Special Report

The Most (and Least) Healthy States: A Survey of All 50

1. Hawaii
> Pct. obese
22.1% (2nd lowest)
> Cardiovascular deaths per 100,000 people: 203 (3rd lowest)
> Primary care physicians per 100,000 people: 141 (9th highest)
> Pct. with health insurance: 94.0% (2nd highest)

Hawaii ranks for the fourth consecutive year as the healthiest state in the country, according to the UHF. It has never ranked worse than sixth overall since the organization introduced the ranking in 1990. The state rates among the top 10 in the majority of health measures as they relate to policy, behavior, and outcomes. It is second best in the country for health insurance coverage, public health funding, and cancer deaths. No state has a lower incidence of preventable hospitalizations than Hawaii.

While it is the healthiest — ranking high in most measures — Hawaii also ranks low in some of the indicators. Specifically, the state has one of the highest rates of chronic drinking, and 44% of Hawaii’s adults fail to get sufficient sleep, a worse rate than in any other state.

2. Vermont
> Pct. obese
24.8% (5th lowest)
> Cardiovascular deaths per 100,000 people: 220 (14th lowest)
> Primary care physicians per 100,000 people: 181 (3rd highest)
> Pct. with health insurance: 93.9% (3rd highest)

Vermont is the second healthiest state in the nation, trailing only Hawaii. The state has some of the nation’s safest communities and strongest health services. With just 121 violent crimes per 100,000 people, Vermont has the lowest violent crime rate in the country — a figure that, when high, can discourage physical activity and cause mental stress. For residents of the state, medical care is very accessible. For every 100,000 Vermonters, there are 181.3 primary care physicians, the third most doctors per capita nationwide. A high prevalence of physicians often coincides with a high health insurance coverage rate. Almost 94% of Vermonters have health insurance, the third largest share in the country.

Vermonters also eat well. The average adult in the state eats 1.5 servings of fruit and 2.0 servings of vegetables every day, a higher consumption and a healthier diet than in all but a few other states.

3. Massachusetts
> Pct. obese
23.3% (3rd lowest)
> Cardiovascular deaths per 100,000 people: 206 (4th lowest)
> Primary care physicians per 100,000 people: 207 (the highest)
> Pct. with health insurance: 96.5% (the highest)

Massachusetts ranks as the third healthiest state for the second consecutive year. One of the strongest indicators of a population’s health is the prevalence of obesity. Obesity can raise the risk of such diseases as heart disease and diabetes, which are some of the most common causes of death. While it is on the rise nationwide, obesity remains a relatively minor problem in Massachusetts compared to most states. Only 23.3% of the state’s adult population is obese, third lowest in the country and well below the 29.6% obesity rate nationwide.

The state also excels in another important health indicator, access to health care. Massachusetts launched health care reform in 2006 that provided near-universal coverage, one of the first states to do so. It now leads the nation in health insurance coverage. Just 3.5% of state residents are not insured, compared to the 13.1% of U.S. residents who are not.

4. Minnesota
> Pct. obese
27.6% (15th lowest)
> Cardiovascular deaths per 100,000 people: 187 (the lowest)
> Primary care physicians per 100,000 people: 146 (7th highest)
> Pct. with health insurance: 93.0% (4th highest)

Minnesota moves back up into the top five after falling to sixth place in the UHF 2014 ranking. While healthy behaviors and healthy outcomes tend to correlate, Minnesota’s residents appear to be in better health than their actions might suggest. The state ranks below the healthiest 10 in smoking, physical inactivity, and obesity, and it has one of the highest excessive drinking rates in the country.

Still, Minnesota has some of the best health outcomes in the country. Residents report the fewest days of poor physical health per month of any state, and they are the least likely to die from cardiovascular diseases. Each year, the state loses a nation-lowest 5,414 years per 100,000 residents on average due to premature death, versus a national rate of 6,997 years lost per 100,000 Americans.

5. New Hampshire
> Pct. obese
27.4% (14th lowest)
> Cardiovascular deaths per 100,000 people: 213 (7th lowest)
> Primary care physicians per 100,000 people: 138 (11th highest)
> Pct. with health insurance: 90.1% (16th highest)

After ranking seventh healthiest last year, New Hampshire improves by two places to rank as the fifth healthiest state in the country today. The improvement is partially due to a decline in sedentary behavior. The share of New Hampshire adults claiming to be physically active increased from 77.6% last year to 81.7% this year.

New Hampshire also has fairly high immunization coverage. Of adolescents between the ages of 13 and 17, 94.4% receive the Tdap vaccine, which protects against tetanus, diphtheria, and pertussis. This is significantly higher than the 87.6% of adolescents who get the vaccine nationwide. The spread of infectious disease is very low in New Hampshire, not just due to high immunization but also responsible and healthy habits. The incidence of chlamydia, for example, is the lowest in the nation. Strong economic conditions are closely tied to positive health outcomes. Just 11.1% of New Hampshire children live below the poverty line, the second lowest child poverty rate in the nation.

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