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Senior Citizen Health & Medicine

America's Health Rankings Finds Only Slight Progress Since Last Year

Life expectancy trails 27 nations, Minnesota still healthiest state

December 5, 2006 – The 17th annual edition of America's Health Rankings were released today, showing only slight improvement over last year - Americans as a whole are only 0.3 percent healthier than they were at this time last year. It also points out that life expectancy in the U.S. still lags far behind 27 other countries. It does have good news if you live in Minnesota, the healthiest state for the fourth year in a row and tied for first in the rate of cardiovascular deaths. (See state chart below news report.)

This 0.3% increase in health for Americans is significantly lower than the nation's average annual improvement of 1.5% documented between 1990 and 2000, and only keeps pace with the 0.3% 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, funded by UnitedHealth Group, in partnership with the American Public Health Association and Partnership for Prevention, is a yearly assessment of the relative healthiness of the nation.

It is 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.

Why has health status stagnated?

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(TM) 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 Rankings(TM) 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 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.

Medicare records show wide differences in chronic illness 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."

>> To view the entire report, please visit http://www.americashealthrankings.org/ or http://www.unitedhealthfoundation.org/ .

Cardiovascular Death Rates by State

Cardiovascular Deaths is measured using a three-year average, age- and race-adjusted death rate due to heart disease, strokes and other cardiovascular disease. The effect of cardiovascular disease on health was measured using mortality data due to the improved accuracy of the data and the ability to adjust for age and race.   

The use of mortality data may not reflect the full impact of cardiovascular disease.  Data also do not reflect new procedures to treat heart disease and prolong the useful lives of patients. 

The table below displays the 2006 ranks, based on 2001 to 2003 data (Centers for Disease Control and Prevention).  This component varies from a low of 230.9 deaths from cardiovascular disease per 100,000 population in Hawaii to over 400 deaths per 100,000 population in Oklahoma and Mississippi.  The national average is 326.0 deaths per 100,000 population, down from 332.9 deaths per 100,000 population last year and 406.3 deaths per 100,000 population in 1990.  

In the last year, the rate of deaths from cardiovascular disease decreased by 19.9 deaths per 100,000 population in Hawaii.  Oklahoma, Louisiana, Alabama, Utah and West Virginia were the only states to experience an increase.   Since 1990, the rate of deaths from cardiovascular disease declined by more than 100 deaths per 100,000 population in 11 states and by more than 75 deaths per 100,000 population in another 19 states.  Oklahoma experienced the least improvement in the rate of deaths from cardiovascular disease, declining by only 7.9 deaths per 100,000 population.  In Mississippi, the rate of deaths from cardiovascular disease decreased by only 24.7 deaths per 100,000 population.

Cardiovascular Deaths