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Massachusetts Ranked 4th Healthiest State in Nation

Thursday, December 19, 2013


Massachusetts continues to lead the nation toward better health.

The state ranks high on key health measures like its relative low prevalence of obesity and smoking, low percentage of uninsured residents, and readily available access to primary care.

Ninety-six-percent health insurance coverage is “something that no other state has” according to Julie Kaviar with the state Office of Health and Human Services. “And people not only have health care, people are actually seeing doctors (and) getting the health care they need.”

Those factors helped Massachusetts place fourth in the nation in this year's health rankings by the United Health Foundation.

Derek Brindisi, director of Worcester's public health division and head of the Central Mass Regional Public Health Alliance that includes surrounding townships Holden, Leicester, Millbury, Shrewsbury, and West Boylston, agreed with Kaviar's assessment while pointing to partnerships that have made health a priority.

Preventative care key

“I think the stars are starting to align,” Brindisi said, around a constellation of preventative care. “There's a greater emphasis on prevention,” leading to better health at a lower cost.

A prime example is the Prevention and Wellness Trust Fund, passed by the state legislature in 2012 which will invest $60 million over four years in the interest of cost containment.

“The first-in-the-nation trust fund will target chronic health issues in specific communities,” said Kaviar. Since different communities face their own health challenges, she said the fund would target specific problems identified by local providers.

Another success has been Mass in Motion, a community-based approach toward healthier eating and living. Comparing obesity rates in communities with that program to areas without, “we're able to demonstrate it's working,” Brindisi said. “Mass in Motion is becoming a national model.”

A policy known as “complete streets,” meanwhile, partners health officials with transportation departments to create more pedestrian-friendly communities, for walking and bicycling to “generally promote healthy outdoor living,” Kaviar said.

Still work to be done

Massachusetts is ranked the second-least obese state in the country, following this year's national trend that saw those rates level off. But there's still plenty of room for improvement according to Maddie Ribble, director of policy and communications at the Massachusetts Public Health Association, an organization that works to improve policy at the state and local level.

“Second place seems pretty good, right? But this epidemic is so bad ... being second shouldn't be any consolation,” Ribble said. “We've never been as bad as the national average, but I don't think you'll find anyone who says they're happy (with the current obesity rate).”

In its latest survey, United Health Foundation tallied 1.2 million obese adults in Massachusetts, a rate of 22.9 percent.

In other indicators, the prevalence of smoking declined nearly 2 percentage points, from 18.2 to 16.4 percent, again echoing national trends.

Effort partner state and local stakeholders

In central Massachusetts, the indicators are more measured — but local officials say the push is on to make Worcester a health haven.

“We have a vision of being the healthiest city in New England by 2020,” Brindisi said, after co-chairing Worcester's Community Health Improvement Initiative in 2012 that included a comprehensive health assessment, launching a community improvement plan.

In county-by-county rankings from the University of Wisconsin's Population Health Institute, Worcester County ranked 9th out of 14.

The community plan's five areas for improvement include health eating/living, behavioral health, access, violence/injury prevention, and health equity.

Also a member of the Massachusetts Public Health Council, Brindisi was involved in the development of a similar statewide plan that just wrapped up.

Contributing to the state's overall health, “a lot goes back to health care reform years ago,” Brindisi said. “A lot of us take that for granted — in a lot of other states that's a problem.”

The United Health Foundation reports a 3.8 percent uninsured population in Massachusetts: half the rate of the next lowest state.

Racial, income disparities in health

But, the foundation found a large health disparity based on educational attainment — a key economic indicator.

Brindisi and Ribble acknowledged that shortcoming. “It's a really troubling disparity,” Ribble said, based along race and income “masked by (the statewide) ranking.”

Touting a recent legislative success improving school nutrition programs, “in a lot of communities, physical education programs have been cut,” Ribble continued. “That's really a disservice to our kids.”

And while smoking rates have declined, thanks to cessation programs supported by organizations and the state health department, Ribble said tobacco companies were now marketing smokeless products where “our approach has not quite caught up.”

The United Health Foundation's rankings, the longest running annual assessment on a state-by-state basis, take into account behaviors, public and health policies, community and environmental conditions, and clinical care data.

Massachusetts' rank this year was unchanged from 2012. In 2010, the state came in second.


Related Slideshow: New England’s Healthiest States

The United Health Foundation recently released its 2013 annual reoprt: America's Health Rankings, which provides a comparative state by state analysis of several health measures to provide a comprehensive perspective of our nation's health issues. See how the New England states rank in the slides below.



All Outcomes Rank: Outcomes represent what has already occurred, either through death, disease or missed days due to illness. In America's Health Rankings, outcomes include prevalence of diabetes, number of poor mental or physical health days in last 30 days, health disparity, infant mortality rate, cardiovascular death rate, cancer death rate and premature death. Outcomes account for 25% of the final ranking.

Determinants Rank: Determinants represent those actions that can affect the future health of the population. For clarity, determinants are divided into four groups: Behaviors, Community and Environment, Public and Health Policies, and Clinical Care. These four groups of measures influence the health outcomes of the population in a state, and improving these inputs will improve outcomes over time. Most measures are actually a combination of activities in all four groups. 

Diabetes Rank: Based on percent of adults who responded yes to the question "Have you ever been told by a doctor that you have diabetes?" Does not include pre-diabetes or diabetes during pregnancy.

Smoking Rank: Based on percentage of adults who are current smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke).

Obesity Rank: Based on percentage of adults who are obese, with a body mass index (BMI) of 30.0 or higher.

Source: http://www.americashealthrankings.org/

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6. Rhode Island

Overall Rank: 19

Outcomes Rank: 30

Determinants Rank: 13

Diabetes Rank: 26

Smoking Rank: 14

Obesity Rank: 13



1. Low prevalence of obesity

2. High immunization coverage among adolescents

3. Ready availability of primary care physicians  


1.High rate of drug deaths

2. High rate of preventable hospitalizations

3. Large disparity in heath status by educational attainment

Source: http://www.americashealthrankings.org/RI

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5. Maine

Overall Rank: 16

Outcomes Rank: 25

Determinants Rank: 12

Diabetes Rank: 23

Smoking Rank: 29

Obesity Rank: 28



1. Low violent crime rate

2. Low percentage of uninsured population

3. Low prevalence of low birthweight  


1. High prevalence of binge drinking

2.High rate of cancer deaths

3. Limited availability of dentists

Source: http://www.americashealthrankings.org/ME

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4. Connecticut

Overall Rank: 7

Outcomes Rank: 15

Determinants Rank: 4

Diabetes Rank: 16

Smoking Rank: 4

Obesity Rank: 12



1. Low prevalence of smoking

2. Low incidence of infectious diseases

3. High immunization coverage among children & adolescents  


1. Moderate prevalence of binge drinking

2. Low high school graduation rate

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/CT

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3. New Hampshire

Overall Rank: 5

Outcomes Rank: 7

Determinants Rank: 5

Diabetes Rank: 16

Smoking Rank: 11

Obesity Rank: 22



1. Low percentage of children in poverty

2. High immunization coverage among children

3. Low infant mortality rate  


1. High prevalence of binge drinking

2.High incidence of pertussis infections

3. Low per capita public health funding

Source: http://www.americashealthrankings.org/NH

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2. Massachusetts

Overall Rank: 4

Outcomes Rank: 14

Determinants Rank: 3

Diabetes Rank: 10

Smoking Rank: 7

Obesity Rank: 2



1. Low prevalence of obesity

2. Low percentage of uninsured population

3. Ready availability of primary care physicians & dentists  


1. High prevalence of binge drinking

2. High rate of preventable hospitalizations

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/MA

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1. Vermont

Overall Rank: 2

Outcomes Rank: 12

Determinants Rank: 1

Diabetes Rank: 4

Smoking Rank: 9

Obesity Rank: 5



1. High rate of high school graduation

2. Low violent crime rate

3. Low percentage of uninsured population  


1. High prevalence of binge drinking

2. Low immunization coverage among children

3. High incidence of pertussis infections

Source: http://www.americashealthrankings.org/VT


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