America’s overall health is being undermined by obesity and diabetes, other chronic diseases, and child poverty; these detriments have been deemed greater than the benefits from improvements in cardiovascular deaths, preventable hospitalizations and smoking cessation, says a new report titled 2011 America’s Health Rankings.

The Rankings is a collaboration between United Health Foundation, the America Public Health Association, and Partnership for Prevention.

No improvement in overall health – while the country’s overall health improved by an average of 0.5% from 2000 to 2010 and 1.6% since the 1990s, the rate was unchanged from 2010 to 2011, the authors wrote.

Vermont is still the healthiest state in the USA, and has been so for the last five years. New York and New Jersey moved up six places and are the most improved states – mainly due to the impressive numbers of people who gave up smoking. Idaho has slipped from ninth to nineteenth place, while Alaska went down five places.

Below are the five healthiest and five unhealthiest states, according to the report:

    Five healthiest states

  • 1. Vermont, score +1.197
  • 2. New Hampshire, score +1.027
  • 3. Connecticut, score +1.010
  • 4. Hawaii, score +0.940
  • 5. Massachusetts, score +0.906
  • Five unhealthiest states

  • 46. Alabama, score -0.607
  • 47. Arkansas, score -0.622
  • 48. Oklahoma, score -0.669
  • 49. Louisiana, score -0.817
  • 50. Mississippi, score -0.822

United Health Foundation board member and executive vice president and chief of medical affairs, UnitedHealth Group, Reed Tuckson, M.D., said:

“Where people live matters. Every state can make improvements to ensure healthier quality of lives for their residents. In the history of the Rankings, we have seen many examples of stakeholders coming together to improve their standing.

States such as Tennessee and Maine – which made explicit efforts to improve their rankings – have shown us that improved public health is achievable but must be tackled in a concerted and aggressive way.”

Jud Richland, M.P.H., president and CEO of Partnership for Prevention, said:

“The Rankings provides comprehensive data states can use to develop prevention solutions and health-improvement plans – empowering their residents to live long, healthy and productive lives.”

The authors explain that their latest Rankings give a snapshot of each state, and is based on 23 measures that include several promising trends:

  • Smoking – there are 25.4% fewer smokers in the USA today than in 2001. In 2011, 17.3% of US adults smoked, compared to 17.9% a year before.
  • Preventable hospitalizations – there were 68.2 preventable hospitalizations per 1,000 Medicare beneficiaries in 2011, compared to 70.6 a year before – 17.3% less than in 2001.
  • Cardiovascular deaths – in 2011, there were 270.4 cardiovascular deaths per 100,000 people, compared to 278.2 a year before – a 22.2% drop since 2001.

The following undesirable trends more than offset improvements:

  • Childhood poverty – 21.5% of US children lived in poverty in 2011, compared to 20.7% a year before – 33.5% more than in 2001.
  • Diabetes – 8.7% of US adults were diagnosed with diabetes in 2011, compared to 8.3% a year before – 42.6% higher than in 2001.
  • Obesity – the national adult obesity rate reached 27.5% in 2011, compared to 26.9% a year before – up 37.5% compared to 2001. This year is the first in which not one US state has an obesity rate below 20%.

The authors remarked on how good and bad trends erased each other out – for every person who gave up smoking in 2011, another became obese.

Dr. Tuckson said:

“While this year’s Rankings shows some important improvements, we also see some very alarming trends – particularly diabetes and obesity – that, left unchecked, will put further strain on our country’s already strained health care resources.

At a time when the nation, states and individual families are grappling with tightening budgets and growing health care expenses, this year’s Rankings sends a loud wakeup call that the burden of preventable chronic disease will continue to get worse unless we take urgent action.

Broad collaboration is the only path to health and financial progress. Government, the private sector, philanthropy and community-based organizations all need to join in a data-driven process to determine and address priorities.”

Georges C. Benjamin, M.D., executive director of the American Public Health Association, said:

“Addressing the leading causes of these largely preventable diseases is essential if we are going to improve the nation’s health. America’s Health Rankings gives us a tool to gauge where we are and where we need to go, and the numbers should drive us to action.”

Even though smoking prevalence has dropped from 29.5% in 1990 to 17.3% this year, it is still the cause of 1 in every 5 premature deaths per year (443,000).

In 1990, only 11.6% of US adults were obese, compared to 27.5% this year, an increase of 137%. More than 1 in every 4 adults are obese today; approximately 65 million people. Obesity prevalence continues to increase and is costing the nation $147 billion just in direct health care expenditure. Experts say the main reason for the obesity explosion is bad eating habits and lack of physical activity.

There are over 20 million adults in the USA today who have been diagnosed with diabetes, i.e. 8.7% of all adults. In 1996, the figure was 4.4%. Studies have indicated that within the next four decades between 1 in every 3 to 5 adults will have been diagnosed with diabetes. The authors say this means there are millions of people today who are either at risk of developing diabetes, or already have it but do not know (have not yet been diagnosed).

By the end of this decade, about 10% of all health care spending will be channeled towards treating diabetes and prediabetes – an annual total of nearly $500 billion (compared to $208 billion today).

Written by Christian Nordqvist