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America’s Health Rankings® presents its 28th Annual Report, providing new insights to the longest-running assessment of the nation’s health on a state-by-state basis.
The 2017 report looks at 35 measures covering behaviors, community and environment, policy, clinical care and outcomes data. The report also serves as a benchmark for states – and the nation – to measure progress, identify emerging trends and drive action for improving public health.
This year, the report reveals that the nation is facing serious public health challenges, including rising rates of premature death and an uneven concentration of key health care providers.
United Health Foundation, through America’s Health Rankings platform, helps policy-makers, public health officials, researchers and communities improve the health, well-being and health care at the local, state and national level.

The Nation Faces Concerning Trends in Mortality

Across the U.S., the premature death rate (the number of years of potential life lost before age 75) increased for the third straight year, reaching 7,214 years lost before age 75 per 100,000 population. This recent rise is concerning, particularly after the premature death rate declined dramatically by 20 percent from 1990 to 2015.
2017 also saw increases in the rates of cardiovascular and drug deaths nationwide. Cardiovascular deaths increased in the U.S. for the second consecutive year. The rate among blacks is significantly higher than the rate among whites, Hispanics, Asians and American Indians/Alaska Natives. Drug deaths continued on an upward trend, increasing by 7 percent to the highest level recorded by America’s Health Rankings (15.0 deaths per 100,000 population) and were particularly high among whites.

Mortality rates are increasing in many states, even those ranked highly for overall health

The report finds that over the past five years, even some of the nation’s healthiest states by overall rank have experienced notable increases in key measures of mortality. Three northeastern states that regularly rank toward the top in overall health have experienced large increases in drug deaths.
  • New Hampshire's rate increased by 118 percent (additional 13.2 deaths per 100,000 population).
  • Massachusetts’ rate increased by 69 percent (additional 8.1 deaths per 100,000 population).
  • Rhode Island’s rate increased by 56 percent (additional 8.9 deaths per 100,0000 population).
This trend is also true for cardiovascular deaths. Although ranked as the fourth healthiest state this year, Utah experienced one of the largest increases in the rate of cardiovascular deaths (additional 21.9 deaths per 100,000 population) from 2012 to 2017.
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Wide variation across the country in the concentration of health care providers

This year's report also examined the concentration of key health care providers, including mental health providers, primary care physicians and dentists, and found wide variation across the country.
Nationwide, the concentration of mental health providers varies most widely, with some states having six times the number of mental health providers per 100,000 population than other states.
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The distribution of primary care physicians and dentists also varies across the country by approximately two to one. Rhode Island, Massachusetts, New York and Connecticut have more than 200 primary care physicians per 100,000 population, compared with fewer than 100 physicians per 100,000 in Utah and Idaho. Similarly, Massachusetts and New Jersey have more than 80 dentists per 100,000 population while Arkansas, Mississippi, Alabama and Delaware have fewer than 45 dentists per 100,000 population.
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This year, Massachusetts ranks as the healthiest state, while Hawaii - which has held the top spot for the past five years - drops to second. Vermont (No.3), Utah (No.4) and Connecticut (No.5) round out the top five states for overall health.
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For the second year in a row, Mississippi (No.50) has the greatest opportunity for improvement in overall health. Louisiana (No.49), Arkansas (No.48) and Alabama (No.47) maintained their rankings from last year, while West Virginia fell three places (No.46) to round out the five states with the most significant areas of opportunity for improvement in health and well-being.
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Florida and Utah experienced the largest rank improvements since last year, rising four places in the rankings to No.32 and No.4 in the country, respectively. Florida's improvements include positive changes in its rankings for the percentage of children in poverty and frequent mental distress since 2016. Utah also improved its rankings for several measures in the same time period, including air pollution and immunizations among children.
North Dakota experienced the largest rank decline, falling seven places in the rankings to No. 18 in the country. The state's rankings for smoking, Salmonella and immunizations among children all declined in the past year.

Addressing mounting challenges to the health of our nation

For the 28th year, America's Health Rankings provides data and insights on a national and state-by-state level, which can be used to drive action in improving the health of our communities. While the report highlights significant challenges facing our country, Unite Health Foundation also recognizes cross-stakeholder collaboration has resulted in local successes, which may have potential for adaptation across geographies. Community leaders looking to improve the health of where they live are encouraged to leverage the report's findings, along with the additional data available on the America's Health Rankings website, to identify opportunities for improvement.

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