Changes from 1990 Results

Overall, the health of the United States' population has improved 17.5 percent since 1990, up by 0.6 percent from the 2003 Edition. As Graph 1 shows, the rate of improvement in the health of the United States' population has leveled out in the past five years. During the 1990s, health improved at an annual rate of 1.5 percent per year. Since 2000, the annual rate of improvement has slipped to 0.2 percent per year.

Graph One: Improvements Since 1990

Nationally, there have been several health improvements since 1990: a 36 percent decline in the rate of motor vehicle deaths from 2.5 to 1.6 deaths per 100,000,000 miles driven, a 36 percent decrease in the incidence of infectious disease from 40.7 to 26.1 cases per 100,000 population, a 31 percent decline in the infant mortality rate from 10.2 to 7.0 deaths per 1,000 live births, a 25 percent decrease in the prevalence of smoking from 29.5 percent to 22.0 percent of the population, a 19 percent decline in violent crime rate from 609 to 495 offenses per 100,000 population, and a 17 percent decrease in the rate of deaths from cardiovascular disease from 406.3 to 336.6 deaths per 100,000 population. However, these gains are offset by the near doubling of the prevalence of obesity from 11.6 percent to 22.8 percent of the population, an increase in the rate of uninsured population from 13.4 percent to 15.6 percent and a 6 percent decrease in the high school graduation rate from 72.9 percent to 68.3 percent of incoming ninth graders who graduate within four years.

A summary of changes from 1990 to 2004 for each state appears in Table 16.

All states show a positive change in overall score between 1990 and 2004. Vermont, Alaska, Oregon and Arizona have improved more than other states and at least 9 percent more than the national average of 17.5 percent (Table 8). Eighteen other states also exceeded the national rate of improvement.

Table 8

The principal reasons for the improvement in these states are from 1990 to 2004 are:

Vermont: Access to adequate prenatal care has increased from 62.6 percent to 85.8 percent of pregnant women receiving adequate prenatal care, the prevalence of smoking has declined from 30.7 percent to 19.5 percent of the population, the total mortality rate has declined from 889.2 to 775.9 deaths per 100,000 population, and the premature death rate has declined from 7,842 to 6,130 years of potential life lost before age 75 per 100,000 population.

Alaska: The total mortality rate has decreased from 876.4 to 799.4 deaths per 100,000 population, the infant mortality rate has decreased from 10.6 to 5.9 deaths per 1,000 live births, and the percentage of children in poverty has declined from 16.6 percent to 11.2 percent of persons under age 18. Also, the violent crime rate has increased from 455 to 563 offenses per 100,000 population, despite a decline in crime rates nationally.

Oregon: The incidence of infectious disease has declined from 92.8 to 17.2 cases per 100,000 population, and the rate of motor vehicle deaths has declined from 3.0 to 1.5 deaths per 100,000,000 miles driven. The percentage of children in poverty has increased from 12.4 percent to 20.1 percent of persons under age, the violent crime rate has dropped from 540 to 292 offenses per 100,000 population, and the infant mortality rate has declined from 9.9 to 5.9 deaths per 1,000 live births.

Arizona: The incidence of infectious disease has declined from 91.0 to 26.2 cases per 100,000 population, and access to adequate prenatal care has increased from 62.8 percent to 68.7 percent of pregnant women receiving adequate prenatal care.

Twenty-seven states have not matched the national rate of change and are slipping further behind. Mississippi and Missouri improved only 9.6 percent and 9.7 percent, respectively, compared to the national 17.5 percent rate of improvement (Table 9). Louisiana and Tennessee have improved only 10.5 percent and 10.7 percent, respectively.

Table 9

The principal reasons for the slow health improvements from 1990 to 2004 are:

Mississippi: The rate of cancer deaths has increased from 192.4 to 215.2 deaths per 100,000 population, the violent crime rate has increased from 269 to 343 offenses per 100,000 population, and the high school graduation rate has declined from 65.6 percent to 59.1 percent of incoming ninth graders who graduate within four years. The percentage of children in poverty has declined from 36.3 percent to 23.1 percent of persons under age 18.

Missouri: The prevalence of smoking has only declined from 27.7 percent to 27.2 percent of the population, a decrease much lower than in other states. The infant mortality rate has declined from 10.5 to 7.9 deaths per 1,000 live births, and the rate of deaths from cardiovascular disease has declined from 400.7 to 370.5 deaths per 100,000 population, but both of these declines are also slower than the improvements experienced nationally.

North Dakota: Access to adequate prenatal care has increased from 67.0 percent to 79.2 percent of pregnant women receiving adequate prenatal care, the prevalence of obesity has more than doubled from 12.3 percent to 24.8 percent of the population, and the rate of cancer deaths has increased from 210.2 to 224.2 deaths per 100,000 population, which shows progress but slower than the national average. The infant mortality rate has decreased from 11.8 to 9.7 deaths per 1,000 live births, a smaller decrease than the nation as a whole.

Tennessee: The violent crime rate has increased from 534 to 717 offenses per 100,000 population, the prevalence of obesity has more than doubled from 11.8 percent to 25.0 percent of the population, and the percentage of children in poverty has declined from 29.6 percent to 18.7 percent of persons under age 18.

Table 16 contains the changes in scores and rankings for all 50 states since the 1990 Edition of America's Health: State Health Rankings. States that have changed less than 17.5 percent are not improving as quickly as the nation as a whole.