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Most and least healthy states in America

  • #20. Iowa

    - Cancer deaths: 195.3 per 100,000 people (#20 worst of all states; 3.2% below national average)
    - Excessive drinking: 23.7% of adults (#2 worst; 30.2% below national average)
    - Drug deaths: 10.6 per 100,000 people (#5 best; 44.8% above national average)
    - Infant mortality: 5.7 deaths per 1,000 live births (#19 best; 1.7% above national average)
    - Public health funding: $91 per person (#24 best; 4.6% above national average)
    - Most healthy trait: Uninsured (4.7% of people; #6 best; 46.6% below national average)
    - Least healthy trait: Salmonella (23.5 cases per 100,000 people; #7 worst; 40.7% above national average)

    Iowa's well-funded public health program includes initiatives to help people quit smoking, screenings for cervical cancer, and food poisoning prevention. Still, the state is combatting heavy drinking and high obesity rates. The obesity rate in Iowa stands at more than 35%, seventh in the country.

  • #19. Wyoming

    - Cancer deaths: 169.5 per 100,000 people (#6 best of all states; 10.5% above national average)
    - Excessive drinking: 19% of adults (#16 worst; 4.4% below national average)
    - Drug deaths: 15.3 per 100,000 people (#17 best; 20.3% above national average)
    - Infant mortality: 4.8 deaths per 1,000 live births (#10 best; 17.2% above national average)
    - Public health funding: $112 per person (#15 best; 28.7% above national average)
    - Most healthy trait: Violent crime (212 offenses per 100,000 people; #7 best; 44.4% below national average)
    - Least healthy trait: Primary care physicians (111 number per 100,000 people; #5 worst; 30.5% below national average)

    Wyoming has one of the highest populations of uninsured people in the country. For those residents, the state offers programs related to aging, behavioral health, financing, and general public health initiatives. Unfortunately, diabetes, occupational death rates, and obesity are all rapidly increasing throughout the state.

  • #18. Maryland

    - Cancer deaths: 187.2 per 100,000 people (#20 best of all states; 1.1% above national average)
    - Excessive drinking: 14.6% of adults (#6 best; 19.8% above national average)
    - Drug deaths: 30.2 per 100,000 people (#6 worst; 57.3% below national average)
    - Infant mortality: 6.5 deaths per 1,000 live births (#16 worst; 12.1% below national average)
    - Public health funding: $104 per person (#18 best; 19.5% above national average)
    - Most healthy trait: Children in poverty (11.6% of children aged 0 to 17; #4 best; 35.6% below national average)
    - Least healthy trait: Drug deaths

    Drug deaths continue to be a problem in Maryland, mostly linked to fentanyl. High violent crime and infant mortality rates challenge the state as well, though it does benefit from relatively low rates of poverty, smoking, and physical distress.

  • #17. Nebraska

    - Cancer deaths: 187.6 per 100,000 people (#21 best of all states; 0.9% above national average)
    - Excessive drinking: 22.3% of adults (#6 worst; 22.5% below national average)
    - Drug deaths: 7.2 per 100,000 people (#1 best; 62.5% above national average)
    - Infant mortality: 5.9 deaths per 1,000 live births (#24 best; 1.7% below national average)
    - Public health funding: $98 per person (#22 best; 12.6% above national average)
    - Most healthy trait: Drug deaths
    - Least healthy trait: Salmonella (20.5 cases per 100,000 people; #11 worst; 22.8% above national average)

    Nebraska continually remains near the top of the rankings thanks to a low drug death rate, high immunizations, and a high percentage of high school graduates. But the state has seen its standing wobble lately as violent crime, cancer deaths, diabetes, and infant mortality have all increased.

  • #16. Idaho

    - Cancer deaths: 184.8 per 100,000 people (#17 best of all states; 2.4% above national average)
    - Excessive drinking: 16.5% of adults (#14 best; 9.3% above national average)
    - Drug deaths: 14.5 per 100,000 people (#15 best; 24.5% above national average)
    - Infant mortality: 5.4 deaths per 1,000 live births (#13 best; 6.9% above national average)
    - Public health funding: $150 per person (#4 best; 72.4% above national average)
    - Most healthy trait: Public health funding
    - Least healthy trait: Primary care physicians (96.6 number per 100,000 people; #1 worst; 39.5% below national average)

    Low rates of violent crime and diabetes help keep Idaho near the top of this year's ranking, as well as a rapid decrease in air pollution and children facing poverty. However, cancer death rates are up, as are cardiovascular death rates.

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  • #15. Virginia

    - Cancer deaths: 190.1 per 100,000 people (#24 best of all states; 0.4% below national average)
    - Excessive drinking: 16.9% of adults (#17 best; 7.1% above national average)
    - Drug deaths: 15.4 per 100,000 people (#18 best; 19.8% above national average)
    - Infant mortality: 5.9 deaths per 1,000 live births (#24 best; 1.7% below national average)
    - Public health funding: $77 per person (#16 worst; 11.5% below national average)
    - Most healthy trait: Violent crime (200 offenses per 100,000 people; #4 best; 47.5% below national average)
    - Least healthy trait: Mental health providers (171.9 per 100,000 people; #11 worst; 30.5% below national average)

    Virginians enjoy healthy perks of living like low violent crime rates, low levels of excessive drinking, and high immunization rates. But the state struggles with some important factors including access to public health funding and a large uninsured population. More than 10% of Virginia's under-65 population doesn't have insurance, and the majority of those uninsured are members of working families.

  • #14. North Dakota

    - Cancer deaths: 176.8 per 100,000 people (#10 best of all states; 6.6% above national average)
    - Excessive drinking: 22.8% of adults (#4 worst; 25.3% below national average)
    - Drug deaths: 9.3 per 100,000 people (#3 best; 51.6% above national average)
    - Infant mortality: 5.4 deaths per 1,000 live births (#13 best; 6.9% above national average)
    - Public health funding: $113 per person (#13 best; 29.9% above national average)
    - Most healthy trait: Drug deaths
    - Least healthy trait: Excessive drinking

    Although North Dakota has a low rate of drug-related deaths, that number rose 207% over the three-year period from 2016–2018. Violent crime is an issue as well, rising 98% over the past 10 years. The state still enjoys low levels of air pollution, high immunization rates, and excellent public health funding.

  • #13. Rhode Island

    - Cancer deaths: 191.7 per 100,000 people (#24 worst of all states; 1.3% below national average)
    - Excessive drinking: 18.6% of adults (#20 worst; 2.2% below national average)
    - Drug deaths: 29.7 per 100,000 people (#7 worst; 54.7% below national average)
    - Infant mortality: 6 deaths per 1,000 live births (#25 worst; 3.4% below national average)
    - Public health funding: $141 per person (#7 best; 62.1% above national average)
    - Most healthy trait: Primary care physicians (274.9 number per 100,000 people; #1 best; 72.2% above national average)
    - Least healthy trait: Drug deaths

    Rhode Island residents enjoy a robustly funded public health system, which offers programs designed to help people quit smoking, manage chronic conditions, register for special health care needs, and get acquainted with being a temporary caregiver. The state still has an uphill slog with drug deaths, mental distress, and obesity, though.

  • #12. California

    - Cancer deaths: 168.9 per 100,000 people (#5 best of all states; 10.8% above national average)
    - Excessive drinking: 17.6% of adults (#23 best; 3.3% above national average)
    - Drug deaths: 12.1 per 100,000 people (#7 best; 37.0% above national average)
    - Infant mortality: 4.2 deaths per 1,000 live births (#5 best; 27.6% above national average)
    - Public health funding: $114 per person (#12 best; 31.0% above national average)
    - Most healthy trait: Mental health providers (356.2 per 100,000 people; #12 best; 44.0% above national average)
    - Least healthy trait: Air pollution (12.8 micrograms of fine particles per cubic meter; #1 worst; 52.4% above national average)

    California is notorious for its high air pollution, only made worse by recent devastating wildfires, but it does contain low obesity and low mortality rates for workers and infants. The state is steadily rising in the rankings thanks to decreasing poverty, as well as increasing insurance coverage and a decline in cancer deaths.

  • #11. New York

    - Cancer deaths: 176.4 per 100,000 people (#9 best of all states; 6.8% above national average)
    - Excessive drinking: 18.4% of adults (#23 worst; 1.1% below national average)
    - Drug deaths: 17 per 100,000 people (#21 best; 11.5% above national average)
    - Infant mortality: 4.5 deaths per 1,000 live births (#7 best; 22.4% above national average)
    - Public health funding: $148 per person (#5 best; 70.1% above national average)
    - Most healthy trait: Public health funding
    - Least healthy trait: Disparity in health status (28.6% point difference; #16 worst; 3.6% above national average)

    After the Empire State bottomed out in the rankings at #41 in 1996, New York's growing public health system is on a mission to become the healthiest state in the country through a comprehensive prevention agenda. But there are still hurdles to jump—the state still battles with low immunization rates, increasing drug deaths, and increasing premature death rates. Fentanyl, an opioid about 100 times stronger than morphine, was involved in about half of New York’s “epidemic level” drug overdose deaths in the first quarter of 2019 alone.

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