Special Report

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

11. New Jersey
> Pct. obese
26.9% (10th lowest)
> Cardiovascular deaths per 100,000 people: 246 (22nd highest)
> Primary care physicians per 100,000 people: 145 (8th highest)
> Pct. with health insurance: 87.9% (25th lowest)

Two primary causes of preventable death are tobacco use and obesity, and New Jersey’s population is among the healthiest by both of these measures. Roughly 15% of the state’s adult population smokes, versus the 18.1% of U.S. adults who do. Similarly, the state’s obesity rate of 26.9% is the 10th lowest and compares to a national rate of just under 30%.

One potential area of concern is the recent increase in drug-related deaths in the state. In the past two years, drug-related fatalities increased from 6.9 deaths per 100,000 people to 13.1 deaths per 100,000 residents.

12. North Dakota
> Pct. obese
32.2% (9th highest)
> Cardiovascular deaths per 100,000 people: 225 (17th lowest)
> Primary care physicians per 100,000 people: 122 (25th highest)
> Pct. with health insurance: 90.9% (10th highest)

North Dakota has undergone a recent economic boom due to the development of new oil fields in the state. As a result, the state now has an unemployment rate of just 2.8%, the lowest in the country. The state’s median annual household income of $60,730 is well above the national median of $53,657. A strong economy and good-paying jobs usually contribute to better health outcomes in a state, and that appears to be the case in North Dakota. In the last five years, the incidence of preventable hospitalizations declined by nearly 27%, one of the larger declines in the country. On average, North Dakota residents report just 2.9 days of poor physical health per month, lower than in any other state and a full day below the national average.

13. New York
> Pct. obese
27.0% (12th lowest)
> Cardiovascular deaths per 100,000 people: 259 (17th highest)
> Primary care physicians per 100,000 people: 170 (5th highest)
> Pct. with health insurance: 90.3% (13th highest)

Poor people living in areas with greater income inequality tend to have worse health than poor people living in areas with less disparity. New York has the greatest level of inequality of any state, yet is the 13th healthiest in the country, in part because of its residents’ relatively healthy behavior. The state reports low chronic drinking and obesity rates, as well as the fourth lowest smoking rate of all states. However, New York also has relatively high incidence of heart disease, high blood pressure, high cholesterol, and deaths due to cardiovascular diseases.

14. Rhode Island
> Pct. obese
27.0% (12th lowest)
> Cardiovascular deaths per 100,000 people: 230 (20th lowest)
> Primary care physicians per 100,000 people: 180 (4th highest)
> Pct. with health insurance: 90.5% (12th highest)

Rhode Island has some significant public health issues. For example, the state has one of the highest rates of drug deaths in the country. Each year, the state records nearly 20 drug-related deaths per 100,000 people, more than seven times the rate in North Dakota, where the least drug deaths per capita occur. Also, over one in five adults in the state report excessive drinking, higher than the 17.6% of Americans who drink excessively nationwide.

Still, the Ocean State ranks highly in several other health related measures. It has the highest immunization rate among children, as well as a high concentration of primary care physicians per capita. The state also spends a great deal — $111 per capita — on programs intended to advance public health. That is roughly $25 more in public health funding per person than the country as a whole.

15. Maine
> Pct. obese
28.2% (18th lowest)
> Cardiovascular deaths per 100,000 people: 219 (12th lowest)
> Primary care physicians per 100,000 people: 135 (12th highest)
> Pct. with health insurance: 89.3% (19th highest)

While not among the healthiest states, Maine improved significantly in public health in the past year. The state’s ranking improved from 20th last year to 15th this year. One reason for the state’s improvement is a marked increase in the newborn vaccination rate. Maine’s immunization rate for children aged 19 to 35 months is 84.7%, a significant increase from 68.0% a year prior, and the highest percentage of all states. Maine is also among the best in the country in preventing the spread of infectious diseases such as chlamydia and salmonella.

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