A Better State Of Health

Since 1990, the nation's health has improved by more than 15 percent, according to the latest report from the UnitedHealth Foundation, an affiliate of Minneapolis-based health care company UnitedHealth Group.

The report analyzed 17 fine-tuned indicators of public health, such as death and disease rates and poverty and crime statistics, to determine each state's health trends. Researchers found health improvements across all states: 32 percent decline in infant mortality, 27 percent lower incidence of infectious disease, 23 percent reduction in child poverty, 22 percent drop in smoking, and 17 percent less violent crime overall.

Although the long-range trend is positive, the overall health of the United States did decrease about 1 percent in the past year, primarily because of a drop in support for public health care and a slight increase in premature death rates. Also, the report authors urge the top-ranking states to avoid complacency because even those states have weak spots.

For example, the healthiest state for two years running has been New Hampshire, claiming top scores in prenatal care and support for public health care. The state also has the lowest infant mortality at less than four deaths per 1,000 births. Some of its biggest challenges, however, are the prevalence of smoking—24 percent of New Hampshirans smoke—and violent crimes, which increased from 97 to 175 per 100,000 residents since 2001.

Second place goes to Minnesota—a state boasting low premature death rates. Minnesota also has strong public support for health care, has few uninsured residents, and has few children in poverty. Even so, the state still has relatively poor prenatal care—little more than 75 percent of pregnant women receive adequate care.

Massachusetts, the third-healthiest state in 2002, has the fewest motor-vehicle deaths and ranks among the top five for high support for public health care, low prevalence of smoking, and low infant mortality. But the state has a high violent crime rate at 476 offenses per 100,000 people.

Movin' On Up
Topping the list of most-improved states, Wyoming showed a 32 percent reduction in child poverty and a drop in the incidence of infectious diseases, from 47.8 to 12.1 per 100,000 residents in the past year. Nevada was runner-up, with a 27 percent decline in child poverty and 22 percent fewer uninsured people. Although several states showed marked improvement (see "Movin' On Up," right), Louisiana, ranked 50th, trails most of its peers in 15 of 17 study categories. The noted exceptions are that the state has good prenatal care and a low incidence of smoking.

The study offers indicators of progress and suggests which areas need improvement for individual states. The study does not offer recommendations because the researchers believe each state should address its own challenges with unique solutions that stimulate continued improvements in the nation's health.

—Chris O'Brien