traverse6056
Unassigned545124
Lake of the Woods5265
Cook3071

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 525758

Reported Deaths: 7379
CountyCasesDeaths
Polk81677809
Linn32838430
Scott27126295
Black Hawk22334382
Woodbury20736263
Johnson20150108
Dubuque18996243
Pottawattamie16215214
Dallas15573115
Story1398059
Warren8637107
Cerro Gordo8141125
Clinton7928115
Webster7419124
Des Moines7153106
Marshall675494
Muscatine6717117
Wapello6546145
Jasper630591
Sioux622477
Lee5977106
Marion567697
Buena Vista503449
Plymouth493388
Henry427155
Benton414760
Jones413564
Bremer403873
Boone397042
Washington395464
Carroll373355
Mahaska372366
Crawford355647
Jackson324047
Dickinson317555
Buchanan312743
Delaware303255
Clay297636
Kossuth293477
Fayette290356
Hardin289253
Tama282878
Page276133
Wright270050
Cedar269527
Winneshiek267744
Hamilton262757
Floyd261049
Clayton252360
Poweshiek242043
Harrison240979
Madison237425
Butler237346
Cass235667
Iowa234336
Jefferson228544
Mills225330
Hancock222840
Winnebago222339
Cherokee217347
Appanoose210157
Lyon209842
Allamakee209456
Calhoun199519
Shelby199542
Union197141
Humboldt188231
Franklin188031
Grundy186137
Chickasaw184522
Mitchell184343
Emmet180146
Louisa178653
Sac175626
Guthrie169338
Clarke163629
Montgomery163146
Keokuk152639
Palo Alto152332
Howard150624
Monroe144340
Ida134141
Greene128818
Davis126825
Lucas126127
Monona124940
Worth12309
Pocahontas122125
Adair118239
Osceola105718
Decatur104813
Taylor100914
Fremont98913
Van Buren95922
Wayne86125
Ringgold78429
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Adams5869
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