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Minnesota’s overall health ranking dips in national report

Minnesota’s overall health ranks sixth among all 50 states, according to the 2014 edition of America’s Health Rankings released Wednesday by the United Health Foundation.

That’s a discouraging drop from the state’s third-place ranking in 2012 and 2013. It’s also a significant change from the first place ranking the state held for six out of seven years from 2000 through 2006. (The exception in that run of years was 2001, when we were ranked second.)

Hawaii was cited, as it was last year, as the healthiest state in the country, followed this year by Vermont, Massachusetts, Connecticut and Utah.

Mississippi came in last in the rankings, preceded by Arkansas, Louisiana, Kentucky and Oklahoma.

“Minnesota continues to perform well in most measures of public health, but we’ve slipped in some key areas and we are still seeing significant racial disparities in health status,” said Minnesota Health Commissioner Dr. Ed Ehlinger, in a statement released by the Minnesota Department of Health.

The annual rankings, done in collaboration with the American Public Health Association and Partnership for Prevention, feature year-by-year data on a wide variety of health measurements. This year marks the 25th anniversary of the rankings, so the report also offers a long-term look at how the states — and the country — have progressed (or regressed) on those measurements since 1990.

Minnesota trends

United Health Foundation

Despite its slip in the overall ranking, Minnesota continues to lead the country with the lowest death rate from cardiovascular disease, including heart attacks and strokes (184.7 deaths per 100,000 population). It also has the second-lowest rate of premature death (down 5 percent in the last two years alone), and the second-lowest rate of “days of poor physical health” (the average number of days in the previous month that a person could not perform work or household tasks due to physical illness).

We also ranked fourth on the percentage of people who report having been diagnosed with diabetes (7.4 percent), the percentage of people who lack health insurance (8.1 percent), and the number of days within the past month that people report their mental health was not good (2.9 days, on average).

The health challenges facing Minnesota that were identified in the report include the state’s high prevalence of binge drinking (we ranked 46th on this measurement), high incidence of whooping cough (pertussis)(we ranked 48th) and low per capita public health funding (we ranked 44th, with an investment of $48 in state and federal funding per resident).

National trends

Looking back over the past 25 years of America’s Health Rankings data, it’s clear that several positive national health trends have taken place since 1990:

  • U.S. life expectancy is now at a record high: 78.8 years. (That number is still disappointingly low, as background information in the America’s Health Rankings report points out. We rank 34th among other nations for life expectancy. Almost all European countries, as well as Japan, Australia, Singapore, Canada, and New Zealand, have a longer life expectancy — at least three years longer in 18 of those countries.)
  • The infant mortality rate has fallen 41 percent. (The U.S. is still ranked a dismal 42nd globally for its infant mortality rate, however. Indeed, 24 countries, including Japan, Australia and most of Western Europe, have infant mortality rates that are half our rate.)
  • The rate of deaths from heart disease has declined 38 percent.
  • The rate of premature death has dropped 20 percent.
  • The smoking rate has declined 36 percent, from 29.5 percent of all adults in 1990 to 19.0 in 2014. Unfortunately, that rate is still far too high. One in five U.S. deaths is still linked to smoking, making it the country’s leading cause of preventable death. (In Minnesota, 19 percent of adults smoke, ranking us 18th for the lowest rate of smokers among all the states.)

Yet, there have been troubling negative trends as well.

  • The U.S. obesity rate has more than doubled, from 11.6 percent of adults in 1990 to 29.4 percent in 2014. (Minnesota’s obesity rate is 25.5 percent, the 10th lowest in report.)
  • The country’s diabetes rate has also more than doubled, from 4.4 percent in 1990 to 9.6 percent today. (Minnesota’s rate is 7.4 percent, the fourth lowest, as already noted.) More than 90 percent of diabetes cases diagnosed in the U.S. are type 2 diabetes, for which being overweight or obese is a major risk factor.

One final observation from this report: Minnesota was ranked No. 1 in the 1990 America’s Health Rankings report, but it has never dropped below 6th place in the ensuing 25 years. The same can’t be said of two of our neighbors. Wisconsin’s overall health ranking has dropped from 7th place in 1990 to 23rd in 2014. And Iowa’s ranking has made a similar precipitous fall, from 6th place in 1990 to 24th in 2014.

You can read the full report, including the specific data for Minnesota (and other states), at the report’s website.

Comments (2)

  1. Submitted by Jim Million on 12/11/2014 - 10:47 am.

    Relative Rankings

    As someone who fairly well understands this stuff, I may have more to say after reading the full report. Until then:

    Relative rankings often change because other less effective players target their weaknesses and suddenly improve greatly in benchmarks already achieved by others, perhaps Minnesota. The article notes a few of those. The noted spending ratios may also indicate that other states have been playing catch up with higher targeted budgets.

    Minnesota’s $48/capita spending may give us a “low” rank there for several reasons. We may truly not be “spending enough” in the eyes of some; we may not need to spend as much because we have already achieved positive results in critical areas; other states may finally be catching up. Or, simply, our population may have grown significantly faster than budget timing. To that issue, we should note that our relative trend has been up (modestly) since about 2009, indicating stability of strength.

    The author does not note a significant possibility that many of us are aging in place. Minnesota is not a “young” state with respect to some others. The author does quietly hypothesize as to other demographic trends, however.

    Overall, it seems we have been spending our money effectively in traditionally critical areas. One must wonder a bit at the internal consistency of the larger report. That requires additional scrutiny.

    The author’s dismay that Minnesota’s 6th place rank is “a discouraging drop from the state’s third-place ranking in 2012 and 2013” must be tempered by relative histories. She adds: “It’s also a significant change from the first place ranking the state held for six out of seven years from 2000 through 2006. (The exception in that run of years was 2001, when we were ranked second.)”

    Those of us who know Minnesota’s care patterns coming out of the 1990s know that we were far ahead of so many other states in terms of the “managed care model.” We did our work early. As one who has always noted this also to be a “managed price model,” I must clearly state that we have achieved significant successes in “managed care.” We actually have a primary clinic structure that does what it was intended to do way back then. Quite frankly, United Health Group took our/their model national, and became the largest vendor, with the help of AARP, of course.

    Other states have been playing catch-up, certainly…and they have been literally paying for it. We should also look at who got on board early with electronic medical records, and who did not. Never minimize the positive health outcomes of that information leap. Let us not become distraught over a “slip” from 3rd to 6th. Let us, rather, study the internals and calmly review our plan.

    More money is certainly not the simplistic answer if we are 6th in the nation. After 25 years of turmoil in managed care, we all should be quite happy with that, especially given the steady upward trend in our stats. That’s called “stability.”

    [If a reader’s “hot button” is “binge drinking,” please disregard this commentary. jrm]

  2. Submitted by pat starkes on 03/25/2015 - 02:02 pm.

    Control your diabetes!

    I have a friend that just lost a leg because of infection. They say his diabetes did not allow him to heal his wound. Now he has to worry about his kidneys shutting down.

    Diabetes is on a rampage. More and more people are developing diabetes in astronomical proportions (directly related to obesity). Manage your diabetes and reduce the risk of complications.

    Diabetes in a nutshell:
    http://www.diabetestech.info

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