Acknowledgement

We at United Health Foundation, along with our partners at the American Public Health Association and Partnership for Prevention are pleased to present the 22nd Edition of America’s Health Rankings®: A Call to Action for Individuals and Their Communities. First published in 1990, America’s Health Rankings provides the longest running state-by-state analysis of our country’s health and the factors that affect it.

The news, overall, is mixed. We are encouraged that through concerted multi-disciplinary efforts, our nation experienced modest improvements in areas such as smoking and violent crime. According to figures recently released by the Centers for Disease Control and Prevention, coronary heart disease has also decreased. Unfortunately, we continue to struggle with worsening rates of obesity and diabetes and no improvements in other chronic health conditions. We recognize that private employers, federal and state governments and individuals are increasingly challenged by escalating health care costs. With chronic disease affecting 130 million Americans and accounting for nearly 75% of these costs, we owe it to ourselves and future generations to act more urgently and creatively to confront these issues.

When it comes to challenges of this magnitude, it’s important to realize that “we’re all in this together.” Government leadership is essential, but government cannot do it alone. The private sector, philanthropy and community-based organizations all need to join in a data-driven process to determine priorities and then recruit the broad range of assets necessary to address these priorities.

The subtitle of this report remains A Call to Action for Individuals and Their Communities. These are not just words but an urgent plea for comprehensive, innovative and sustained engagement. Whether it’s making a personal change like quitting smoking or exercising; supporting community initiatives that create safe and healthy environments in which to live and work; or creating health enhancing policies or programs, the point is that too much is at stake to leave these issues unaddressed. Now is the time!

We invite you to share proven or innovative programs that have made a difference in your community by emailing unitedhealthfoundationinfo@uhc. com. You can also find and follow America’s Health Rankings on Facebook at www.facebook.com/ AmericasHealthRankings and Twitter at @AHR_ Rankings. Let us all exchange ideas, share information and learn from each other as we work to turn the tide on the health challenges facing the nation.

As with previous editions, we are pleased to include the insights of thoughtful health leaders. Their commentaries are intended to start conversations, generate ideas and showcase innovative means for improving public health. This year’s contributors include:

• Regina Benjamin, M.D., M.B.A, United States Surgeon General, who discusses the importance of prevention and promoting wellness, as chronic disease is costly to our nation in more ways than one.
• Thomas R. Frieden, M.D., M.P.H., Director, Centers for Disease Control and Prevention, who discusses that information is power, and that we must use this power to understand our country’s biggest health problems, to make healthier choices, and to improve the health of the nation.
• Glen P. Mays, Ph.D., M.P.H. and F. Douglas Scutchfield, M.D., National Coordinating Center for Public Health Services and Systems Research at the University of Kentucky College of Public Health, who discuss the fact that despite spending far more resources on health care than any other nation on earth, the U.S. continues to lag behind many other industrialized nations and the need to encourage and support multi-sector action to address this, and other disparities.
• Georges C. Benjamin, M.D., Executive Director, American Public Health Association, who discusses the importance of measuring health factors under the header of “what gets measured gets done" and goes beyond that idea to argue that the real need lies in taking action to address the challenges these measures represent.
• Jud Richland, M.P.H., President and CEO, Partnership for Prevention, who discusses the importance of making prevention a priority and the importance of collaboration in doing so.
• Elizabeth Seaquist, M.D. and Victor Montori, M.D., representing the Decade of Discovery Program, write about the growing epidemic of diabetes and the innovative partnership between the University of Minnesota and the Mayo Clinic in launching Decade of Discovery: A Minnesota Partnership to Conquer Diabetes, a 10-year effort to prevent, optimally treat and ultimately cure type 1 and type 2 diabetes.
• Andrew Webber, President and CEO, National Business Coalition on Health, who discusses the imperative for engaging the private sector in effective public-private partnerships to create effective and creative strategies to tackle public health issues.
• Greg Vigdor, President & CEO, Washington Health Foundation and the Healthiest State in the Nation Campaign who presents the thinking behind the campaign, the 40,000 individuals involved in the campaign and their progress to date toward their goal of becoming the Healthiest State in the Nation.

We are greatly appreciative of the expertise and guidance provided by our Scientific Advisory Committee, comprised of leading public health scholars and led by Anna Schenk, Ph.D., M.S.P.H., Director, Public Health Leadership Program and North Carolina Institute for Public Health for the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. They have once again fulfilled their charge of reviewing, maintaining and continually advancing the report's methodological framework.

We also offer our gratitude and most profound respect for the dedicated efforts of our nation's public health, clinical and health policy professionals who work tirelessly every day on behalf of the people of this country.

Reed V. Tuckson, M.D.
United Health Foundation Board Member
UnitedHealth Group Executive Vice President
and Chief of Medical Affairs

Georges C. Benjamin, M.D.
Executive Director
American Public Health Association

Jud Richland, M.P.H.
President and CEO
Partnership for Prevention