State Health Rankings show 17.5 percent improvement in America’s overall health during the past 15 years

United Health Foundation, together with the American Public Health Association (APHA) and Partnership for Prevention, today released the 15th annual America’s Health: State Health Rankings at the APHA’s Annual Meeting in Washington, D.C.

This year’s report reveals a 17.5 percent improvement in America’s overall health during the past 15 years. However, the report also shows that the rate of improvement is slowing significantly due to a combination of personal, community and public health issues. During the 1990s, health in the United States improved by an annual rate of 1.5 percent each year. However, during the 2000s, health in the United States has improved by an annual rate of only 0.2 percent each year – 1/8 the rate experienced during the 1990s.

“During the last four years, the data clearly indicate that we as a nation still have a lot more work to do in improving risk factors that result in disease. This year’s report specifically highlights the prevalence of obesity, the infant mortality rate – which has experienced its first increase in 40 years – and access to essential health services as priorities for action,” explained Dr. William McGuire, chairman of the United Health Foundation board. “It is the foundation’s hope that individuals, community leaders and those involved in creating public policy will use the information found in America’s Health: State Health Rankings – in addition to other state-specific data – to address the factors that affect the overall health of their communities.”

America’s Health: State Health Rankings is a comprehensive, multi-dimensional, yearly analysis of the relative healthiness of the American population using information supplied by credible sources such as the U.S. Departments of Health and Human Services, Education, and Labor and the National Safety Council. Led by the School of Public Health at the University of North Carolina at Chapel Hill, a distinguished panel of public health scholars oversees the methodology for the rankings, and an independent research group analyzes the data to author the report.

America’s Health: State Health Rankings utilizes 18 measures that include prevalence of smoking, high school graduation rates, infant mortality rates, premature death, and per capita public health spending to produce a composite assessment of each state’s health. Ultimately, these measures reflect three essential contributors to healthiness: the decisions made by individuals that promote health and prevent disease; the community environment that affects the health of individuals and families; and the health policies made by public and elected officials that determine the availability of public health and medical-care resources.

Perhaps no issue better illustrates how these three categories affect health than the increasing prevalence of obesity. This year’s report reveals that the prevalence of obesity has increased by 97.0 percent since 1990, and now affects 22.8 percent of the total population of the United States. Obesity is known to contribute to a variety of diseases, preventable healthcare costs and diminished workplace productivity.

“If we are to succeed in combating the obesity epidemic, individuals need to make responsible choices, communities need to mobilize resources, and effective public policies need to be enacted that promote appropriate childhood nutrition and encourage physical activity,” added Dr. Reed Tuckson, vice president for United Health Foundation.

“While we as a nation must focus on persistent challenges, we must also celebrate and learn from our successes,” stated Dr. Georges Benjamin, executive director of the APHA. “During the past 15 years, each state has effectively addressed health challenges with innovative solutions, and, therefore, each state has experienced real success in targeted areas.”

The 2004 edition of America’s Health: State Health Rankings reports that Minnesota, New Hampshire and Vermont are the healthiest states in the country, followed by Hawaii, Utah and Massachusetts. The least healthy states are Tennessee (48), Mississippi (49) and Louisiana (50).

As noted before, the trend of very minimal health improvement, which began in 2000, was again demonstrated by the modest 0.6 percent health status improvement in this year’s report. Unfortunately, challenges that frustrated opportunities for greater improvement in overall health status included an 8.0 percent increase in the percentage of children living in poverty; a 2.6 percent increase in the percentage of people who were uninsured; a 3.2 percent increase in the percentage of obese persons; and a 1.4 percent increase in the infant mortality rate.

“At its essence, this report is a call to action,” explained John Clymer, president of Partnership for Prevention. “It provides important information that should mobilize policymakers, community leaders, employers and individuals to contribute to the advancement of their own healthiness as well as the healthiness of their state and nation.”

The 2004 edition of the rankings marks the 15th annual report about the healthiness of each state’s population and of the nation as a whole. In the past 15 years, the report has proven to be an important resource for citizens and communities and has helped to raise awareness of public health issues. With the assistance of the media, it has helped to stimulate discourse regarding the quality of health in communities across the nation. It also has been a valuable tool in assisting public officials and state legislators in their deliberations regarding interventions to improve the quality of health in their states.

“The methodology devised for this report is a direct reflection of the evolving expectations and role of health in our society as well as our ability to measure the numerous aspects that affect health,” said Tom Eckstein, principal, Arundel Street Consulting – the research group that analyzes the data.

United Health Foundation was established in 1999 by UnitedHealth Group as a nonprofit, private foundation. Sponsoring this report is evidence of United Health Foundation's commitment to providing information in support of the health and medical decisions made by physicians and health professionals, individuals and community leaders that lead to better health outcomes and healthier communities.

The complete report, in addition to more information about United Health Foundation and its work, is available at

The American Public Health Association, the oldest and largest organization of public health professionals, represents more than 50,000 members from over 50 public health occupations. More information is available at

Partnership for Prevention is a nonprofit, nonpartisan organization that develops evidence-based solutions to major national health challenges. Partnership's mission is to improve Americans' health by preventing illness and injury and by promoting health. Its members include leading employers, healthcare providers, patient groups, health policy organizations, academic health centers and public health agencies. Information about policies and interventions to improve states' health status is available at and


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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