Updated

Hawaii is the healthiest state and Americans overall are more obese and less active, reveal new findings from the annual America’s Health Rankings.

The state-by-state analysis has highlighted the highs and lows of the nation’s health for the past 25 years, both long- and short-term, Medical News Today reported. The report is published by the United Health Foundation, along with the American Public Health Association and Partnership for Prevention.

For the third consecutive year, Hawaii has been rated the healthiest state, followed by Vermont and Massachusetts. The least healthy state for the third consecutive year is Mississippi, while Arkansas and Louisiana were named the second and third least healthy states in this year’s report.

Hawaii’s steady ranking is due to factors such as a low prevalence of smoking and obesity, a low percentage of children in poverty, and low rates of preventable hospitalizations, cancer deaths and cardiovascular deaths.

Mississippi faces challenges including a high prevalence of obesity, physical inactivity, diabetes and children in poverty, as well as a limited availability of primary care physicians.

Overall, America’s obesity rate increased from 27.6 to 29.4 percent of adults from 2013 to 2014— a 153 percent increase over 1990 figures.

While life expectancy is at an all-time high of 78.8 years— 34th in the world— the past 25 years have shown a study rise in chronic conditions— many of them preventable— that compromise quality of life.

Among the short-term successes and challenges in the past year, Americans have decreased smoking prevalence by 3 percent, increased immunization coverage by 5 percent, and decreased infant mortality by 4 percent. However, drug deaths have increased by 7 percent, obesity has increased by 7 percent, and physical inactivity has increased 3 percent.

"It is inevitable that increases in the rates of obesity and physical inactivity will result in more people suffering from significant chronic diseases that compromise the quality of their lives, adversely affect their families and are unaffordable for the nation,” said Dr. Reed Tuckson, senior medical adviser to United Health Foundation.
The report also points to long-term successes and challenges.

In the past 25 years, smoking prevalence has decreased 36 percent, air pollution has decreased, infant mortality has decreased 41 percent, cancer deaths declined 4 percent, and cardiovascular deaths declined 38 percent.

Since 1990, eight challenges have remained unchanged or have deteriorated, the study found. Obesity increased 153 percent, physical inactivity remains high, and the diabetes rate has shown a steady upward climb, but data from the last three years shows a leveling of the prevalence.

According to the study, 19.9 percent of children live in poverty, which is above the 23-year low of 15.8 percent in 2002, but near the 1990 level of 20.6 percent.

"U.S. health outcomes are much worse than most other developed countries despite spending a greater percentage of our resources [on] health care than all other countries. We have an opportunity to make dramatic improvements [in] health if we focus on prevention,” said Anna Schenck, chair of America’s Health Rankings Scientific Advisory Committee. “This type of opportunity only comes around once in a generation. Now is the time."

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