About the Annual Report

Highlights

Find out health trends in obesity, smoking, diabetes and physical inactivity, and see how states rank for overall health. Use dropdown menus to narrow or expand information.

State Rankings Obesity Smoking Diabetes Physical Inactivity

Overall State Rankings

See how states stack up on overall health. Click on states or use dropdown menu to get more information on each state.

Obesity

Explore data on one of the greatest health threats in the US, affecting more than 1 in 4 adults.

USA Obesity (1990-2014) see more
  • Percentage of the population estimated to be obese, with a body mass index (BMI) of 30.0 or higher.
  • Percentage of adults who are obese, with a body mass index (BMI) of 30.0 or higher. (2011 BRFSS Methodology)

Smoking

Although it is trending downward, smoking is still the leading cause of preventable death in the US.

USA Smoking (1990-2014) see more
  • Percentage of population over age 18 that smokes on a regular basis.
  • Percentage of adults who are smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke). (2011 BRFSS Methodology)

Diabetes

Diabetes is increasing in the US, but a healthy lifestyle can often prevent or delay the onset of diabetes.

USA Diabetes (1996-2014) see more
  • Percent of adults who responded yes to the question "Have you ever been told by a doctor that you have diabetes?" Does not include pre-diabetes or diabetes during pregnancy.
  • Percentage of adults who responded yes to the question "Have you ever been told by a doctor that you have diabetes?" (Excludes pre-diabetes and gestational diabetes). (2011 BRFSS Methodology)

Physical Inactivity

As a nation, we need to get up and get moving. Regular exercise is integral to a healthy lifestyle.

USA Physical Activity (1997-2014) see more
  • Percent of adults who indicated that they participated in physical activities during the past month.
  • Percent of adults who indicated that they participated in physical activities during the past month. (2011 BRFSS Methodology)

Findings

Findings

For the third consecutive year, Hawaii is the healthiest state in America’s Health Rankings®–2014 Edition. Vermont ranks second, also for the third consecutive year. Massachusetts improves to third after spending 2 years ranked fourth. Connecticut improves 3 places to fourth, and Utah joins the top 5 states after spending 2 years ranked sixth. Minnesota and New Hampshire drop out of the top 5.

Mississippi ranks 50th for the third consecutive year. Arkansas, Louisiana, Kentucky, and Oklahoma complete the bottom 5 states. Oklahoma changes from 44th to 46th, and Kentucky changes from 45th to 47th, which moves West Virginia and Alabama out of the bottom 5 states.

Hawaii has consistently been in the top 6 states since the inception of the rankings in 1990. Its continued presence among the top states is due to its low prevalence of both smoking and obesity; a low percentage of children in poverty; small disparity in health status by education level; and low rates of preventable hospitalizations, cancer deaths, and cardiovascular deaths. Hawaii’s challenges are a high prevalence of binge drinking at 18.3% of the adult population, a high incidence of Salmonella infections at 24.7 cases per 100,000 population, and a low immunization coverage among children. Hawaii’s immunization coverage among children decreased 17% in the last year, moving its rank from 1st to 40th.

Mississippi has ranked among the bottom 3 states since the inception of the rankings. Mississippi ranks well for low prevalence of binge drinking, high immunization coverage among children, and small disparity in health status. However, it ranks in the bottom 5 states on 16 of the 27 measures including a high prevalence of obesity, physical inactivity, diabetes, children in poverty, and low birthweight infants; low high school graduation rate; limited availability of primary care physicians and dentists; and a high incidence of infectious disease. Mississippi also ranks 50th for all health determinants combined, so its overall ranking is unlikely to change significantly in the near future. 

 

Largest Changes in Rank Since 2013 Edition (1 Year)

Rank Improved 2013 Rank 2014 Rank Change  
Maryland 24 16 8  
Texas 36 31 5  
Virginia 26 21 5  
Alabama 47 43 4  
California 21 17 4  
Rhode Island 19 15 4  
South Dakota 22 18 4  
Rank Declined 2013 Rank 2014 Rank Change
Wyoming 17 25 8
Idaho 12 18 6
Iowa 18 24 6
Delaware 31 35 4
Maine 16 20 4

Change in last 25 years

Largest Changes in Rank Since 1990 Edition (25 Years)

Rank Improved 1990 Rank 2014 Rank Change  
New York 40 14 26  
Vermont 20 2 18  
Oregon 28 12 16  
Maryland 31 16 15  
Alaska 37 26 11  
News Jersey 21 11 10  
         
Rank Declined 1990 Rank 2014 Rank Change
Iowa 6 24 18
Wisconsin 7 23 16
Kansas 12 27 15
Oklahoma 32 46 14
Ohio 27 40 13
Missouri 24 36 12
Indiana 30 41 11
Successes

National Successes Since the 2013 Edition

Successes

 

National Successes - Long Term Changes

Measure

Changes

Smoking

Since 1990 smoking decreased 36% from 29.5% to 19.0% of adults who smoke regularly.

High School Graduation

At 81% of ninth graders graduating within 4 years, high school graduation is still a challenge. However, it is slowly trending upward from 71.7% in 2004.

Violent Crime

At 387 offenses per 100,000 population, violent crime is 37% lower than in 1990 and 49% lower than its peak in 1993.

Air Pollution

The average amount of fine particulates in the air continues to decline from 13.2 micrograms per cubic meter in 2003 to 9.9 micrograms per cubic meter in 2014.

Preventable Hospitalizations

Preventable hospitalizations continue to decline. In 2001, there were 82.5 discharges per 1,000 Medicare beneficiaries; in 2014, there were 62.9 discharges per 1,000 Medicare beneficiaries.

Occupational Fatalities

Occupational fatalities have declined in the last 8 years from 5.3 deaths per 100,000 workers in 2007 to 3.8 deaths per 100,000 workers. This is the second consecutive year the rate is below 4 deaths per 100,000 workers.

Infant Mortality

Since 1990, infant mortality decreased 41% from 10.2 to 6.0 deaths per 1,000 live births, although most of that decline occurred between 1990 and 1999. Even though the infant mortality rate is the lowest in US history, it is double the rate of many developed countries. In addition, large racial geographic disparities exist within the country.

Premature Death

Since 1990, premature death declined 20% from 8,716 to 6,976 years of potential life lost before age 75. Premature death, like several other metrics, has leveled off in the last decade compared with improvements made in the 1990s.

Cancer Deaths

Cancer deaths declined 4% from 197.5 deaths in 1990 to 189.9 deaths per 100,000 population.

Cardiovascular Deaths

Since 1990, cardiovascular deaths declined 38% from 405.1 to 251.4 deaths per 100,000 population. This continues a relatively constant improvement of 2% to 3% yearly.

Challenges

National Challenges Since the 2013 Edition

Challenges since past edition

National Successes - Long Term Changes

 

Challenges

Obesity

Since 1990, obesity has increased 153% from 11.6% to 29.4% of adults.

Physical Inactivity

Physical inactivity remains high at 23.5% of adults and has not changed appreciably for the last decade.

Children in Poverty

At 19.9% of children, the children in poverty measure is far above the 23-year low of 15.8% in the 2002 Edition and near the 1990 level of 20.6%.

Public Health Funding

State public health funding continues its slow decline over the past 4 years. Since 2011, it decreased from $95.01 to $90.00 in expenditures per person at the state level.

Immunization Coverage - Children

Nationwide, comprehensive immunization coverage among children aged 19 to 35 months is only 70.4%. It increased marginally in the past year.

Immunization Coverage - Adolescents

Nationwide, comprehensive immunization coverage among teens aged 13 to 17 years is only 67.1%. It increased marginally in the past year.

Low Birthweight

In the last 20 years, the prevalence of low birthweight infants has increased from 7.1% to 8.0% nationwide. The good news is that it appears to have peaked in 2009 and is trending downward.

Diabetes

In the nation, 9.6% of adults report they have been told they have diabetes. There has been a steady, upward climb in the prevalence of diabetes, although data from the last 3 years shows a leveling of the prevalence.

International Comparisons

When health in the United States is compared with health in other countries, the picture is disappointing. On nearly all indicators of mortality, survival, and life expectancy, the United States ranks at or near the bottom among high-income countries. In 2013, WHO estimated the infant mortality rate in the United States at 6 deaths per 1,000 live births, ranking the United States 42nd among WHO nations along with Bosnia and Herzegovina, Serbia, Slovakia, and Macedonia. In 24 countries — including the majority of western European countries, Japan, and Australia — the infant mortality rate is half the US rate.

IMR around the world

Another measure used to compare the health of nations is life expectancy, which is highly influenced by infant mortality rates as well as death at all ages. The United States, at 79 years of age, ranks 34th for life expectancy and is tied with Colombia, Costa Rica, Cuba, Nauru, and Qatar. Almost all western European countries, Japan, Australia, Singapore, Canada, and New Zealand have a longer life expectancy than the United States. Eighteen countries have a life expectancy at least 3 years longer than the US life expectancy.

World map of life expectancy

While US rankings for infant mortality and life expectancy are disappointingly low, expenditure on health care, as measured by percent of gross domestic product (GDP) spent on health by private and public sectors, is highest in the United States at 17.9 percent of GDP. Only 23 countries, shown on the tab below, spend more than 10 percent of GDP on health. All other developed countries with health expenditures more than 10 percent of GDP have both a lower infant mortality rate and a higher life expectancy than the United States.

World map of healthcare expenditures

Infant Mortality Life Expectancy Health Expenditures

Infant Mortality

Deaths per 1,000 live births

Alphabetical          Rank Order    
Country Infant Mortality Rank   Country Infant Mortality Rank
Afghanistan 70 183   Andorra 2 1
Albania 13 79   Finland 2 1
Algeria 22 113   Iceland 2 1
Andorra 2 1   Japan 2 1
Angola 102 193   Luxembourg 2 1
Antigua and Barbuda 8 52   Norway 2 1
Argentina 12 73   Singapore 2 1
Armenia 14 89   Slovenia 2 1
Australia 3 10   Sweden 2 1
Austria 3 10   Australia 3 10
Azerbaijan 30 126   Austria 3 10
Bahamas 10 63   Cyprus 3 10
Bahrain 5 34   Czech Republic 3 10
Bangladesh 33 134   Denmark 3 10
Barbados 13 79   Estonia 3 10
Belarus 4 25   Germany 3 10
Belgium 4 25   Ireland 3 10
Belize 14 89   Israel 3 10
Benin 56 168   Italy 3 10
Bhutan 30 126   Monaco 3 10
Bolivia (Plurinational State of) 31 131   Netherlands 3 10
Bosnia and Herzegovina 6 42   Portugal 3 10
Botswana 36 138   Republic of Korea 3 10
Brazil 12 73   San Marino 3 10
Brunei Darussalam 8 52   Belarus 4 25
Bulgaria 10 63   Belgium 4 25
Burkina Faso 64 177   Croatia 4 25
Burundi 55 165   France 4 25
Cabo Verde 22 113   Greece 4 25
Cambodia 33 134   Lithuania 4 25
Cameroon 61 175   Spain 4 25
Canada 5 34   Switzerland 4 25
Central African Republic 96 192   United Kingdom of Great Britain and Northern Ireland 4 25
Chad 89 190   Bahrain 5 34
Chile 7 47   Canada 5 34
China 11 69   Cuba 5 34
Colombia 15 94   Hungary 5 34
Comoros 58 173   Malta 5 34
Congo 36 138   Montenegro 5 34
Cook Islands 8 52   New Zealand 5 34
Costa Rica 8 52   Poland 5 34
Côte d'Ivoire 71 184   Bosnia and Herzegovina 6 42
Croatia 4 25   Serbia 6 42
Cuba 5 34   Slovakia 6 42
Cyprus 3 10   The former Yugoslav Republic of Macedonia 6 42
Czech Republic 3 10   United States of America 6 42
Democratic People's Republic of Korea 22 113   Chile 7 47
Democratic Republic of the Congo 86 189   Latvia 7 47
Denmark 3 10   Malaysia 7 47
Djibouti 57 172   Qatar 7 47
Dominica 10 63   United Arab Emirates 7 47
Dominican Republic 24 117   Antigua and Barbuda 8 52
Ecuador 19 103   Brunei Darussalam 8 52
Egypt 19 103   Cook Islands 8 52
El Salvador 14 89   Costa Rica 8 52
Equatorial Guinea 69 181   Kuwait 8 52
Eritrea 36 138   Lebanon 8 52
Estonia 3 10   Maldives 8 52
Ethiopia 44 151   Saint Kitts and Nevis 8 52
Fiji 20 109   Sri Lanka 8 52
Finland 2 1   Russian Federation 9 61
France 4 25   Ukraine 9 61
Gabon 39 145   Bahamas 10 63
Gambia 49 160   Bulgaria 10 63
Georgia 12 73   Dominica 10 63
Germany 3 10   Oman 10 63
Ghana 52 162   Tonga 10 63
Greece 4 25   Uruguay 10 63
Grenada 11 69   China 11 69
Guatemala 26 122   Grenada 11 69
Guinea 65 179   Romania 11 69
Guinea-Bissau 78 187   Thailand 11 69
Guyana 30 126   Argentina 12 73
Haiti 55 165   Brazil 12 73
Honduras 19 103   Georgia 12 73
Hungary 5 34   Libya 12 73
Iceland 2 1   Seychelles 12 73
India 41 149   Syrian Arab Republic 12 73
Indonesia 25 120   Albania 13 79
Iran (Islamic Republic of) 14 89   Barbados 13 79
Iraq 28 125   Mauritius 13 79
Ireland 3 10   Mexico 13 79
Israel 3 10   Peru 13 79
Italy 3 10   Republic of Moldova 13 79
Jamaica 14 89   Saint Lucia 13 79
Japan 2 1   Saudi Arabia 13 79
Jordan 16 99   Tunisia 13 79
Kazakhstan 15 94   Venezuela (Bolivarian Republic of) 13 79
Kenya 48 159   Armenia 14 89
Kiribati 45 155   Belize 14 89
Kuwait 8 52   El Salvador 14 89
Kyrgyzstan 22 113   Iran (Islamic Republic of) 14 89
Lao People's Democratic Republic 54 163   Jamaica 14 89
Latvia 7 47   Colombia 15 94
Lebanon 8 52   Kazakhstan 15 94
Lesotho 73 185   Palau 15 94
Liberia 54 163   Panama 15 94
Libya 12 73   Vanuatu 15 94
Lithuania 4 25   Jordan 16 99
Luxembourg 2 1   Samoa 16 99
Madagascar 40 146   Saint Vincent and the Grenadines 17 101
Malawi 44 151   Turkey 17 101
Malaysia 7 47   Ecuador 19 103
Maldives 8 52   Egypt 19 103
Mali 78 187   Honduras 19 103
Malta 5 34   Paraguay 19 103
Marshall Islands 31 131   Trinidad and Tobago 19 103
Mauritania 67 180   Viet Nam 19 103
Mauritius 13 79   Fiji 20 109
Mexico 13 79   Nicaragua 20 109
Micronesia (Federated States of) 30 126   Suriname 20 109
Monaco 3 10   Niue 21 112
Mongolia 26 122   Algeria 22 113
Montenegro 5 34   Cabo Verde 22 113
Morocco 26 122   Democratic People's Republic of Korea 22 113
Mozambique 62 176   Kyrgyzstan 22 113
Myanmar 40 146   Dominican Republic 24 117
Namibia 35 137   Philippines 24 117
Nauru 30 126   Tuvalu 24 117
Nepal 32 133   Indonesia 25 120
Netherlands 3 10   Solomon Islands 25 120
New Zealand 5 34   Guatemala 26 122
Nicaragua 20 109   Mongolia 26 122
Niger 60 174   Morocco 26 122
Nigeria 74 186   Iraq 28 125
Niue 21 112   Azerbaijan 30 126
Norway 2 1   Bhutan 30 126
Oman 10 63   Guyana 30 126
Pakistan 69 181   Micronesia (Federated States of) 30 126
Palau 15 94   Nauru 30 126
Panama 15 94   Bolivia (Plurinational State of) 31 131
Papua New Guinea 47 157   Marshall Islands 31 131
Paraguay 19 103   Nepal 32 133
Peru 13 79   Bangladesh 33 134
Philippines 24 117   Cambodia 33 134
Poland 5 34   South Africa 33 134
Portugal 3 10   Namibia 35 137
Qatar 7 47   Botswana 36 138
Republic of Korea 3 10   Congo 36 138
Republic of Moldova 13 79   Eritrea 36 138
Romania 11 69   United Republic of Tanzania 36 138
Russian Federation 9 61   Rwanda 37 142
Rwanda 37 142   Sao Tome and Principe 37 142
Saint Kitts and Nevis 8 52   Uzbekistan 37 142
Saint Lucia 13 79   Gabon 39 145
Saint Vincent and the Grenadines 17 101   Madagascar 40 146
Samoa 16 99   Myanmar 40 146
San Marino 3 10   Yemen 40 146
Sao Tome and Principe 37 142   India 41 149
Saudi Arabia 13 79   Tajikistan 41 149
Senegal 44 151   Ethiopia 44 151
Serbia 6 42   Malawi 44 151
Seychelles 12 73   Senegal 44 151
Sierra Leone 107 194   Uganda 44 151
Singapore 2 1   Kiribati 45 155
Slovakia 6 42   Timor-Leste 46 156
Slovenia 2 1   Papua New Guinea 47 157
Solomon Islands 25 120   Turkmenistan 47 157
Somalia 90 191   Kenya 48 159
South Africa 33 134   Gambia 49 160
South Sudan 64 177   Sudan 51 161
Spain 4 25   Ghana 52 162
Sri Lanka 8 52   Lao People's Democratic Republic 54 163
Sudan 51 161   Liberia 54 163
Suriname 20 109   Burundi 55 165
Swaziland 56 168   Haiti 55 165
Sweden 2 1   Zimbabwe 55 165
Switzerland 4 25   Benin 56 168
Syrian Arab Republic 12 73   Swaziland 56 168
Tajikistan 41 149   Togo 56 168
Thailand 11 69   Zambia 56 168
The former Yugoslav Republic of Macedonia 6 42   Djibouti 57 172
Timor-Leste 46 156   Comoros 58 173
Togo 56 168   Niger 60 174
Tonga 10 63   Cameroon 61 175
Trinidad and Tobago 19 103   Mozambique 62 176
Tunisia 13 79   Burkina Faso 64 177
Turkey 17 101   South Sudan 64 177
Turkmenistan 47 157   Guinea 65 179
Tuvalu 24 117   Mauritania 67 180
Uganda 44 151   Equatorial Guinea 69 181
Ukraine 9 61   Pakistan 69 181
United Arab Emirates 7 47   Afghanistan 70 183
United Kingdom of Great Britain and Northern Ireland 4 25   Côte d'Ivoire 71 184
United Republic of Tanzania 36 138   Lesotho 73 185
United States of America 6 42   Nigeria 74 186
Uruguay 10 63   Guinea-Bissau 78 187
Uzbekistan 37 142   Mali 78 187
Vanuatu 15 94   Democratic Republic of the Congo 86 189
Venezuela (Bolivarian Republic of) 13 79   Chad 89 190
Viet Nam 19 103   Somalia 90 191
Yemen 40 146   Central African Republic 96 192
Zambia 56 168   Angola 102 193
Zimbabwe 55 165   Sierra Leone 107 194

*Rank among 194 member countries of WHO

Life Expectancy 

Years at birth

Alphabetical           Rank Order    
Country Life Expectancy Rank   Country Life Expectancy Rank
Afghanistan 60 166   Japan 84 1
Albania 74 81   Andorra 83 2
Algeria 72 103   Australia 83 2
Andorra 83 2   Italy 83 2
Angola 51 190   San Marino 83 2
Antigua and Barbuda 75 67   Singapore 83 2
Argentina 76 55   Switzerland 83 2
Armenia 71 110   Canada 82 8
Australia 83 2   Cyprus 82 8
Austria 81 19   France 82 8
Azerbaijan 72 103   Iceland 82 8
Bahamas 75 67   Israel 82 8
Bahrain 77 44   Luxembourg 82 8
Bangladesh 70 117   Monaco 82 8
Barbados 78 40   New Zealand 82 8
Belarus 72 103   Norway 82 8
Belgium 80 29   Spain 82 8
Belize 75 67   Sweden 82 8
Benin 59 167   Austria 81 19
Bhutan 68 129   Finland 81 19
Bolivia (Plurinational State of) 68 129   Germany 81 19
Bosnia and Herzegovina 77 44   Greece 81 19
Botswana 62 156   Ireland 81 19
Brazil 74 81   Malta 81 19
Brunei Darussalam 77 44   Netherlands 81 19
Bulgaria 74 81   Portugal 81 19
Burkina Faso 58 172   Republic of Korea 81 19
Burundi 56 179   United Kingdom of Great Britain and Northern Ireland 81 19
Cabo Verde 74 81   Belgium 80 29
Cambodia 72 103   Chile 80 29
Cameroon 56 179   Denmark 80 29
Canada 82 8   Lebanon 80 29
Central African Republic 51 190   Slovenia 80 29
Chad 51 190   Colombia 79 34
Chile 80 29   Costa Rica 79 34
China 75 67   Cuba 79 34
Colombia 79 34   Nauru 79 34
Comoros 62 156   Qatar 79 34
Congo 59 167   United States of America 79 34
Cook Islands 76 55   Barbados 78 40
Costa Rica 79 34   Croatia 78 40
Côte d'Ivoire 53 186   Czech Republic 78 40
Croatia 78 40   Kuwait 78 40
Cuba 79 34   Bahrain 77 44
Cyprus 82 8   Bosnia and Herzegovina 77 44
Czech Republic 78 40   Brunei Darussalam 77 44
Democratic People's Republic of Korea 70 117   Dominican Republic 77 44
Democratic Republic of the Congo 52 189   Estonia 77 44
Denmark 80 29   Maldives 77 44
Djibouti 61 162   Panama 77 44
Dominica 75 67   Peru 77 44
Dominican Republic 77 44   Poland 77 44
Ecuador 75 67   Suriname 77 44
Egypt 71 110   Uruguay 77 44
El Salvador 72 103   Argentina 76 55
Equatorial Guinea 55 181   Cook Islands 76 55
Eritrea 63 150   Mexico 76 55
Estonia 77 44   Montenegro 76 55
Ethiopia 64 146   Oman 76 55
Fiji 69 122   Saudi Arabia 76 55
Finland 81 19   Slovakia 76 55
France 82 8   The former Yugoslav Republic of Macedonia 76 55
Gabon 63 150   Tunisia 76 55
Gambia 61 162   United Arab Emirates 76 55
Georgia 74 81   Venezuela (Bolivarian Republic of) 76 55
Germany 81 19   Viet Nam 76 55
Ghana 62 156   Antigua and Barbuda 75 67
Greece 81 19   Bahamas 75 67
Grenada 73 99   Belize 75 67
Guatemala 72 103   China 75 67
Guinea 58 172   Dominica 75 67
Guinea-Bissau 54 183   Ecuador 75 67
Guyana 63 150   Hungary 75 67
Haiti 62 156   Libya 75 67
Honduras 74 81   Paraguay 75 67
Hungary 75 67   Saint Lucia 75 67
Iceland 82 8   Serbia 75 67
India 66 139   Sri Lanka 75 67
Indonesia 71 110   Thailand 75 67
Iran (Islamic Republic of) 74 81   Turkey 75 67
Iraq 70 117   Albania 74 81
Ireland 81 19   Brazil 74 81
Israel 82 8   Bulgaria 74 81
Italy 83 2   Cabo Verde 74 81
Jamaica 74 81   Georgia 74 81
Japan 84 1   Honduras 74 81
Jordan 74 81   Iran (Islamic Republic of) 74 81
Kazakhstan 68 129   Jamaica 74 81
Kenya 61 162   Jordan 74 81
Kiribati 66 139   Latvia 74 81
Kuwait 78 40   Lithuania 74 81
Kyrgyzstan 69 122   Malaysia 74 81
Lao People's Democratic Republic 66 139   Mauritius 74 81
Latvia 74 81   Niue 74 81
Lebanon 80 29   Romania 74 81
Lesotho 50 193   Saint Kitts and Nevis 74 81
Liberia 62 156   Saint Vincent and the Grenadines 74 81
Libya 75 67   Seychelles 74 81
Lithuania 74 81   Grenada 73 99
Luxembourg 82 8   Nicaragua 73 99
Madagascar 64 146   Palau 73 99
Malawi 59 167   Samoa 73 99
Malaysia 74 81   Algeria 72 103
Maldives 77 44   Azerbaijan 72 103
Mali 57 176   Belarus 72 103
Malta 81 19   Cambodia 72 103
Marshall Islands 70 117   El Salvador 72 103
Mauritania 63 150   Guatemala 72 103
Mauritius 74 81   Vanuatu 72 103
Mexico 76 55   Armenia 71 110
Micronesia (Federated States of) 69 122   Egypt 71 110
Monaco 82 8   Indonesia 71 110
Mongolia 67 136   Morocco 71 110
Montenegro 76 55   Republic of Moldova 71 110
Morocco 71 110   Tonga 71 110
Mozambique 53 186   Ukraine 71 110
Myanmar 66 139   Bangladesh 70 117
Namibia 67 136   Democratic People's Republic of Korea 70 117
Nauru 79 34   Iraq 70 117
Nepal 68 129   Marshall Islands 70 117
Netherlands 81 19   Trinidad and Tobago 70 117
New Zealand 82 8   Fiji 69 122
Nicaragua 73 99   Kyrgyzstan 69 122
Niger 59 167   Micronesia (Federated States of) 69 122
Nigeria 54 183   Philippines 69 122
Niue 74 81   Russian Federation 69 122
Norway 82 8   Solomon Islands 69 122
Oman 76 55   Uzbekistan 69 122
Pakistan 65 144   Bhutan 68 129
Palau 73 99   Bolivia (Plurinational State of) 68 129
Panama 77 44   Kazakhstan 68 129
Papua New Guinea 62 156   Nepal 68 129
Paraguay 75 67   Syrian Arab Republic 68 129
Peru 77 44   Tajikistan 68 129
Philippines 69 122   Tuvalu 68 129
Poland 77 44   Mongolia 67 136
Portugal 81 19   Namibia 67 136
Qatar 79 34   Sao Tome and Principe 67 136
Republic of Korea 81 19   India 66 139
Republic of Moldova 71 110   Kiribati 66 139
Romania 74 81   Lao People's Democratic Republic 66 139
Russian Federation 69 122   Myanmar 66 139
Rwanda 65 144   Timor-Leste 66 139
Saint Kitts and Nevis 74 81   Pakistan 65 144
Saint Lucia 75 67   Rwanda 65 144
Saint Vincent and the Grenadines 74 81   Ethiopia 64 146
Samoa 73 99   Madagascar 64 146
San Marino 83 2   Senegal 64 146
Sao Tome and Principe 67 136   Yemen 64 146
Saudi Arabia 76 55   Eritrea 63 150
Senegal 64 146   Gabon 63 150
Serbia 75 67   Guyana 63 150
Seychelles 74 81   Mauritania 63 150
Sierra Leone 46 194   Sudan 63 150
Singapore 83 2   Turkmenistan 63 150
Slovakia 76 55   Botswana 62 156
Slovenia 80 29   Comoros 62 156
Solomon Islands 69 122   Ghana 62 156
Somalia 53 186   Haiti 62 156
South Africa 59 167   Liberia 62 156
South Sudan 55 181   Papua New Guinea 62 156
Spain 82 8   Djibouti 61 162
Sri Lanka 75 67   Gambia 61 162
Sudan 63 150   Kenya 61 162
Suriname 77 44   United Republic of Tanzania 61 162
Swaziland 54 183   Afghanistan 60 166
Sweden 82 8   Benin 59 167
Switzerland 83 2   Congo 59 167
Syrian Arab Republic 68 129   Malawi 59 167
Tajikistan 68 129   Niger 59 167
Thailand 75 67   South Africa 59 167
The former Yugoslav Republic of Macedonia 76 55   Burkina Faso 58 172
Timor-Leste 66 139   Guinea 58 172
Togo 58 172   Togo 58 172
Tonga 71 110   Zimbabwe 58 172
Trinidad and Tobago 70 117   Mali 57 176
Tunisia 76 55   Uganda 57 176
Turkey 75 67   Zambia 57 176
Turkmenistan 63 150   Burundi 56 179
Tuvalu 68 129   Cameroon 56 179
Uganda 57 176   Equatorial Guinea 55 181
Ukraine 71 110   South Sudan 55 181
United Arab Emirates 76 55   Guinea-Bissau 54 183
United Kingdom of Great Britain and Northern Ireland 81 19   Nigeria 54 183
United Republic of Tanzania 61 162   Swaziland 54 183
United States of America 79 34   Côte d'Ivoire 53 186
Uruguay 77 44   Mozambique 53 186
Uzbekistan 69 122   Somalia 53 186
Vanuatu 72 103   Democratic Republic of the Congo 52 189
Venezuela (Bolivarian Republic of) 76 55   Angola 51 190
Viet Nam 76 55   Central African Republic 51 190
Yemen 64 146   Chad 51 190
Zambia 57 176   Lesotho 50 193
Zimbabwe 58 172   Sierra Leone 46 194

*World Health Organization, extracted October 22, 2914 

Total HEALTH Expenditures

Percent of Gross Domestic Product

Alphabetical         Rank Order    
Country Health Care Expenditures** Rank   Country Health Care Expenditures** Rank
Afghanistan 8.7 45   United States of America 17.9 1
Albania 6 110   Marshall Islands 15.6 2
Algeria 5.3 132   Liberia 15.5 3
Andorra 8.3 54   Tuvalu 15.4 4
Angola 3.5 172   Sierra Leone 15.1 5
Antigua and Barbuda 5.2 134   Micronesia (Federated States of) 12.8 6
Argentina 8.5 49   Netherlands 12.4 7
Armenia 4.5 152   France 11.8 8
Australia 9.1 37   Republic of Moldova 11.7 9
Austria 11.5 11   Lesotho 11.6 10
Azerbaijan 5.4 126   Austria 11.5 11
Bahamas 7.5 67   Germany 11.3 12
Bahrain 3.9 162   Switzerland 11.3 12
Bangladesh 3.6 169   Denmark 11.2 14
Barbados 6.3 102   Canada 10.9 15
Belarus 5 141   Belgium 10.8 16
Belgium 10.8 16   Kiribati 10.7 17
Belize 5.8 119   Rwanda 10.7 17
Benin 4.5 152   Serbia 10.5 19
Bhutan 3.8 166   New Zealand 10.3 20
Bolivia (Plurinational State of) 5.8 119   Paraguay 10.3 20
Bosnia and Herzegovina 9.9 24   Costa Rica 10.1 22
Botswana 5.3 132   Japan 10.1 22
Brazil 9.3 31   Bosnia and Herzegovina 9.9 24
Brunei Darussalam 2.3 188   Jordan 9.8 25
Bulgaria 7.4 71   Spain 9.6 26
Burkina Faso 6.2 107   Sweden 9.6 26
Burundi 8.1 56   Palau 9.5 28
Cabo Verde 3.9 162   Portugal 9.5 28
Cambodia 5.4 126   United Kingdom of Great Britain and Northern Ireland 9.4 30
Cameroon 5.1 138   Brazil 9.3 31
Canada 10.9 15   Greece 9.3 31
Central African Republic 3.8 166   Finland 9.2 33
Chad 2.8 181   Georgia 9.2 33
Chile 7.2 75   Italy 9.2 33
China 5.4 126   Malawi 9.2 33
Colombia 6.8 83   Australia 9.1 37
Comoros 4.5 152   Iceland 9.1 37
Congo 3.2 176   Malta 9.1 37
Cook Islands 3.4 174   Norway 9 40
Costa Rica 10.1 22   Uruguay 9 40
Côte d'Ivoire 7.1 77   Djibouti 8.8 42
Croatia 6.8 83   Slovenia 8.8 42
Cuba 8.6 46   South Africa 8.8 42
Cyprus 7.3 72   Afghanistan 8.7 45
Czech Republic 7.7 63   Cuba 8.6 46
Democratic Republic of the Congo 5.6 123   Honduras 8.6 46
Denmark 11.2 14   Togo 8.6 46
Djibouti 8.8 42   Argentina 8.5 49
Dominica 5.9 112   Maldives 8.5 49
Dominican Republic 5.4 126   Saint Lucia 8.5 49
Ecuador 6.4 96   Swaziland 8.5 49
Egypt 5 141   Namibia 8.4 53
El Salvador 6.7 86   Andorra 8.3 54
Equatorial Guinea 4.7 146   Nicaragua 8.2 55
Eritrea 2.6 184   Burundi 8.1 56
Estonia 5.9 112   Ireland 8.1 56
Ethiopia 3.8 166   Solomon Islands 8.1 56
Fiji 4 160   Uganda 8 59
Finland 9.2 33   Sao Tome and Principe 7.9 60
France 11.8 8   Hungary 7.8 61
Gabon 3.5 172   Slovakia 7.8 61
Gambia 5 141   Czech Republic 7.7 63
Georgia 9.2 33   Montenegro 7.6 64
Germany 11.3 12   Panama 7.6 64
Ghana 5.2 134   Ukraine 7.6 64
Greece 9.3 31   Bahamas 7.5 67
Grenada 6.4 96   Israel 7.5 67
Guatemala 6.7 86   Nauru 7.5 67
Guinea 6.3 102   Republic of Korea 7.5 67
Guinea-Bissau 5.9 112   Bulgaria 7.4 71
Guyana 6.6 92   Cyprus 7.3 72
Haiti 6.4 96   Lebanon 7.3 72
Honduras 8.6 46   Sudan 7.3 72
Hungary 7.8 61   Chile 7.2 75
Iceland 9.1 37   Niger 7.2 75
India 4.1 158   Côte d'Ivoire 7.1 77
Indonesia 3 179   Kyrgyzstan 7.1 77
Iran (Islamic Republic of) 6.7 86   The former Yugoslav Republic of Macedonia 7.1 77
Iraq 3.6 169   Tunisia 7 80
Ireland 8.1 56   United Republic of Tanzania 7 80
Israel 7.5 67   Luxembourg 6.9 82
Italy 9.2 33   Colombia 6.8 83
Jamaica 5.9 112   Croatia 6.8 83
Japan 10.1 22   Samoa 6.8 83
Jordan 9.8 25   El Salvador 6.7 86
Kazakhstan 4.2 157   Guatemala 6.7 86
Kenya 4.7 146   Iran (Islamic Republic of) 6.7 86
Kiribati 10.7 17   Lithuania 6.7 86
Kuwait 2.5 187   Niue 6.7 86
Kyrgyzstan 7.1 77   Poland 6.7 86
Lao People's Democratic Republic 2.9 180   Guyana 6.6 92
Latvia 6 110   Viet Nam 6.6 92
Lebanon 7.3 72   San Marino 6.5 94
Lesotho 11.6 10   Zambia 6.5 94
Liberia 15.5 3   Ecuador 6.4 96
Libya 3.9 162   Grenada 6.4 96
Lithuania 6.7 86   Haiti 6.4 96
Luxembourg 6.9 82   Mauritania 6.4 96
Madagascar 4.1 158   Morocco 6.4 96
Malawi 9.2 33   Mozambique 6.4 96
Malaysia 4 160   Barbados 6.3 102
Maldives 8.5 49   Guinea 6.3 102
Mali 5.8 119   Mongolia 6.3 102
Malta 9.1 37   Russian Federation 6.3 102
Marshall Islands 15.6 2   Turkey 6.3 102
Mauritania 6.4 96   Burkina Faso 6.2 107
Mauritius 4.8 145   Mexico 6.2 107
Mexico 6.2 107   Nigeria 6.1 109
Micronesia (Federated States of) 12.8 6   Albania 6 110
Monaco 4.4 155   Latvia 6 110
Mongolia 6.3 102   Dominica 5.9 112
Montenegro 7.6 64   Estonia 5.9 112
Morocco 6.4 96   Guinea-Bissau 5.9 112
Mozambique 6.4 96   Jamaica 5.9 112
Myanmar 1.8 191   Saint Kitts and Nevis 5.9 112
Namibia 8.4 53   Suriname 5.9 112
Nauru 7.5 67   Uzbekistan 5.9 112
Nepal 5.5 124   Belize 5.8 119
Netherlands 12.4 7   Bolivia (Plurinational State of) 5.8 119
New Zealand 10.3 20   Mali 5.8 119
Nicaragua 8.2 55   Tajikistan 5.8 119
Niger 7.2 75   Democratic Republic of the Congo 5.6 123
Nigeria 6.1 109   Nepal 5.5 124
Niue 6.7 86   Yemen 5.5 124
Norway 9 40   Azerbaijan 5.4 126
Oman 2.6 184   Cambodia 5.4 126
Pakistan 2.7 183   China 5.4 126
Palau 9.5 28   Dominican Republic 5.4 126
Panama 7.6 64   Tonga 5.4 126
Papua New Guinea 5.2 134   Trinidad and Tobago 5.4 126
Paraguay 10.3 20   Algeria 5.3 132
Peru 5.1 138   Botswana 5.3 132
Philippines 4.6 151   Antigua and Barbuda 5.2 134
Poland 6.7 86   Ghana 5.2 134
Portugal 9.5 28   Papua New Guinea 5.2 134
Qatar 2.2 189   Saint Vincent and the Grenadines 5.2 134
Republic of Korea 7.5 67   Cameroon 5.1 138
Republic of Moldova 11.7 9   Peru 5.1 138
Romania 5.1 138   Romania 5.1 138
Russian Federation 6.3 102   Belarus 5 141
Rwanda 10.7 17   Egypt 5 141
Saint Kitts and Nevis 5.9 112   Gambia 5 141
Saint Lucia 8.5 49   Senegal 5 141
Saint Vincent and the Grenadines 5.2 134   Mauritius 4.8 145
Samoa 6.8 83   Equatorial Guinea 4.7 146
San Marino 6.5 94   Kenya 4.7 146
Sao Tome and Principe 7.9 60   Seychelles 4.7 146
Saudi Arabia 3.2 176   Singapore 4.7 146
Senegal 5 141   Venezuela (Bolivarian Republic of) 4.7 146
Serbia 10.5 19   Philippines 4.6 151
Seychelles 4.7 146   Armenia 4.5 152
Sierra Leone 15.1 5   Benin 4.5 152
Singapore 4.7 146   Comoros 4.5 152
Slovakia 7.8 61   Monaco 4.4 155
Slovenia 8.8 42   Timor-Leste 4.3 156
Solomon Islands 8.1 56   Kazakhstan 4.2 157
South Africa 8.8 42   India 4.1 158
South Sudan 2.6 184   Madagascar 4.1 158
Spain 9.6 26   Fiji 4 160
Sri Lanka 3.2 176   Malaysia 4 160
Sudan 7.3 72   Bahrain 3.9 162
Suriname 5.9 112   Cabo Verde 3.9 162
Swaziland 8.5 49   Libya 3.9 162
Sweden 9.6 26   Thailand 3.9 162
Switzerland 11.3 12   Bhutan 3.8 166
Syrian Arab Republic 3.4 174   Central African Republic 3.8 166
Tajikistan 5.8 119   Ethiopia 3.8 166
Thailand 3.9 162   Bangladesh 3.6 169
The former Yugoslav Republic of Macedonia 7.1 77   Iraq 3.6 169
Timor-Leste 4.3 156   Vanuatu 3.6 169
Togo 8.6 46   Angola 3.5 172
Tonga 5.4 126   Gabon 3.5 172
Trinidad and Tobago 5.4 126   Cook Islands 3.4 174
Tunisia 7 80   Syrian Arab Republic 3.4 174
Turkey 6.3 102   Congo 3.2 176
Turkmenistan 2 190   Saudi Arabia 3.2 176
Tuvalu 15.4 4   Sri Lanka 3.2 176
Uganda 8 59   Indonesia 3 179
Ukraine 7.6 64   Lao People's Democratic Republic 2.9 180
United Arab Emirates 2.8 181   Chad 2.8 181
United Kingdom of Great Britain and Northern Ireland 9.4 30   United Arab Emirates 2.8 181
United Republic of Tanzania 7 80   Pakistan 2.7 183
United States of America 17.9 1   Eritrea 2.6 184
Uruguay 9 40   Oman 2.6 184
Uzbekistan 5.9 112   South Sudan 2.6 184
Vanuatu 3.6 169   Kuwait 2.5 187
Venezuela (Bolivarian Republic of) 4.7 146   Brunei Darussalam 2.3 188
Viet Nam 6.6 92   Qatar 2.2 189
Yemen 5.5 124   Turkmenistan 2 190
Zambia 6.5 94   Myanmar 1.8 191

**Total expenditure on health as % of gross domestic product 

 

25 Year Perspective

 America’s Health Rankings® was first released in 1990. This was a time when the definition of health and the role of public health were rapidly evolving. It was 26 years after the landmark 1964 Surgeon General’s Report on Smoking and Health as well as 8 years before the Tobacco Master Settlement Agreement between attorneys general of 46 states and 4 of the largest tobacco companies. In this period, research supporting the connection between population health and socioeconomic factors expanded, entered mainstream discussion, and became increasingly accepted. Surgeon General Quote

Twenty-five years ago, this stimulating research and a distinguished expert panel formed the wellspring of America’s Health Rankings®. The Rankings was built upon the WHO definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” It was based on the premise that determinants of health directly influence health outcomes. The model has evolved over the last 25 years, but its emphasis on health determinants remains, and today the determinants account for three-quarters of each state’s final ranking. The determinants are divided into 4 categories: behavior, community and environment, policy, and clinical care. 

The Rankings compare each state’s health with that of all others states for a single year. The Rankings do not track the progress of the nation’s overall health over time but provide a year-to-year snapshot of state heath. However, the measure premature death, defined as the number of years not lived by people who die before age 75, can be used to examine our nation’s health over the last 25 years as that measure strongly correlates with the final outcome score (r=0.92) of the Rankings. While premature death is a good proxy for the nation’s health, it does not reflect quality of life.

Measures of Mortality

Premature Death

premature death

In the last 25 years, premature death decreased 20%, from 8,716 to 6,976 years lost before age 75 per 100,000 population. This improvement means an increase in years of productive life in the population. While premature death has decreased nationally, improvement differs greatly by state. In New York, in the last 25 years premature death improved 41%, from 9,754 to 5,737 years of potential life lost, whereas in Oklahoma premature deaths worsened 13%, from 8,551 to 9,654 years of potential life lost. Declines in infant mortality and cardiovascular deaths are 2 measures that contributed greatly to the decline in premature death over the last quarter of a century.

Infant Mortality

Infant mortality

Infant mortality has declined 41% over the last 25 years, from 10.2 to 6.0 deaths per 1,000 live births. While this improvement is notable and the result of decades of continued effort, US infant mortality lags far behind other developed countries and many middle-income countries. The improvement in US infant mortality varies geographically. For example, Alaska improved 58%, from 10.6 to 4.5 deaths per 1,000 live births in the last 25 years, while Ohio improved only 22%, from 9.9 to 7.7 deaths per 1,000 live births.

 

Cardiovascular DeathsCardiovascular Deaths

Cardiovascular disease remains the nation’s leading killer despite a steep decline in cardiovascular mortality over the last 25 years. In 1990, the US cardiovascular death rate was 405.1 deaths per 100,000 population. Today’s rate is 251.4 deaths per 100,000 population, a decline of 38%. The improvement in US cardiovascular deaths varies geographically. In the last 25 years, Minnesota improved 47%, from 350.6 to 184.7 deaths per 100,000 population, while Oklahoma improved only 23%, from 415.3 to 322.0 deaths per 100,000 population.

Cancer DeathsCancer deaths

 America’s Health Rankings® has tracked cancer deaths since 1990. Since a peak in 1996, there has been a slow-but-steady decrease in cancer mortality, reflecting a decline in incidence of some cancers, like lung cancer, and improvements in cancer treatment. The population’s longer lifespan over the last 25 years and the overall aging of the population have masked some improvement in cancer mortality as more cancer occurs in older individuals. From 1996 to 2014, US cancer mortality declined 8%, from 205.5 to 189.9 deaths per 100,000 population. In this same time span, this advance varied geographically, with Maryland improving 16%, from 224.0 to 187.7 deaths per 100,000 population, and Oklahoma worsening 6%, from 202.4 to 214.1 deaths per 100,000 population.Cancer quotation

These gains occurred during a period of mixed social economic indicators, as shown by the prevalence of children in poverty.

Children in Poverty

 

After a decade of decline, in 2002 the prevalence of children in poverty rose for almost a decade from 15.8% to 21.4%. Fortunately, it has declined in the last few years. States experienced much of the same cyclic nature of children in poverty, however the magnitude of the cycles varies from state to state.

Health Determinants / Risk Factors

Key to improving overall health is reducing the leading causes of death, including tobacco use. Since 1990, tobacco use has dropped significantly, yet almost 1 in 5 adults (19.0%) still smoke regularly. In the early 1990s, more than 1 in 4 smoked – so there has been progress, albeit slow. It is especially encouraging to see the 0.3% annual decrease from 2003 through 2011. This rate of decline appears to continue from 2012 through 2014. (Changes in data-collection methodology between 1990 and 1991 and between 2011 and 2012 do not allow a comparison over all 25 years).Smoking trends

Smoking among adults with low educational attainment is disproportionately large throughout the United States. Nationally, the prevalence of smoking among adults with less than a high school education is 32% – 4 times the prevalence among adults with a college degree. The prevalence of smoking among those with less than a high school degree varies greatly from state to state, with it being 3.5 times higher in Alaska than in California. In no state is the prevalence of smoking among those with a high school degree or less significantly lower than those with a college degree.smoking rates by educational attainment

Even as we celebrate the decline in cigarette smoking, there is increasing concern about youth smoking tobacco using hookahs (water pipes for smoking) and about other forms of tobacco use such as smoking cigars as well as using smokeless tobacco and e-cigarettes. Reducing all tobacco use is important in reducing the impact of adverse inhaled chemicals and particulates on health.

LegendOur nation’s struggle with obesity continues and is a leading cause of preventable death in the United States. It has increased almost yearly since 1990. Obesity appears to be abating among the very young[1] and is identified as a “winnable battle” by the Centers for Disease Control and Prevention. The graph below shows US self-reported obesity as it climbs and approaches 3 of every 10 adults (29.4%). This increase varies geographically, with obesity in Colorado more than tripling from 6.9% of adults in 1990 to 21.3% in 2014 and not quite doubling in Florida, moving from 13.6% of adults in 1990 to 26.4% in 2014.Obesity trends

The prevalence of obesity varies with educational attainment. Obesity among college graduates is only two-thirds of the obesity rate among those with less education. Obesity is also strongly associated with income.disparity in obesity

Physical inactivity, defined as the lack physical activity by individuals outside the work environment, has stagnated at the level of around 1 in 4 adults in the last few years. In an era when the work environment is becoming more sedentary, the need for physical activity and exercise outside the workplace is crucial in preventing and managing chronic disease.physical inactivity

Similar to obesity and smoking, inactivity varies by educational attainment. Making opportunities for activity part of each day for all adults -- regardless of work environment, educational attainment, or income -- will begin to address this disparity.Physical inactivity disparities

Increasing obesity has an ominous connection with the future prevalence of diabetes. The graph to the left parallels the graph above showing an increase in obesity. Self-reported diabetes has more than doubled in the last 20 years and is at 9.6% of the adult population. Furthermore, diabetes can be silent for years, and a lab test is required to positively identify. Thus, many cases go undiagnosed.[2] The increase in diabetes varies geographically; in Colorado the increase from 1996 to 2014 is 3% of the population, while in Alabama the increase in that same time span is 9%.Diabetes trends 1996 to 2014

 

Winnable battles

High School Graduation

High School Graduation 1990 to 2014A direct, upstream way to address the number of adults impacted by health disparities related to educational attainment is to improve education among teens. A more informed and educated populace creates greater opportunities for health across the population.

Graduation disparity by raceImprovements in the high school graduation rate have been consistent; there are now 9% more incoming freshman graduating 4 years later than in 2004. The current graduation rate of 81% is the highest in the last 25 years. Not all states have realized these gains since 2004. In Tennessee, there are 24% more incoming ninth graders graduating in 2014, and in Nevada, there are 10% fewer incoming ninth graders graduating in 2014. Unfortunately, not all races and ethnicities experience these improvements equally; graduation rates remain lower for blacks, Native Americans, and Hispanics compared with whites and Asians.

Violent Crime

Violent crime from 1990 to 2014Another bright spot in the nation’s health is the dramatic reduction in violent crime since the early 1990s. Violent crime is reduced almost 50% from its 1993 peak. This decline, however, does camauflauge the fact that homicide is still the leading cause of death among youth aged 10 to 24 years. Violent crime varies geographically, with 15 states experiencing an increase since 1990 -- led by the 168% increase in South Dakota. In New York, violent crime has dropped 60% since 1990.

Clinical Care

Preventable HospitalizationsSince 2001, preventable hospitalizations have declined 24% from 82.5 to 62.9 hospitalizations per 1,000 Medicare beneficiaries. In Mississippi, there are 37.7 fewer preventable hospitalizations per 1,000 Medicare beneficiaries in 2014 than in 2001 – a 32% decline. Louisiana has 35.3 fewer preventable hospitalizations per 1,000 Medicare beneficiaries in 2014 than in 2001 – a 35% decline.

Looking over the 25 years of health captured by America’s Health Rankings®, there are many accomplishments to celebrate. However, a lot of work remains so that we can all live up to our full life potential. Life expectancy at birth, while the highest it has ever been at 78.7 years, still lags other developed countries, leaving us substantial room for improvement. Another key challenge is that health gains are not experienced equally across the United States by state, race/ethnicity or educational attainment.


 

[1] Centers for Disease Control and Prevention. http://www.cdc.gov/obesity/data/childhood.html. Accessed October24, 2014.

[2] American Diabetes Association. http://www.diabetes.org/diabetes-basics/statistics/.0  Accessed October 24, 2014.

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Americas Health Rankings - 2013 Edition
America's Health Rankings, 2013 Edition; A Call to Action for Individuals and Their Communities, released December 2013

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Americas Health Rankings, 2013 Edition in Spanish

Americas Health Rankings - 2014 Edition
America's Health Rankings, 2014 Edition; A Call to Action for Individuals and Their Communities, released December 2014