Special Report

America's Most (and Least) Healthy States

4. Kentucky
> Pct. obese: 33.2% (5th highest)
> Cardiovascular deaths per 100,000: 297.3 (8th highest)
> Physicians per 100,000: 103.0 (13th lowest)
> Pct. visiting dentist in 2012: 56.4 (25th highest)

While nationally cancer deaths have fallen 4% since 1990 to a rate of 189 per 100,000 Americans, the prevalence of cancer in Kentucky remain stubbornly high. Kentucky led the nation with 228 cancer deaths per 100,000 people. The popularity of tobacco in the state likely contributed to the cancer death rate. More than 26% of residents reported a smoking habit, a higher rate than in every state except for West Virginia. Residents also struggled with obesity. Nearly a third of residents were considered obese, one of the highest rates nationwide. Kentucky also led the nation for youth obesity, with 18% of teenagers considered obese. Economic factors likely play a role in the state’s poor health outcomes. For example, nearly 32% of children in Kentucky lived in poverty last year, the worst rate nationwide.

3. Louisiana
> Pct. obese: 33.1% (6th highest)
> Cardiovascular deaths per 100,000: 307.5 (5th highest)
> Physicians per 100,000: 123.7 (20th highest)
> Pct. visiting dentist in 2012: 49.6 (12th lowest)

Like all of the least healthy states, Louisiana’s obesity rate was relatively high last year. More than 33% of adults were considered obese, the sixth highest rate. While the national obesity rate rose from a year ago, it actually fell slightly in Louisiana from the year before. Poor diets among state residents also contributed to Louisiana’s low health ranking. On average, residents in only one other state consumed less vegetables daily than people in Louisiana. Smoking was also more common in Louisiana than in all but a handful of states. Unhealthy habits tend to be more common in poorly educated populations. The four-year graduation rate for Louisiana ninth graders was 72%, worse than in all but four other states. Louisiana households were also the poorest in the nation with a median household income of less than $40,000 in 2013.

2. Arkansas
> Pct. obese: 34.6% (3rd highest)
> Cardiovascular deaths per 100,000: 313.7 (4th highest)
> Physicians per 100,000: 102.6 (12th lowest)
> Pct. visiting dentist in 2012: 41.7 (the lowest)

While more than 70% of children had been immunized nationwide in 2013, just 57% of children in Arkansas were vaccinated, the worst rate in the country. Arkansas residents were also the least likely to make an annual visit to the dentist, with less than 55% doing so last year. And like all unhealthy states, Arkansas residents struggled with obesity. Nearly 35% of state residents were considered obese last year, the third highest rate nationwide. Nearly 18% of high school-aged residents were also considered obese, the second-highest rate. Low incomes likely contributed in part to poor health outcomes. A typical household made $39,919 in 2013, less than every state except for Louisiana.

1. Mississippi
> Pct. obese: 35.1% (the highest)
> Cardiovascular deaths per 100,000: 346.0 (the highest)
> Physicians per 100,000: 81.8 (2nd lowest)
> Pct. visiting dentist in 2012: 41.9 (2nd lowest)

Mississippi is once again the least healthy state in the nation. More than 35% of residents were obese last year, the highest rate in the U.S. This was likely due in part to just 61.9% of residents reporting exercising routinely, the lowest rate nationwide. Based on daily vegetable consumption, Mississippians also had the worst diets in the country. In terms of clinical care, the state is in need of improvement. There were 41.9 dentists and 81.8 primary care physicians per 100,000 people, both the second-lowest rates in the country. Premature death was estimated to have cost roughly 10,354 years of life for every 100,000 residents, the highest figure reviewed. Specifically, there were 346 cardiovascular deaths per 100,000 people, the highest in the nation. Yet another example of the residents’ poor health and of Mississippi’s poor quality health care system is the infant mortality rate, which, at 9.1 deaths per 1,000 live births, was the worst rate in the country.

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