The 25 Healthiest States in 2013

You're probably used to hearing bad news about our nation's health, but a new report indicates it's beginning to look up. In 2013, Americans improved in more than two-thirds of the measures used in America's Health Rankings, an annual state-by-state assessment published jointly by the United Health Foundation, American Public Health Association, and Partnership for Prevention.
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The range of criteria used to determine the rankings includes concrete health measures (like cancer deaths and diabetes rates), lifestyle factors (smoking and alcohol use), and quality-of-life indicators (air pollution, violent crime).

Challenges remain

Declines in the smoking rate (from 21.2% to 19.6%) and levels of physical inactivity (26.2% to 22.9%) are most impressive, says Dr. Reed Tuckson, MD, external senior medical advisor to the United Health Foundation. "We're also relieved that for the first time since 1998, the obesity rate did not worsen." But despite this progress, there's plenty of room for improvement: nearly 28% of American adults are obese, and close to 20% still smoke.
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Residents of the following 25 states are ahead of the curve when it comes to getting (and staying) healthy.

25. Alaska

2012 Rank: 24Change: -2
Strengths:

• Low levels of air pollution
• Low prevalence of low birthweight
• Small disparity in health status by educational attainment

Challenges:

• High violent crime rate
• High incidence of chlamydia infections
• Low immunization coverage among children

24. Maryland

2012 Rank: 20Change: -4
Strengths:

• Low prevalence of smoking
• Low percentage of children in poverty
• Ready availability of primary care physicians and dentists

Challenges:

• High violent crime rate
• High prevalence of low birthweight and high infant mortality rate
• High levels of air pollution

23. Montana

2012 Rank: 28Change: +5
Strengths:

• Low prevalences of obesity and diabetes
• Low levels of air pollution
• Low rate of cancer deaths

Challenges:

• High prevalence of binge drinking
• High percentage of uninsured population
• Limited availability of primary care physicians

22. South Dakota

2012 Rank: 23Change: +1
Strengths:

• Low rate of drug deaths
• Low levels of air pollution
• Few poor mental and physical health days per month

Challenges:

• High prevalence of smoking
• High prevalence of binge drinking
• Low immunization coverage among children and adolescents

21. California

2012 Rank: 21Change: None
Strengths:

• Low prevalence of smoking
• Low prevalence of physical inactivity
• Low infant mortality, cancer deaths, and premature death rates

Challenges:

• High levels of air pollution
• High percentage of uninsured population
• Low immunization coverage among children

20. Wisconsin

2012 Rank: 13Change: -7
Strengths:

• High rate of high school graduation
• High immunization coverage among children
• Low percentage of uninsured population

Challenges:

• High prevalence of binge drinking
• High incidence of infectious diseases
• Low per capita public health funding

19. Rhode Island

2012 Rank: 16Change: -3
Strengths:

• High prevalence of obesity
• High immunization coverage among adolescents
• Ready availability of primary care physicians

Challenges:

• High rate of drug deaths
• High rate of preventable hospitalizations
• Large disparity in health status by educational attainment

18. Iowa

2012 Rank: 17Change: -1
Strengths:

• High rate of high school graduation
• Low percentage of children in poverty
• Few poor mental and physical health days per month

Challenges:

• High prevalence of obesity
• High prevalence of binge drinking
• Limited availability of primary care physicians

17. Wyoming

2012 Rank: 25Change: +8
Strengths:

• Low violent crime rate
• Low percentage of children in poverty
• Low levels of air pollution

Challenges:

• High prevalence of smoking
• Low immunization coverage among adolescents
• Limited availability of primary care physicians

16. Maine

2012 Rank: 15Change: -1
Strengths:

• Low violent crime rate
• Low percentage of uninsured population
• Low prevalence of low birthweight

Challenges:

• High prevalence of binge drinking
• High rate of cancer deaths
• Limited availability of dentists

15. New York

2012 Rank: 18Change: +3
Strengths:

• Low prevalences of obesity and smoking
• High per capita public health funding
• Ready availability of primary care physicians and dentists

Challenges:

• Low rate of high school graduation
• High percentage of children in poverty
• Low immunization coverage among children

14. Washington

2012 Rank: 12Change: -2
Strengths:

• Low prevalence of physical inactivity
• Low rate of preventable hospitalization
• Low infant mortality rate and low prevalence of low birthweight

Challenges:

• High rate of drug deaths
• High incidence of pertussis infections
• Low immunization coverage among children

13. Oregon

2012 Rank: 14Change: +1
Strengths:

• Low prevalence of physical inactivity
• Low rate of preventable hospitalization
• Low infant mortality rate and low prevalence of low birthweight

Challenges:

• Low high school graduation rate
• Low immunization coverage among children
• Many poor mental and physical health days per month

12. Idaho

2012 Rank: 19Change: +7
Strengths:

• Low prevalence of smoking
• Low rate of preventable hospitalization
• Low prevalence of low birthweight

Challenges:

• Limited availability of primary care physicians
• Low immunization coverage among children and adolescents
• High incidence of pertussis infections

11. Nebraska

2012 Rank: 11Change: None
Strengths:

• Low rate of drug deaths
• Low prevalence of low birthweight
• Few poor mental and physical health days per month

Challenges:

• ?High prevalence of binge drinking
• Moderate prevalence of obesity
• Large disparity in health status by educational attainment

10. New Jersey

2012 Rank: 10Change: None
Strengths:

• Low rate of drug deaths
• Low percentage of children in poverty
• Ready availability of primary care physicians and dentists

Challenges:

• High prevalence of physical inactivity
• High prevalence of low birthweight
• High rate of preventable hospitalizations

9. North Dakota

2012 Rank: 8Change: -1
Strengths:

• Low rate of drug deaths
• High rate of high school graduation
• Few poor mental and physical health days per month

Challenges:

• High prevalence of binge drinking
• High prevalence of obesity
• High rate of occupational fatalities

8. Colorado

2012 Rank: 9Change: +1
Strengths:

• Low prevalences of obesity, physical inactivity, and diabetes
• Low levels of air pollution
• Low rate of preventable hospitalizations

Challenges:

• High prevalence of binge drinking
• High rate of drug deaths
• Large disparity in health status by educational attainment

7. Connecticut

2012 Rank: 7Change: None
Strengths:

• Low prevalence of smoking
• Low incidence of infectious diseases
• High immunization coverage among children and adolescents

Challenges:

• Moderate prevalence of binge drinking
• Low high school graduation rate
• Large disparity in health status by educational attainment

6. Utah

2012 Rank: 6Change: None
Strengths:

• Low prevalence of smoking and binge drinking
• Low prevalences of physical inactivity, obesity, and diabetes
• Low rate of preventable hospitalizations

Challenges:?

• High rate of drug deaths
• High incidence of pertussis infections
• Limited availability of primary care physicians

5. New Hampshire

2012 Rank: 5Change: None
Strengths:

• Low percentage of children in poverty
• High immunization coverage among children
• Low infant mortality rate

Challenges:

• High prevalence of binge drinking
• High incidence of pertussis infections
• Low per capita public health funding

4. Massachusetts

2012 Rank: 4Change: None
Strengths:

• Low prevalence of obesity
• Low percentage of uninsured population
• Ready availability of primary care physicians and dentists

Challenges:

• High prevalence of binge drinking
• High rate of preventable hospitalizations
• Large disparity in health status by educational attainment

3. Minnesota

2012 Rank: 3Change: None
Strengths:

• Low prevalences of physical inactivity and diabetes
• High rate of high school graduation
• Low rates of premature death and cardiovascular disease deaths

Challenges:

• High prevalence of binge drinking
• Low per capita health funding
• Low immunization coverage among children

2. Vermont

2012 Rank: 2Change: None
Strengths:

• High rate of high school graduation
• Low violent crime rate
• Low percentage of uninsured population

Challenges:

• High prevalence of binge drinking
• Low immunization coverage among children
• High incidence of pertussis infections

1. Hawaii

2012 Rank: 1Change: None
Strengths:

• Low prevalences of smoking and obesity
• High immunization coverage among children
• Low rate of preventable hospitalizations

Challenges:

• High prevalence of binge drinking
• Low high school graduation rate
• High incidence of salmonella infections

The Unhealthiest States

You've heard about the healthiest states, but what about the unhealthy ones? The lowest-ranking states are Louisiana (#48), Arkansas (#49), and Mississippi (#50), mostly due to high rates of sedentary living, obesity, and diabetes.
The good news: leaders in several low-ranking states are making efforts to turn it around. This year in Tennessee (#42), for example, governor Bill Haslam launched the Governor's Foundation for Health and Wellness. Texas (#36) is also showing improvement. "San Antonio's mayor, Julian Castro, really gets it," says Dr. Tuckson. Castro created SA2020, a movement to improve well-being among San Antonians across 11 key areas by the year 2020.
To view the full America's Health Rankings report, visit americashealthrankings.org.