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The 2012 America's Health Rankings highlight troubling levels of obesity, diabetes, high blood pressure and sedentary behavior. Medical advances are allowing more people to live with those conditions.

The bottom line: Americans "are living longer, sicker" with more chronic illness, says Reed Tuckson of theUnited Health Foundation, a not-for-profit foundation that sponsors the report with the American Public Health Association and the Partnership for Prevention.

For the sixth consecutive year, Vermont tops the list of healthiest states, says the report, which uses data from the Centers for Disease Control and Prevention, American Medical Association, Census Bureau and even the FBI. It looks at 24 measures of health, including tobacco and alcohol abuse, exercise, infectious diseases, crime rates, public health funding, access to immunizations, premature birth rates and cancer and heart disease rates.

States that are most successful on the rankings "have good results in a majority of the conditions we evaluate," Tuckson says. But states such as Mississippi and Louisiana, which tied for last place, "are over represented in key measures like tobacco consumption, lack of exercise and obesity ? the fundamentals," he adds.

Although socioeconomic factors play an important role in some states' consistent low rankings, "we know it is possible to improve; states are capable of doing that," says Georges Benjamin, executive director of the American Public Health Association. Key to that effort is "taking lessons from things they do well and applying them more vigorously to the things they are not doing well."

Louisiana has low rates of binge drinking and a high rate of childhood immunization, but it ranks in the bottom five states on 13 of 24 health measures, including obesity and diabetes.

But "we don't have to accept those" indicators, says Karen DeSalvo, health commissioner for New Orleans. She says an extensive effort is underway "to get us to the place we need to be ... to be a healthy state."

States that showed the most substantial improvement in rankings include New Jersey (up nine places on the list); Maryland (up five). Alabama, Colorado, Massachusetts, Nebraska, Oklahoma, and Rhode Island each moved up three.

Among the unhealthy behaviors the report cites:

  • More than a quarter (26.2%) of all Americans are sedentary, defined as not doing any physical activity outside of work for 30 days. But it's 36% in Mississippi, and 35.1% in both Tennessee and West Virginia.
  • 27.8% of U.S. adults are obese, defined as being roughly 30 or more pounds over a healthy weight. That's 66 million people ? more than the entire population of the United Kingdom. In even the least obese state, Colorado, more than 20% of the population is obese.
  • The percentage of adults with diabetes is 9.5% nationally, but it's 12% or higher in West Virginia, South Carolina and Mississippi.
  • 30.8% of U.S. adults have high blood pressure, but that ranges from a low of 22.9% in Utah to a high of 40.1% in Alabama. High blood pressure, or hypertension, is a primary risk for cardiovascular disease ? problems related to the heart and the blood vessels.

"There's no way that this country can possibly afford the medical care costs and consequences of these preventable chronic illnesses," says Tuckson. "We have two freight trains headed directly into each other unless we take action now."

"People have to be successful at taking accountability for their own health-related decisions."

Life expectancy in the USA is now 78.5 years; premature deaths have dropped 18% since 1990, and deaths from cardiovascular disease are down 34.6%. Cancer deaths are down 7.6%.

How states stack up

  1. Vermont
  2. Hawaii
  3. N.H.
  4. Massachusetts
  5. Minnesota
  6. Connecticut
  7. Utah
  8. New Jersey
  9. Maine
  10. Rhode Island
  11. Colorado
  12. North Dakota (tied)
  13. Oregon
  14. Washington (tied)
  15. Nebraska
  16. Wisconsin
  17. Idaho
  18. New York
  19. Maryland
  20. Iowa
  21. Virginia
  22. California
  23. Wyoming
  24. Kansas
  25. Arizona
  26. Pennsylvania
  27. South Dakota
  28. Alaska
  29. Montana
  30. Illinois
  31. Delaware
  32. New Mexico
  33. North Carolina
  34. Florida
  35. Ohio
  36. Georgia
  37. Michigan
  38. Nevada
  39. Tennessee
  40. Texas
  41. Indiana
  42. Missouri
  43. Oklahoma
  44. Kentucky
  45. Alabama
  46. South Carolina
  47. West Virginia
  48. Arkansas
  49. Louisiana
  50. Mississippi (tied)

Source: United Health Foundation, 2012

Unhealthy conditions

  • Percentage of U.S. adults* who are obese: 27.8%
  • Percentage who are physically inactive: 26.2%
  • Percentage who smoke: 21.2%

*18 and older
Source: United Health Foundation, 2012

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