Changes from 2003 Results

The overall health of the United States' population, as measured by America's Health: State Health Rankings - 2004 Edition, increased 0.6 percent from 2003 to 2004. The improvement was the result of a decrease in the prevalence of smoking from 23.0 percent to 22.0 percent of the population, an increase in the high school graduation rate from 67.3 percent to 68.3 percent of incoming ninth graders who graduate within four years, a decrease in the violent crime rate from 505 to 495 offenses per 100,000 population, an increase in per capita public health spending from $50 to $59 per person and an increase in the percent of health dollars allocated to public health from 5.7 percent to 6.1 percent of health budget expenditures. Some of these improvements were offset by an increase in the infant mortality rate from 6.9 to 7.0 deaths per 1,000 live births, as well as an increase in the prevalence of obesity from 22.1 percent to 22.8 percent of the population and an increase in the percentage of children in poverty from 16.3 percent to 17.6 percent of persons under age 18.

Table 15 shows comparisons of scores and rankings between 2003 and 2004. Comparisons of state scores from 2003 to 2004 indicate that 22 states had a positive change in their overall score on health. The largest positive increases (Table 6) were Alaska (+8.4 points on overall score), Arizona (+5.1 points), Oklahoma (+4.9 points), and Hawaii (+4.3 points). All other increases were less than 4.0 points.

Table 6

The principal reasons for the improvement in these states are:

Alaska: Support for public health improved as indicated by increases in per capita public health spending and the percentage of the state's health budget spent on public health. Also, the prevalence of smoking decreased from 29.3 percent to 26.2 percent of the population, the incidence of infectious disease decreased from 18.4 to 15.3 cases per 100,000 population, and the infant mortality rate declined from 7.5 to 5.9 deaths per 1,000 live births.

Arizona: The prevalence of smoking decreased from 23.4 percent to 20.8 percent of the population, the percentage of children in poverty decreased from 22.3 percent to 19.1 percent of persons under age 18, and per capita public health spending almost doubled from $67 to $128 per person.

Oklahoma: The percentage of children in poverty declined from 21.4 percent to 17.0 percent of persons under age 18, and the incidence of infectious disease decreased from 19.9 to 15.9 cases per 100,000 population. The prevalence of obesity increased from 22.9 percent to 24.4 percent of the population, and the rate of uninsured population increased from 17.3 percent to 20.4 percent.

Hawaii: The prevalence of smoking declined from 21.0 percent to 17.2 percent of the population, the percentage of children in poverty declined from 15.9 percent to 12.0 percent of persons under age 18, and the high school graduation rate increased from 61.0 percent to 64.8 percent of incoming ninth graders who graduate within four years.

This year, the overall score of 28 states declined. The states with the largest decreases (Table 7) were South Dakota (-5.2 points in overall score), Washington (-3.8 points) and Oregon (-3.6 points). Other state declines were 3.5 points or less.

Table 7

The principal reasons for the declines in these states are:

South Dakota: The rate of motor vehicle deaths increased from 2.0 to 2.4 deaths per 100,000,000 miles driven, the prevalence of obesity increased from 21.2 percent to 22.9 percent of the population, the high school graduation rate increased from 71.9 percent to 77.8 percent of incoming ninth graders who graduate within four years, and the percentage of children in poverty increased from 8.2 percent to 14.0 percent of persons under age 18.

Washington: The percentage of children in poverty increased from 13.7 percent to 19.1 percent of persons under age 18, the number of limited activity days per month increased from 1.9 to 2.2 days in the previous 30 days, and the prevalence of smoking decreased from 21.5 percent to 19.5 percent of the population.

Oregon: The rate of uninsured population increased from 14.6 percent to 17.2 percent, the percentage of children in poverty increased from 15.1 percent to 20.1 percent of persons under age 18, and per capita public health spending declined from $27 to $19 per person.