Off-peak condition

Increases in the infectious disease rate and the percentage of people without health insurance, along with a drop in per-capita public health spending, caused Massachusetts to slip three notches, to ninth place, in the United Health Foundation’s annual ranking of health status in the 50 states, released in December. The Bay State peaked at third place in 2002, below only New Hampshire and Minnesota in healthiness, but has lost ground since then in just about every criterion. One reason is that the rest of the nation is slowly catching up to us in healthy habits. For example, the smoking rate in Massachusetts dropped from 19.5 percent of the adult population in the 2002 report to 18.4 percent this time; nationally,however, it dropped even more steeply, from 22.9 percent to 20.8 percent over the same period. Similarly, the percentage of pregnant women receiving “adequate” prenatal care dropped here, from 83.9 percent to 83.4 percent of all pregnant women, while rising ever so slightly at the national level from 76.0 to 76.2 percent.

Massachusetts still gets a lot of points when it comes to “risk factors,” thanks to consistently low numbers in motor-vehicle deaths, workplace fatalities, and the incidence of obesity—which, combined with a low smoking rate,may help to explain a low rate of heart attack deaths. According to the latest data, the rate is 279 deaths per 100,000 residents, as opposed to 333 deaths at the national level. (New Mexico, in contrast, has among the lowest rates of deaths from health causes but has extraordinarily high numbers of auto-accident fatalities and homicides.) But the Bay State has consistently been slightly above the national average in cancer deaths—208 deaths per 100,000 people, compared with 204 nationally.Like most urban states, it has also had trouble keeping down its rate of infectious diseases (defined by the UHF as including AIDS, tuberculosis, and hepatitis). In the latest index Massachusetts fell from 29th to 37th in that category, with a rate of 24.3 cases per 100,000 residents, versus 21.3 the previous year.

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Finally, while the poverty rate in Massachusetts remains low, the state lost points with the UHF because of an uptick in the number of people without health insurance (from 10.7 percent of the population in 2003 to 11.7 percent in 2004) and a cut in public health spending (from $170 per person in 2002 to $150 in 2003).

AMERICA’S HEALTH RANKINGS

Rank State Cardiovascular Death Rate
(Reverse Rank)*
Cancer Death Rate
(Reverse Rank)*
Infectious Disease Rate
(Reverse Rank)**
1. Minnesota 1 15 14
2. Vermont 22 24 7
3. New Hampshire 13 23 10
4. Utah 5 1 13
5. Hawaii 2 2 34
6. North Dakota 17 8 1
7. Connecticut 10 11 38
8. Main 8 45 5
9. Massachusetts 7 33 37
10. Iowa 24 21 6
11. Nebraska 14 13 12
12. Rhode Island 21 31 29
13. Wisconsin 23 19 8
14. Washington 16 18 22
15. New Jersey 28 35 44
16. Idaho 10 6 4
17. Colorado 4 4 19
18. Oregon 13 28 25
19. Wyoming 18 14 9
20. South Dakota 20 12 2
21. Montana 12 22 3
22. California 30 17 41
23. Kansas 26 20 11
24. Virginia 25 29 30
25. Pennsylvania 33 36 35
26. New York 36 10 50
27. Ohio 40 43 16
28. Illinois 31 38 32
29. Michigan 42 27 23
30. Alaska 5 16 24
31. Arizona 9 5 39
32. Indiana 38 47 17
33. Delaware 27 34 45
34. Maryland 29 32 48
35. Missouri 43 39 28
36. North Carolina 32 26 31
37. Nevada 35 42 33
38. New Mexico 3 3 21
39. Texas 37 17 42
40. Florida 19 9 49
41. West Virginia 46 49 15
42. Kentucky 47 50 18
43. Georgia 41 25 47
44. Oklahoma 50 44 20
45. Alabama 44 37 26
46. South Carolina 34 30 43
47. Arkansas 45 41 27
48. Tennessee 48 46 36
49. Louisiana 39 48 46
50. Mississippi 49 39 40
* Based on 2000-02 data from the Centers for Disease Control and Prevention
** Based on 2002-04 data from the Centers for Disease Control and Prevention

Source: America’s Health Rankings 2005, United Health Foundation (www.unitedhealthfoundation.org).