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America's annual health report card now available

Robin Wulffson MD's picture
health status, state-by-state, smoking, obesity, diabetes, sedentary lifestyle

On December 11, Unite Health Foundation released their annual America’s Health Rankings, which is an annual comprehensive assessment of the nation’s health on a state-by state basis. Sorry America, you did not earn an A; however, some areas of improvement were noted.

The report, which is published jointly by United Health Foundation, American Public Health Association, and Partnership for Prevention, found that unhealthy behavior and preventable illnesses threaten many American’s length and quality of life. Some unhealthy behaviors, such as smoking, have leveled off; however, 21% of Americans are still lighting up. More disturbing is the fact that 1,000 children a day are puffing on coffin nails. Here are some highlights of the report:

  • Advances in medicine cannot offset Americans’ unhealthy lifestyles.
  • Nearly 28% of the population is obese and more than 26% get no exercise, resulting in increasing prevalence of diabetes and high blood pressure.
  • Where people live matters: significant differences define five healthiest and least healthy states.

For the sixth year in a row, Vermont is the nation’s healthiest state. Hawaii is ranked second, followed by New Hampshire, Massachusetts, and Minnesota. The five least healthy states are South Carolina (46), West Virginia (47), Arkansas (48), and Mississippi and Louisiana, which tied for the 49th slot. States that showed the most substantial improvement in rankings include: New Jersey (nine slots), Maryland (five slots), and Alabama, Colorado, Massachusetts, Nebraska, Oklahoma and Rhode Island (three slots).

The death rates in the following areas have declined: premature (18% decline), cardiovascular (34.6% decline), and cancer (7.6%). However, Americans are experiencing troubling levels of obesity (27.8% of the adult population), diabetes (9.5% of the adult population), high blood pressure (30.8% of the adult population) and sedentary behavior (26.2% of the adult population).

“As a nation, we’ve made extraordinary gains in longevity over the past decades, but as individuals we are regressing in our health,” said Reed Tuckson, M.D., medical adviser, United Health Foundation, and executive vice president and chief of medical affairs, UnitedHealth Group. “We owe this progress not only to medical breakthroughs, but to public health advocates who are working tirelessly to advance wellness on the community level. But our public health heroes cannot do it alone. Longer lives need not be sicker lives, so we must all come together to do more to prevent the risk factors within our personal control.”

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“The detailed information in the Rankings provides a roadmap for helping America become healthier,” said Eduardo Sanchez, M.D., chairman, Partnership for Prevention. “Even the healthiest states can identify areas for improvement, while those with lower rankings can see what’s possible by looking at where they stand.”

Sedentary behavior, which is defined as not doing any physical activity outside of work for the last 30 days, is at dangerous levels, affecting 26.2% of Americans. Rates of sedentary behavior are as high as 35.0% of the adult population in Mississippi, Tennessee and West Virginia. These statistics need to be understood in the context that even minimal action can produce meaningful results, as evidenced by a recent study that showed that moving from sedentary to mild activity increases life expectancy by 1.8 years.

Obesity continues to be at epidemic levels and is one of the fastest-growing health challenges confronting our nation. The national median of obese adults is 27.8%; that means more than 66 million adults are obese, more than the entire population of the United Kingdom. In even the least obese state, Colorado, more than 20% of the population is obese. The combination of sedentary behavior and poor diet inevitably lead to increasing levels of obesity, which contributes to diabetes, cardiovascular disease, cancer and other negative health outcomes. Additionally, the economic burden of obesity is worrisome. By 2030, medical costs associated with treating preventable obesity-related diseases are estimated to increase to $66 billion per year, and the loss in economic productivity could be between $390 billion and $580 billion annually, according to F as in Fat: How Obesity Threatens America's Future 2012, a report released by Trust for America's Health and the Robert Wood Johnson Foundation.

Diabetes is also at epidemic levels. The percentage of adults with diabetes is as high as 12.0% in West Virginia, South Carolina and Mississippi. The national median of adults with diabetes is 9.5%. A 2010 report from the UnitedHealth Center for Health Reform & Modernization indicates that if these rates are not reduced, diabetes and pre-diabetes will account for about 10% of total health care spending by 2020, at an annual cost of almost $500 billion.

America’s Health Rankings also finds that 30.8% of adults nationwide say they have elevated blood pressure, which is a primary risk factor for cardiovascular disease. The prevalence of high blood pressure ranges from a low of 22.9% of adults in Utah to a high of 40.1% in Alabama. A recent study from the Centers for Disease Control and Prevention found that 39.4% of hypertensive adults are unaware of their high blood pressure, indicating that the actual burden of hypertension might be even higher than 30.8%. The same CDC study found that 53.5% of adults who know they have hypertension do not have their condition under control.

The complete report is available at this link.

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