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Healthcare scorecard: The bad offsets the good

MINNETONKA, Minn. — United Health Foundation’s "2011 America’s Heath Rankings," released Tuesday, found that increases in obesity, diabetes and children in poverty are offsetting improvements in smoking cessation, preventable hospitalizations and cardiovascular deaths. According to the report, the country’s overall health did not improve between 2010 and 2011 — a drop from the 0.5% average annual rate of improvement between 2000 and 2010, and the 1.6% average annual rate of improvement seen in the 1990s.

“Where people live matters. Every state can make improvements to ensure healthier quality of lives for their residents,” stated Reed Tuckson, United Health Foundation board member and EVP and chief of medical affairs for the UnitedHealth Group. “In the history of the rankings, we have seen many examples of stakeholders coming together to improve their standing. States, such as Tennessee and Maine — which made explicit efforts to improve their rankings — have shown us that improved public health is achievable but must be tackled in a concerted and aggressive way.”

For the fifth year in a row, Vermont is the nation’s healthiest state. States that showed the most substantial improvement include New York and New Jersey, both moving up six places, largely because of improvements made in smoking cessation. Idaho and Alaska showed the most downward movement. Idaho dropped 10 spots, from number nine to 19 in this year’s rankings, and Alaska dropped five places.

To see the rankings in full, click here.

This year’s rankings, which offers a state-by-state snapshot of population health based on 23 measures, includes several positive nationwide trends:

  • Smoking cessation: 17.3% of the population smoked in 2011, down from 17.9% in 2010 — a 3.4% decline since 2010; a 25.4% decline since 2001;

  • Preventable hospitalizations: 68.2 preventable hospitalizations per 1,000 Medicare enrollees in 2011, down from 70.6 preventable hospitalizations in 2010 — a 3.4% decline since 2010; a 17.3% decline since 2001; and

  • Cardiovascular deaths: 270.4 deaths per 100,000 in 2011, down from 278.2 deaths per 100,000 in 2010 — a 2.8% decline since 2010; a 22.2% decline since 2001.

These improvements were offset by increases in:

  • Obesity: 27.5% of the adult population in 2011, up from 26.9% of the adult population in 2010 — a 2.2% increase since 2010; a 37.5% increase since 2001. 2011 marks the first year when no state had an obesity prevalence under 20%;

  • Diabetes: 8.7% in 2011, up from 8.3% in 2010 — a 4.8% increase since 2010; a 42.6% increase since 2001; and

  • Children in poverty: 21.5% in 2011, up from 20.7% in 2010 — a 3.9% increase since 2010; a 33.5% increase since 2001.

The fact that the country did not improve in overall health status means there was a balance between improvements and detriments across all 23 measures. A compelling example of this stagnation is the improvement in the number of smokers being offset by worsening rates of obesity: the rankings found that, for every person who quit smoking in 2011, another person became obese. And a 2010 report from the UnitedHealth Center for Health Reform & Modernization indicated that if current trends continue, diabetes and prediabetes will account for approximately 10% of total healthcare spending by 2020 at an annual cost of almost $500 billion — up from an estimated $208 billion this year.

“While this year’s rankings shows some important improvements, we also see some very alarming trends — particularly diabetes and obesity — that, left unchecked, will put further strain on our country’s already strained health care resources,” Tuckson said. “At a time when the nation, states and individual families are grappling with tightening budgets and growing healthcare expenses, this year’s rankings sends a loud wakeup call that the burden of preventable chronic disease will continue to get worse unless we take urgent action."

In conjunction with the report, United Health Foundation is launching an interactive “Take Action for Change” campaign to incent Americans to adopt healthier habits. “Take Action for Change” is designed to inspire people to adopt healthier behaviors. For every day someone pledges an “act of health” on the America’s Health Rankings Facebook page, United Health Foundation will make a 25 cent donation — up to a total of $50,000 — to nonprofit organizations dedicated to improving the nation’s health.

Visitors to the Facebook page will be able to upload their own “acts of health” and vote for which nonprofit organization will receive the donation.

The American Cancer Society, Campaign for Tobacco-Free Kids and YMCA are partnering with United Health Foundation on this initiative.


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