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Public Health Rankings

Measuring the health of state populations


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A thick layer of fog rolls over the Mississippi River toward Dubuque, Iowa, Monday, Oct. 23, 2017. (Dave Kettering/Telegraph Herald via AP)

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Public health is worth one-third of the weight in ranking the Best States for health care. This subcategory evaluated six metrics: mortality rate, suicide rate, smoking rate, mental health, infant mortality rate and adult obesity rate. The Centers for Disease Control and Prevention provided the data, which were collected between 2015 and 2016, for each of the public health metrics. A population’s overall health is a strong indicator of the quality of life in a given state, providing insight into access to nutrition, economic challenges and other barriers to health that may persist within a state.

Five of the top-10 states for public health also rank in the top 10 overall: Minnesota, Utah, Washington, Massachusetts and Colorado. Hawaii, which also ranks first in health care, has the second-best public health in the nation. Though California ranks No. 36 for health care access and No. 14 for health care quality, it takes the top spot for public health. Mississippi takes the No. 50 slot, with some of the worst mortality rates, infant mortality rates and obesity rates in the U.S.

Best States for Public Health

Public Health Rank State Low Infant Mortality Rate Low Mortality Rate Low Obesity Rate Low Smoking Rate Low Suicide Rate Mental Health
#1 California CA 4 2 4 2 5 13
#2 Hawaii HI 18 1 3 3 9 3
#3 New York NY 6 3 7 9 2 14
#4 Massachusetts MA 3 8 2 5 3 26
#5 New Jersey NJ 8 7 13 8 1 16
#6 Minnesota MN 15 4 17 14 14 4
#7 Connecticut CT 19 5 9 4 7 18
#8 Colorado CO 7 9 1 17 45 15
#9 Washington WA 10 10 19 7 25 21
#10 Utah UT 12 17 5 1 42 23
#11 Iowa IA 2 23 37 22 19 8
#12 Idaho ID 9 26 14 12 43 17
#13 New Hampshire NH 1 24 10 31 33 33
#14 Vermont VT 5 16 12 24 38 27
#15 Maryland MD 33 19 25 6 4 9
#16 Rhode Island RI 25 13 11 11 8 41
#17 Nebraska NE 20 15 38 23 13 5
#18 Florida FL 29 6 15 16 23 22
#19 Arizona AZ 17 11 22 13 34 25
#20 Illinois IL 27 25 33 18 6 7
#21 Virginia VA 24 18 21 15 18 19
#22 Texas TX 21 27 43 10 10 12
#23 Oregon OR 14 14 20 19 40 36
#24 Wisconsin WI 23 20 28 25 22 24
#25 Wyoming WY 11 22 16 34 48 28
#26 Kansas KS 26 32 29 26 32 6
#27 New Mexico NM 13 31 18 21 47 30
#28 Montana MT 22 28 6 33 49 11
#29 South Dakota SD 41 21 23 32 39 1
#30 Nevada NV 16 34 8 20 46 45
#31 North Dakota ND 39 12 36 38 35 2
#32 Pennsylvania PA 28 35 26 30 24 32
#33 Maine ME 32 33 24 37 30 34
#34 North Carolina NC 44 36 35 28 15 29
#35 Michigan MI 31 37 41 40 17 40
#36 Alaska AK 35 29 30 35 50 10
#37 Delaware DE 49 30 27 27 11 20
#38 Georgia GA 47 38 31 29 16 31
#39 Missouri MO 30 39 34 44 37 39
#40 South Carolina SC 36 40 39 39 28 43
#41 Ohio OH 40 41 32 45 21 35
#42 Indiana IN 42 42 40 41 26 38
#43 Tennessee TN 37 44 45 43 29 42
#44 Louisiana LA 46 43 46 47 20 37
#45 Oklahoma OK 43 45 42 36 44 46
#46 Kentucky KY 34 48 44 49 31 48
#47 Alabama AL 48 47 48 42 27 47
#48 Arkansas AR 45 46 47 48 36 49
#49 West Virginia WV 38 49 50 50 41 50
#50 Mississippi MS 50 50 49 46 12 44

Low Infant Mortality Rate

This metric measures the number of infant deaths per 1,000 live births in 2015. The infants could have died at any point before their first birthday. Half of the top-10 states with the lowest infant mortality rates were in the Far West or New England, and with an infant death rate of just 4.1 per 1,000 live births, New Hampshire ranked first for this metric. In No. 50 Mississippi, the rate was 9.45 infants in 2015.

The infant mortality rate of for black America is more than double the rate for white babies. Many of the top-10 states with the lowest infant mortality rates also have a smaller black population than the national average of 12 percent, the exceptions New Jersey and New York, according to 2015 U.S. Census data. A combination of factors contribute to the higher infant death rate for black babies, who are more likely to be born less healthy and to less-educated mothers.

Low Mortality Rate

This measures the number of deaths in a state in 2016. The rate was then age-adjusted per a population of 100,000. A lower mortality rate indicated a higher ranking for this metric. With 572 deaths per 100,000 people, No. 1 Hawaii had the lowest mortality rate in 2016, followed by California. Mississippi ranked last with nearly 949 deaths per 100,000 people. Regionally, the Far West had the lowest mortality rate, followed by New England and the Mid-Atlantic states.

Since 1970, the U.S. has seen a substantial decline in mortality among middle-aged and elderly Americans, fueled by a combination of prevention, treatment and behavior changes. However, the mortality rate for whites ages 45 to 54 has spiked in the last two decades, particularly among women, though men still have higher mortality rates and tend to die at a younger age.

Low Obesity Rate

In 2016, more than one in three Americans were obese, a figure that has increased sharply since the 1980s. Obesity significantly increases the risk for life-threatening and chronic conditions including heart disease, stroke and Type 2 diabetes, which together cost the U.S. billions of dollars annually.

This evaluates the percentage of adults in a state who were obese in 2016. Obese adults are those who have a body mass index of 30 or higher; a healthy BMI is typically between 18.5 and 24.9. A lower obesity rate indicated a higher ranking for this metric. In Colorado, which ranked first, about one in five adults were obese in 2016, while in No. 50 West Virginia, approximately 38 percent of adults were obese. Fellow Southeast states Mississippi, Alabama, Arkansas and Louisiana rounded out the five states with the highest adult obesity rates in 2016.

Low Smoking Rate

Smoking is the leading cause of preventable deaths in the U.S., and contributes to more than a quarter of cancer deaths. Still, the number of adult smokers has steadily declined over the past few decades, with a sharp drop from nearly 21 percent in 2005 to 15.5 percent in 2016.

This metric measures the percentage of a state’s adult population that smoked cigarettes in 2016. The Centers for Disease Control and Prevention asked adults to identify as smokers or non-smokers, and those who refused to answer were not counted for this metric. A lower smoking rate earned states a higher ranking for this metric. In No. 1 Utah, less than 9 percent of adults smoked, while in No. 50 West Virginia, 1 in 4 adults smoked cigarettes in 2016. All five of the states with the highest smoking rates are located in the Southeast.

Low Suicide Rate

Suicide is one of the leading causes of death in the U.S., and suicide rates have been increasing for nearly 20 years, particularly among middle-aged men and adolescent girls. Historically, suicide rates are about four times higher among males than females, though two to three times more females attempt suicide than males. In 2016, white males accounted for 70 percent of suicides in the U.S.

This metric evaluates the number of suicides per 100,000 people in 2016, with a lower rate earning states a higher ranking. With less than 8 suicides per 100,000 people, New York was first for this metric, while No. 50 Alaska had slightly more than 26 suicides per 100,000 residents.

Mental Health

This metric counts the percentage of adults who reported poor mental health in at least 14 of the last 30 days in a 2016 survey with the Centers for Disease Control and Prevention. Survey participants were asked the following question: "Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?" Any respondent who reported 14 or more days of poor mental health was counted for this metric. With about 8 percent of people reporting at least 14 days of poor mental health in the last month, South Dakotans earned the No. 1 slot for this metric, and North Dakota followed close behind at 9 percent. In 50th-ranked West Virginia, about 17 percent of adults reported 14 days or more of poor mental health.

Anxiety and depression are two of the most common mental health conditions, and cost the global economy about $1 trillion annually. People with untreated anxiety and depression can have unhealthy behaviors that lead to chronic conditions like diabetes and obesity and are also more likely to abuse alcohol or drugs.