Special Report

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

Michael B. Sauter, Thomas C. Frohlich, Evan Comen, Samuel Stebbins

6. Connecticut
> Pct. obese
26.3% (8th lowest)
> Cardiovascular deaths per 100,000 people: 218 (11th lowest)
> Primary care physicians per 100,000 people: 169 (6th highest)
> Pct. with health insurance: 91.8% (6th highest)

The relationship between income and health is complicated. In general, however, people with greater economic resources tend to be able to afford healthier choices and better health care, and they live in communities that promote healthier behaviors. Connecticut has the fourth highest annual median household income in the nation, at $71,161. For many in the state, the higher incomes mean better access to medical care. Nearly 95% of adolescents are immunized against meningitis, for example, the second highest such share nationwide. Additionally, 83.1% of adults have had their blood cholesterol checked in the last five years, also the second highest share in the country. Connecticut has some of the lowest rates of premature death in the country. Each year, residents lose 5,573 years of life due to premature death for every 100,000 residents, third-lowest in the country.

7. Utah
> Pct. obese
25.7% (6th lowest)
> Cardiovascular deaths per 100,000 people: 219 (13th lowest)
> Primary care physicians per 100,000 people: 91 (7th lowest)
> Pct. with health insurance: 86.7% (17th lowest)

Utah is one of the healthiest of all states — likely due in part to its large Mormon population, for whom certain unhealthy behaviors are restricted. Just 9.7% of state adults smoke, the lowest smoking rate nationwide. Similarly, just 12.1% of Utah adults drink excessively, the third smallest share in the country. Healthy behaviors in the state have likely contributed to its relatively strong health outcomes. Utah has the lowest share, 7.1%, of adult residents with diabetes, which is the seventh leading cause of death in the United States. Utah also has a relatively low death rate from cancer, which nationwide is the second leading cause of death. There are 146.1 cancer deaths per 100,000 people in Utah annually, the least in the nation per capita.

8. Colorado
> Pct. obese
21.3% (the lowest)
> Cardiovascular deaths per 100,000 people: 196 (2nd lowest)
> Primary care physicians per 100,000 people: 123 (23rd highest)
> Pct. with health insurance: 87.8% (24th lowest)

Obesity is an important factor in measuring an area’s health. It correlates with such healthy behaviors as exercise and diet, and increases the risk of certain diseases. Obesity, along with tobacco use, is one of the leading causes of preventable death in the country — and Colorado has the lowest obesity rate in the country. While nearly 30% of American adults are obese, just 21.3% of Colorado adult residents are.

On the other hand, Colorado residents report relatively high rates of binge drinking. Also, exposure to the state’s cold weather may contribute to the relatively high incidence of pertussis — whooping cough — at 27.3 cases per 100,000 people annually, fifth highest. Still, its residents tend to live longer and healthier than most Americans. Residents report a very low incidence of a range of maladies, ranking in the best three for heart disease, diabetes, cancer deaths, cholesterol, and stroke.

9. Washington
> Pct. obese
27.3% (13th lowest)
> Cardiovascular deaths per 100,000 people: 213 (6th lowest)
> Primary care physicians per 100,000 people: 128 (16th highest)
> Pct. with health insurance: 88.4% (24th highest)

The primary factor contributing to good health in Washington is its strong clinical care. Just 6.4% of babies are born with low birthweight, less than the 8.0% of babies born with low birthweight nationwide. Good prenatal care may also be partially responsible for the state’s low infant mortality. In Washington, five children die before turning one year old out of every 1,000 live births, one of the lowest infant mortality rates in the country.

Many Washington residents only visit the hospital when they actually need to, reducing unnecessary exposure to disease. The incidence of preventable hospitalizations in Washington is the sixth lowest in the country.

10. Nebraska
> Pct. obese
30.2% (20th highest)
> Cardiovascular deaths per 100,000 people: 225 (16th lowest)
> Primary care physicians per 100,000 people: 123 (24th highest)
> Pct. with health insurance: 89.5% (17th highest)

Educated Americans are far less likely to adopt unhealthy behaviors like smoking, and heavy drinking. The higher earning potential from high school and college education also often leads to longer, healthier lives. In Nebraska, 88.5% of ninth graders graduate within four years, the second highest graduation rate in the country. Drug deaths, a rapidly rising cause of death nationwide, is also fairly low in the Midwestern state. Drugs cause 7.3 deaths per 100,000 residents in Nebraska, compared to 13.5 per 100,000 residents in the country as a whole.

When surveyed about their mental health habits, Nebraska residents responded on average that they experienced 2.8 days of poor mental health and 3.0 days of poor physical health out of the last 30 — both the third lowest of any state.