Introduction

Health is a result of our behaviors, our individual genetic predisposition to disease, the environment and the community in which we live, the clinical care we receive and the policies and practices of our health care and prevention systems. Each of us — individually, as a community, and as a society — strives to optimize these health determinants, so that all of us can have a long, disease-free and robust life regardless of race, gender or socio¬economic status.

This report looks at the four groups of health determinants that can be affected:

1. Behaviors include the everyday activities we do that affect our personal health. It includes habits and practices we develop as individuals and families that have an effect on our personal health and on our utilization of health resources. These behaviors are modifiable with effort by the individual supported by community, policy and clinical interventions.
2. Community and environment reflects the reality that the daily conditions in which we live our lives have a great effect on achieving optimal individual health. These factors can be modified by a concerted effort by the community and its elected officials supported by state and federal agencies, professional associations, advocacy groups and businesses.
3. Public and health policies are indicative of the availability of resources to encourage and maintain health and the extent that public and health programs reach into the general population. Policies can have very wide reach throughout the state and promote healthy living and judicious consumption of healthcare resources.
4. Clinical care reflects the quality, appropriateness and cost of the care we receive at doctors’ offices, clinics and hospitals. All health determinants are intertwined and must work together to be optimally effective.

For example, an initiative that addresses tobacco cessation requires not only efforts on the part of the individual but also support from the community in the form of public and health policies that promote non¬smoking and the availability of effective counseling and care at clinics. Similarly, sound prenatal care requires individual effort, education, access to and availability of prenatal care coupled with high quality health care services. Addressing obesity, which is a health epidemic now facing this country, requires coordination among almost all sectors of the economy including food producers, distributors, restaurants, grocery and convenience stores, exercise facilities, parks, urban and transportation design, building design, educational institutions, community organizations, social groups, healthcare delivery and insurance to complement and augment individual actions.

America’s Health Rankings® combines individual measures of each of these determinants with the resultant health outcomes into one, comprehensive view of the overall health of a state. America’s Health Rankings® employs a unique methodology, developed and periodically reviewed by a panel of leading public health scholars, which balances the contributions of various factors, such as smoking, obesity, binge drinking, high school graduation rates, children in poverty, access to care and incidence of preventable disease, to a state’s health. The report is based on data from the U.S. Departments of Health and Human Services, Commerce, Education and Labor; U.S. Environmental Protection Agency; the American Medical Association; the Dartmouth Atlas Project; and the Trust for America’s Health.

The 2011 Edition of America’s Health Rankings® is considered a benchmark of the relative health of states due to its longevity and its sound model. Numerous states incorporate this report into their annual review of programs, and several organizations use this study as a reference point when assigning goals for health improvement programs.

Purpose

The ultimate purpose of America’s Health Rankings® is to stimulate action by individuals, elected officials, medical professionals, public health professionals, employers, educators and communities to improve the health of the population of the United States. We do this by promoting public conversation concerning health in our states, as well as providing information to facilitate citizen, community and group participation. We encourage participation in all elements: behaviors, community and environment, clinical care, and public and health policies. Each person individually, and in their capacity as an employee, employer, educator, voter, community volunteer, medical professional, public health official or elected official, can contribute to the advancement of the healthiness of their state. Proven, effective and innovative actions can improve the health of people in every state whether the state is first or 50th.