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America improves health, but risks growing

Improvement slowing, though, and could stall, survey says

By Michael Coren
United States
University of North Carolina at Chapel Hill

ATLANTA, Georgia (CNN) -- The average resident of Minnesota stands a better chance of avoiding smoking, car accidents and obesity than a friend living 900 miles to the south in Tennessee.

That is among the findings of a study released on Monday by the United Health Foundation, which has been tracking the nation's health for the past 15 years.

The nationwide study found plenty to cheer about -- Americans are getting healthier and smoking is on the decline -- but improvements are slowing and could stall completely if trends continue.

"There is an urgency in this year's report that we haven't had in recent years," said Dr. Reed Tuckson, a physician and vice-president of the non-profit United Health Foundation. "Each state has its own set of challenges to work through. ... There is much more room to go."

People in every state enjoy better health today on average than 15 years ago, but the improvements have not been distributed evenly.

Minnesota, New Hampshire and Vermont are considered the healthiest states in the country, followed by Hawaii (4), Utah (5) and Massachusetts (6).

Southern states, which have consistently ranked near the bottom of the rankings, accounted for the bottom 11 states in the 2004 survey including Tennessee (48), Mississippi (49) and Louisiana (50).

Tuckson said that while health levels are not expected to fall, he doesn't anticipate any significant gains in the near future.

The study found the nation enjoyed a 17.5 percent improvement in overall health since 1990. It credits three factors including better personal health choices, safer communities and public health efforts, including a number of risk factors that have plunged during the 15 years.

Motor vehicle deaths and infectious disease are down -- both by about 36 percent. A nationwide anti-tobacco campaign helped push down smoking rates by 25 percent.

But the study also found that health improvements during the past four years fell to an average of .2 percent. That is down from a peak of 1.5 percent per year in the 1990s. Rising poverty, obesity and the number of uninsured people are threatening the gains made since then. This year marked the fourth consecutive year in which national health improvements fell below 1 percent.

However, several health advances were apparent in 2004.

Struggling states, like Mississippi and Tennessee, made improvements in reducing infectious disease and smoking. Alaska, Arizona and Oklahoma showed the best performance over 2003 with average health increases of more than 5 percent, including better marks for public health spending, exercise and disease prevention.

However, even within states, discrepancies between racial groups were large with minorities suffering disproportionately. Blacks and American Indians reported the most health problems leading to what the study called "premature death." This was true even in the healthiest states.

"In Minnesota, many more white, non-Hispanic individuals enjoy a longer, productive life than their American Indian or black, non-Hispanic counterparts," the survey found.

The study considered a range of factors from personal behavior such as smoking and high school graduation rates to public health spending and crime and poverty rates to make its determinations.

Several trends were seen as straining American's health nationwide.

Infant mortality in the United States rose for the first time in 40 years, inching up 1.4 percent from 2003 levels with seven deaths per 1,000 births. The United States is now ranked 29th in the world in terms of infant mortality despite a 31 percent decrease since 1990. That rate is twice that of developed countries such as Japan and Sweden.

Obesity has also doubled during the past 15 years, to about 23 percent of the population. This puts more people are at risk for diabetes and heart disease as well as contributing to rising health costs and lost productivity.

Childhood poverty rose as well. It now includes 17.6 percent of American minors, up 8 percent from last year. This problem was found across the nation with Oregon, Virginia, Washington and Rhode Island all reporting increases of at least 5 percent. More people in 38 states became uninsured in 2004, limiting their access to quality health care, according to the study.

The United Health Foundation states that individuals, community leaders and policy makers should use the report to tackle problems highlighted in the study, said Dr. William McGuire, chairman of the United Health Foundation board. The study is overseen by a panel of public health specialists from the University of North Carolina at Chapel Hill.

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