Online-only: America’s overall health improving in some areas, declining in others
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* Teddi Dineley Johnson

The nation’s overall health has improved slightly, according to a new report, but rising rates of obesity, children living in poverty and diabetes continue to be worrisome for states’ health.

The report, which annually ranks the nation’s health on a state-by-state basis, shows improvements in some areas of America’s health status, including preventable hospitalizations and infectious diseases. Tobacco use has also declined, according to the 2010 edition of “America’s Health Rankings,” and four states — Utah, California, Massachusetts and Washington — have driven their smoking rates to less than 15 percent, which is a goal for all states. But while smoking has decreased to a 21-year low in the United States, tobacco use rates are still unacceptably high, according to the report.

“Obesity and tobacco use are top contributors to a variety of diseases, including heart disease, cancer, stroke, diabetes and other leading causes of premature death and disability,” said Georges C. Benjamin, MD, FACP, FACEP (E), executive director of APHA, which publishes the rankings jointly with United Health Foundation and Partnership for Prevention. “We cannot avoid these critical public and personal health battles. We must work with multiple stakeholders and our public health partners to develop comprehensive solutions to solve this problem.”

Released in December, the report found that the prevalence of obesity in the United States has climbed 132 percent over the past decade, rising from about 12 percent in 1990 to nearly 27 percent of Americans now tipping the scales into the obesity range. The prevalence of obesity ranges from about 19 percent in Colorado to more than one-third of population in Louisiana and Mississippi. On a more positive note, 16 states maintained or decreased their rates of obesity in the last year.

Rising rates of obesity are also contributing to an epidemic of diabetes in the United States. According to the report, the number of adults diagnosed with diabetes has climbed 19 percent since 2005. A report released in October by the U.S. Centers for Disease Control and Prevention warned that as many as one in three U.S. adults could have diabetes by 2050 if current trends continue.

Equally troubling is that more children than ever are living in households below the poverty threshold established by the U.S. Census Bureau. According to the report, about 21 percent of U.S. children younger than 18 are living in poverty, up from about 17 percent in 2007. Children living in poverty face challenges that include lack of access to health care, limited availability of healthy foods and fewer choices for physical activity and educational opportunities.

For the fourth consecutive year, the report ranks Vermont at the top of list of the nation’s healthiest states. Vermont has climbed steadily in overall health for the last 12 years, according to the report, which highlights the state’s low rate of uninsurance, high rate of public health funding, ready access to early prenatal care and high rate of high school graduation. Also ranked near the top are Massachusetts, which the report placed second in the nation for overall health, followed by New Hampshire, Connecticut and Hawaii.

Mississippi — with its high rates of obesity and children living in poverty — continues to trail the nation in terms of overall health, with Louisiana, Arkansas, Nevada and Oklahoma rounding out the bottom five.

The annual assessment of the nation’s health draws on data from a variety of sources, including the Centers for Disease Control and Prevention, the American Medical Association, the U.S. Department of Education and the U.S. Census Bureau.

For more information or to download a copy of the report, visit [www.americashealthrankings.org](http://www.americashealthrankings.org).

*   Copyright The Nation’s Health, American Public Health Association