Special Report

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

21. Virginia
> Pct. obese
28.5% (20th lowest)
> Cardiovascular deaths per 100,000 people: 239 (25th lowest)
> Primary care physicians per 100,000 people: 127 (17th highest)
> Pct. with health insurance: 88.4% (24th highest)

Violence can lead to premature death, and residents of unsafe communities frequently endure higher levels of stress that can also lead to poor health outcomes later in life. Virginia’s violent crime rate of 196 incidents per 100,000 residents each year is nearly the lowest in the nation. However, state residents are by no means the healthiest Americans. In fact, by several measures, the health of Virginians has declined. Drug-related fatalities, while not especially high compared with other states, increased 13% from 8.4 deaths to 9.5 deaths per 100,000 residents. Also, Virginia’s smoking rate of 19.5% is slightly higher than the nationwide share of 18.1% — it also increased from 19.0% over the past two years.

22. Iowa
> Pct. obese
30.9% (16th highest)
> Cardiovascular deaths per 100,000 people: 245 (24th highest)
> Primary care physicians per 100,000 people: 89 (6th lowest)
> Pct. with health insurance: 92.8% (5th highest)

Across the country, 17.6% of Americans drink excessively. In Iowa, 22.3% of residents drink excessively, the third highest share of any state. Heavy drinking may be widespread in the Midwestern state, but drug abuse is not. Drug overdose, a rising cause of death nationwide, is relatively uncommon in Iowa. While each year there are 13.5 deaths from drug overdose per 100,000 Americans nationwide, there are 8.7 drug deaths per 100,000 Iowans — the fourth lowest annual drug death rate in the nation.

Completing high school dramatically increases the likelihood of leading a healthy life. While Iowans are not the healthiest state residents in the nation, strong education in the state has likely contributed to relatively healthy outcomes. In Iowa, 89.7% of high school students graduate within four years, the highest graduation rate in America.

23. Montana
> Pct. obese
26.4% (9th lowest)
> Cardiovascular deaths per 100,000 people: 228 (18th lowest)
> Primary care physicians per 100,000 people: 103 (10th lowest)
> Pct. with health insurance: 84.7% (11th lowest)

Montana has a generally poor immunization record among both adults and children. The state ranks in the bottom 10 for the immunization of human papillomavirus (HPV) — a common sexually transmitted disease — among men, meningitis immunization among adolescents 13 to 17, and the immunization of children aged 19 to 35 months for a variety of ailments. Perhaps in part due to the state’s poor immunization rate, Montana has the highest rate of new cases of pertussis – or whooping cough – at 66 cases per 100,000 people, versus a national rate of nine cases per 100,000 Americans.

Two other health problems that are likely related and that Montana is struggling with are a high suicide rate — the highest in the country — as well as one of the highest rates of chronic drinking. Alcohol abuse has been identified as a determinant of suicide. The state’s suicide rate of 24 suicides per 100,000 residents each year is nearly double the national rate of 13 suicides per 100,000.

24. Wisconsin
> Pct. obese
31.2% (14th highest)
> Cardiovascular deaths per 100,000 people: 237 (24th lowest)
> Primary care physicians per 100,000 people: 125 (19th highest)
> Pct. with health insurance: 91.8% (6th highest)

Excessive drinking can lead to fetal damage, liver disease, hypertension, cardiovascular disease, and other health problems. In Wisconsin, 23.3% of adults drink excessively, a higher share than in any state but North Dakota.

An education is one of the most important steps to leading a healthy life. On average, educated Americans live longer than their less-educated peers. While Wisconsin residents are by no means the nation’s healthiest, 88.0% of students in the state complete high school within four years, tying Texas for the third highest graduation rate nationwide.

25. Wyoming
> Pct. obese
29.5% (24th lowest)
> Cardiovascular deaths per 100,000 people: 231 (21st lowest)
> Primary care physicians per 100,000 people: 89 (5th lowest)
> Pct. with health insurance: 87.3% (21st lowest)

Although Wyoming ranks as the 25th healthiest state, it is leading in one factor that can contribute to better health — child poverty. Children living in poverty are three times as likely to have unmet health needs, and Wyoming’s child poverty rate of 10.6% is the lowest in the country — it is also nearly half the national child poverty rate of 21.1%. However, child immunization rates are relatively low. For example, just 64% of state children aged 19 to 35 months are properly vaccinated. Nationwide, 71.6% of children are vaccinated.

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