As Gov. Tim Pawlenty was gearing up for re-election in late 2005, he began drawing attention to Minnesota’s high and slightly improving national rankings on measures of public health.
Just three years earlier, on his way to becoming the most conservative governor the state had elected in a half-century, Pawlenty’s stock campaign speech had been all about how Minnesota had been slipping on key indicators since the Time magazine cover in 1973. He frequently used the imagery of warning lights on a car’s dashboard and the need for new leadership to get Minnesota in the shop, tuned up and purring again, mostly by shrinking government.
DFL leaders hotly retorted that those enviable health rankings had been achieved decades earlier under liberal DFL and more moderate Republican leadership. Further, they argued, that superiority had been preserved largely because the DFL state Senate had been able to thwart Pawlenty’s proposed cuts in programs that expanded access and quality health care to low- and moderate-income families.
When challenging incumbents, Minnesota candidates in both parties inevitably trumpet any decline in rankings they can find. After winning and holding office for a while, they seize on rankings that all along have been consistently near the very top.
Rankings do matter to Minnesotans. We tend to flaunt them more, than, say, Mississippians, for the obvious reason that we perennially are near the top and they are not. We actually rank high in state pride, based on those rankings. In a 2014 report based on Gallup polling data, Minnesota ranked 10th in state pride, measured by agreement with the question that “my state is the best or one of the best states in which to live.” Most of the other states in the top 10 were in the Mountain West or Pacific Northwest. Braggadocios Texas made the top 10, also New Hampshire and North Dakota.
Cynics have suggested over the years that this rankings obsession is due partly to Minnesota’s provincial insecurity complex. We suffer from a compulsion to find relevance and distinction above all the other less populated and unimportant jurisdictions between California, the eastern megalopolis and the Sun Belt. Defensiveness about winters – “as hard as the Ice Age,” Time described them in 1973 – also fuels ranking mania.
My own rejoinder to kinfolk in my native Texas who wonder why I live in Siberia always goes something like this: “OK, it’s cold in the winter, but your summers are pure hell, plus we rank higher than y’all on almost all the really important things.’’ I usually add Gen. Philip Sheridan’s observation in 1866 that if he owned Texas and hell, he’d rent out Texas and live in hell.
Rankings, made easier since 1973 with spreadsheet technology and digital wizardry seem to have become a national phenomenon as well, and a favorite form of clickbait on the internet. Just search for “states ranked by …” or “how does Minnesota rank on …” and you can wander down rabbit holes for hours.
Caveats must be applied to any presentation of rankings. No single ranking based on one metric from one source can possibly tell the whole truth about a state, or even a situation within the state. Interest groups routinely cherry-pick and weaponize rankings from sources that lend support to their talking points and ignore those that provide contrary context. Rankings from nonpartisan and national mainstream media sources and those that consider several factors are generally more credible than single-factor rankings from partisan or ideological groups.
All qualifiers considered, rankings and aggregate data do provide a general sense of things and help us get beyond anecdotal impressions on the state of our state. They serve an important purpose for voters and for public servants who seek to improve the lives of the people they serve, and to make the state as competitive and attractive as possible for workers and employers.
Then and now on the main things
A review of the key indicators flagged by Time a half-century ago suggests that Minnesota generally has maintained its advantage. We remain one of the better places in the world in which to live, to work, to create and recreate and even to retire. The glaring exceptions are racial disparities (see Part II of this series) and declines around some aspects of education and governance.
The rankings cited in this commentary and in accompanying charts are from U.S. Census data or government sources, unless indicated otherwise. Baseline 1970s data are simply not available for many of today’s rankings. Subsequent articles in this series will be informed by rankings on various aspects such as business vitality, taxes and spending, environmental conditions, arts and culture and civic health.
Arguably, the rankings that matter most are those that measure the degree to which people are, to borrow a phrase from Benjamin Franklin, “healthy, wealthy and wise.” (Franklin’s prescription for achieving these things was “early to bed and early to rise” and wouldn’t you know it, Minnesotans ranks 3rd best for getting enough sleep at night, according to the Sleep Foundation.)
On longevity, a crucial bottom-line measure of health, Minnesota holds steady. We were second in 1970 and third in 2022, rising from 73.0 to 79.1. All states improved over this period, but other Midwestern states dropped out of the top 10 and were replaced mostly by coastal states.
A clear pattern emerges on this metric and on many others that measure quality of life and socio-economic condition. Out of the top 10 for longevity in 2019, nine were “blue,” or liberal Democratic states that embraced the Affordable Care Act and typically provided more public assistance for health care access. Declining health metrics have been well documented in states where more conservative white majorities prevail, and that have rejected or obstructed the Affordable Care Act and expansions of Medicaid eligibility.
On more comprehensive multi-factor health rankings that measure many criteria, Minnesota still ranks consistently high: third on the Commonwealth Fund’s ranking of State Health System Performance; seventh on the United Health Foundation’s list of Healthiest States; and third on WalletHub’s list for Best States for Health Care. Not so great: We are only 17th least obese, only 18th lowest in tobacco use, and way too high in alcohol consumption, at 38th (higher ranking is less alcohol per person).
A perhaps surprising bright spot: Minnesota ranked fourth (least bad) on Wallet Hub’s recent ranking of drug problem severity in the states. More than 21 metrics were considered, ranging from arrest and overdose rates to opioid prescriptions, availability of addiction and mental health treatment, and employee drug testing laws.
So we’re relatively healthier compared to 1973 and to other states now, but as that annoying TV commercial asks incessantly, what’s in our wallets?
Time in 1973 stated, without specifying a ranking that poverty rates were “among the lowest in the nation.” And while admiring a versatile and balanced economy, it reported that Minnesota was only a middling 19th in per capita income.
Major progress here. Minnesota’s poverty ranking improved from 15th lowest in 1970 to fourth lowest in 2021 and median income climbed from 17th to 12th. The rankings bounce around a bit year to year, but generally Minnesota hovered around 20th a half-century ago and now often comes closer to the top 10. (A glaring qualifier, analyzed at length in the previous installment, are larger racial gaps than in most states.)
Perhaps more important than annual income, Minnesota ranks even higher on personal wealth, or an impressive third in median net worth, according to a report earlier this year by CNBC. And the website www.chamberofcommerce.org ranks Minnesota 10th “richest” using six criteria including real per capita personal income, per capita consumption expenditures, poverty rates, state and local general revenue, and the amount a resident needs to be considered part of its top 5%.
These rankings fly in the face of a constant refrain from the right, increasingly strident in recent years, that Minnesota’s progressive policies are bad for business and our economy. In fact, the state continues to rank high in Fortune 500 companies per capita, patents per capita and on many indicators of business vitality. A recent “Best States for Business” ranking from CNBC placed Minnesota ninth. A future commentary in this series will delve further into Minnesota’s basic economic character and performance over the last half-century.
Few correlations to health and prosperity are stronger than educational attainment, and here again Minnesota has stayed above average on most metrics since 1973. However, trouble spots in this realm are among our most worrisome.
Citing Minnesota’s emergence as one of the nation’s leading “brain-industry centers” Time in 1973 reported that “the citizens are well educated; the high school dropout rate, 7.6%, is the nation’s lowest.’’ Time also cited a cultural tradition that included “a near-worship for education” but didn’t go into much further detail.
Although Minnesota’s annual dropout rate had improved to 4.1 by 2018, other states caught up on education investment and improved faster, while our increasing racial disparities took a toll on overall attainment and test scores. Minnesota has dropped to 12th (still higher than all Midwestern states except North Dakota) in the dropout rate, according to www.USAFacts.org.
The most recent rankings on educational attainment, compiled by Wikipedia, place Minnesota fifth in high school graduates (94%), 11th in four-year diplomas (39%) , and 20th in post-grad degrees (13%).
However, Minnesota no longer can claim to be among the top 10 in the basic conditions of its public educational systems. Several multi-factor rankings of educational quality place us in the teens or 20s. U.S. News ranked Minnesota 17th for “Best States for Education.”
Looking beyond just test scores and schools, Minnesota generally ranks very high on more comprehensive assessments of well-being for children and young people. The multi-factor 2020 Kids Count profile by the Annie E. Casey Foundation ranks Minnesota 3rd overall for the well-being of children.
The most complete upside take on our rankings, already on coffee tables in thousands of Minnesota living rooms, is the 2017 book, “Amazing MN: State Rankings & Unusual Information.” The author is Lee Lynch, a prominent retired advertising executive and civic leader, an unapologetic booster of Minnesota and the Twin Cities. The blurb on the jacket of the lavishly illustrated 272-page volume promises to tell a story of Minnesota as “a model for prosperity, creativity, and quality of life (and) not the usual tourism hype about Paul Bunyan or the best bed-and-breakfasts. It’s about the fabric of the state, its constant investment in the arts, its dedication to the environment, its balanced economy, its educational attainment, and, above all, its water.”
Optimism is in order but smugness with these rankings is not a good look. Time in 1973 perceptively found fault with a Minnesota tendency toward “middle-class complacency” and “a kind of porcine self-satisfaction,” captured a century ago by Sinclair Lewis in “Main Street” and his other novels based in his home state. (Not to brag, but Lewis was the first writer from the United States to win the Nobel Prize for Literature.)
Moreover, our dismal rankings on racial disparities and a loss of stature on educational systems and good-government performance are every bit as important as our superlatives. But taking some pride in doing well because we have done the right things ought to be OK. And when a state does as well as Minnesota on so many rankings, year-after-year over many decades, it might just mean we have been doing at least some things right. Doubling down on our strong suit, a compassionate and pragmatic egalitarianism, might be the best course forward.
Next: Minnesota’s enduring essence: Aspiration for equality
Sources and links: (see citations in lists accompanying this installment)
“Minnesota’s Still the Healthiest State,” Star Tribune, Dec. 13, 2005, access through Saint Paul Public Library newspaper archives: https://sppl.org/