Study rates Minnesota healthiest U.S. state

David Brown, Washington Post

Published on November 8, 2004 in the Star Tribune

Scrape off the color on the red states and the blue states and underneath is a different way of looking at America's regional differences.

There are the smoking states and the obesity states; the high-infant-mortality states and the stay-in-high-school states; the heart-attack states and the killed-on-the-job states.

Today, for the 15th time, a public health organization is releasing its assessment of the health of the nation, and of each state, as measured by a composite of 18 variables.

"We really hope this represents a call to action," said Reed Tuckson, an official of the Minnesota-based United Health Foundation. "Each state is unique, each has its own problems. The point is to address the problems where you live."

Minnesota has ranked in top 2 for past 15 years

Healthiness has increased for the country and every state since the first report was produced in 1990. Overall improvement has slowed in the past five years, however, and by some measures -- obesity rates, lack of health insurance, poverty levels and infant morality -- national performance is now worsening.

The three healthiest states are Minnesota, New Hampshire and Vermont. Their high ranking reflects, among other things, low rates of poverty and premature death, safer-than-average drivers and generous spending on public health. Minnesota has ranked No. 1 for nine of the past 15 years and has never been out of the top two. At the other end of the list are Tennessee, Mississippi and, as in 14 of the 15 years, Louisiana in last place.

Their low rankings arise from high rates of poverty, infant mortality and cancer, the large numbers of smokers in those states and, with the exception of Tennessee, many people without health insurance.

The project was started by Northwestern National Life Insurance Co. in 1990 as a way to explain why insurers' claims experience differed so much from state to state -- and to identify interventions that might improve a state's health.

United Health Foundation, a public health research organization, took over the project in 1999. In 2001, it was joined by the American Public Heath Association, the professional organization of public health officials, and the advocacy group Partnership for Prevention.

states are scored using data from the Centers for Disease Control and Prevention, the National Safety Council, the Census Bureau and similar agencies. The data fall into four categories: risk behaviors, such as smoking and obesity; health outcomes, such as death rates; community environment, such as crime rates and the number of uninsured; and health policies, and measured by public health budgets.

At the same time that improvements were occurring in some categories since 1990, the prevalence of obesity almost doubled, from 12 percent to 23 percent. Those without health insurance rose from 13 percent to 16 percent. The percentage of ninth-graders who graduated from high school within four years fell from 73 percent to 68 percent.

Last year brought some bad news.

Obesity prevalence increased from 22.1 to 22.8 percent of the population. The percentage of children in poverty rose from 16.3 to 17.6. In the smallest -- but possibly most significant -- change, infant mortality rose for the first time in 40 years, from 6.9 to 7 deaths in the first year of life for every 1,000 live births.

"Given the meaning of infant mortality as the definer of quality of a civilization, this statistic is worrisome," Tuckson said.

The United States is now 28th in the world in infant mortality.

The report reveals wide variations between states in many of the 18 measurements.

• The percentage of children in poverty ranged from 7 percent in New Hampshire and 10 percent in Minnesota to 32 percent in Washington, D.C., and 27 percent in West Virginia, Arkansas and New Mexico.
  
• The high school graduation rate was 90 percent in New Jersey, 84 percent in North Dakota and 83 percent in Iowa, but only 54 percent in Georgia and 49 percent in South Carolina.
  
• Vermont, Massachusetts and Connecticut had the fewest deaths per 100 million miles driven. Montana had the highest motor vehicle death rate - three times Vermot's -- with South Dakota and Mississippi close behind.

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