After a decade of robust gains, America's health has leveled off and may be poised to take a plunge, an analysis warns.
The 2008 America's Health Rankings, out today, offer a comprehensive look at nearly two decades of progress in access to medical care, immunizations, prenatal care, infant mortality, heart disease deaths, smoking cessation, deaths by infectious disease, violent crime and occupational fatalities.
The analysis of 22 measures indicates that the nation's health improved by 18% from 1990 to 2000. For the past four years, however, progress has stalled. What worries health experts most is that ballooning waistlines, addiction to tobacco and mounting rates of chronic diseases threaten the gains.
"This is a perfect storm," says Reed Tuckson of the United Health Foundation, sponsor of the analysis with the American Public Health Association and Partnership for Prevention.
Vermont is the healthiest state, the analysis showed, with a smoking rate that was 17.6%, below the national average of 20%; a slower increase in obesity than the national rate, and a higher proportion of people with health insurance. Louisiana is the least healthy, with high infant mortality, high death rates from cancer, and high rates of racial disparities in health care.
Vermont Gov. Jim Douglas credits the state's progress to his "Blueprint for Health" plan, launched in 2003, for putting a premium on prevention, early diagnosis and management of chronic disease.
Louisiana's secretary of health and hospitals, Alan Levine, says Gov. Bobby Jindal has proposed an overhaul of medical care, one that would vastly expand access to private health insurance. Jindal also supports creating a coordinated Medicaid managed care system for low-income residents that rewards prevention and efficient, coordinated care, Levine says. "In Louisiana, we have two choices," he says. "We can make excuses for being No. 50, or we can change the system."
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