Health Outcomes

These components measure the burden that disease and death place on the overall health of a population. Measures range from counting days in which people feel their normal activities are limited to overall mortality and years of potential life lost.

Limited Activity Days

Limited Activity Days is the average number of days in the previous 30 days that a person could not perform work or household tasks due to physical or mental illness. The data are collected by the Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention and rely on the accuracy of each respondent's estimate of the number of limited activity days lost in the past month.

Table 30 displays the 2004 ranks, based on 2003 data (Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention). In the last year, the number of limited activity days decreased the most in Alaska, Montana and Arkansas (decreases of 0.4, 0.3 and 0.2 days per month, respectively) and increased the most in Hawaii and Kentucky (increases of 0.7 and 0.6 days per month, respectively). Since 1990, the number of limited activity days has decreased the most in Arkansas and Mississippi (decreases of 4.9 and 4.6 days per month, respectively). No state has experienced an increase since 1990.

Cardiovascular Deaths

Cardiovascular Deaths is measured using a three-year average, age- and race-adjusted death rate due to heart disease, strokes and other cardiovascular disease. The effect of cardiovascular disease on health was measured using mortality data due to the improved accuracy of the data and the ability to adjust for age and race. This measure replaces the previous heart disease measure, Heart Deaths, and enlarges the scope of deaths included in the measure, thus counteracting some of the narrowing in scope when the risk for heart disease was altered to the prevalence of obesity, a change also occurring in this Edition.

The use of mortality data may not reflect the full impact of cardiovascular disease. Data also do not reflect new procedures to treat heart disease and prolong the useful lives of patients.

Table 31 displays the 2004 ranks, based on 1999 to 2001 data (Centers for Disease Control and Prevention). This component varies from a low of 251.6 deaths from cardiovascular disease per 100,000 population in Hawaii to 411.6 deaths per 100,000 population in Oklahoma. The national average is 336.6 deaths per 100,000 population, down from 343.6 deaths per 100,000 population last year and 406.3 deaths per 100,000 population in 1990.

In the last year, the rate of deaths from cardiovascular disease decreased by more than 15 deaths per 100,000 population in Wyoming, Idaho and Hawaii. Utah was the only state to experience an increase, by 1.6 deaths per 100,000 population. Since 1990, the rate of deaths from cardiovascular disease has declined by more than 100 deaths per 100,000 population in Maine, New Hampshire, Massachusetts and Vermont. Oklahoma has experienced the least improvement in the rate of deaths from cardiovascular disease, declining by only 12.7 deaths per 100,000 population.

Cancer Deaths

Cancer Deaths is measured using a three-year average, age- and race-adjusted death rate due to cancer. The effect of cancer on health was measured using mortality data due to the improved accuracy of the data and the ability to adjust for age and race.

Table 32 displays the 2004 ranks, based on 1999 through 2001 data (Centers for Disease Control and Prevention). The rate varies from less than 170 cancer deaths per 100,000 population in Utah and Hawaii to more than 220 deaths per 100,000 population in Kentucky, West Virginia, Louisiana and Indiana. The national average is 204.1 deaths per 100,000 population, a decrease of 1.2 deaths per 100,000 population from the 2003 Edition and an increase of 3.2 deaths per 100,000 population from the 1990 Edition.

The rate of cancer deaths has decreased by more than five deaths per 100,000 population in Rhode Island and New Hampshire since the 2003 Edition. Cancer deaths increased by more than five deaths per 100,000 population in South Dakota, Wyoming, Vermont, North Dakota and Idaho. Since the 1990 Edition, cancer deaths have decreased in 15 states. It declined by more than 10 deaths per 100,000 population in Alaska, Maryland, Hawaii and Connecticut and increased by more than 20 deaths per 100,000 population in Wyoming, Mississippi and Kentucky.

Total Mortality

Total Mortality is an accurate, reliable measure of the effects of poor health. The mortality rate is age- and race-adjusted and is an average of the most recent three years of data.

Table 33 displays the 2004 ranks, based on 1999 to 2001 data (Centers for Disease Control and Prevention). The total mortality rate varies from 675.4 deaths per 100,000 population in Hawaii to 1,006.1 deaths per 100,000 population in West Virginia. The national average is 867.1 deaths per 100,000 population, which is down 4.5 deaths from the 2003 Edition.

Since 2003, South Dakota and Vermont have seen the largest decreases in total mortality rates - 25.6 and 25.5 fewer deaths per 100,000 population, respectively. Idaho, Hawaii, New Mexico and Alaska experienced increases in total mortality of 10 or more additional deaths per 100,000 population.

Since the 1990 Edition, the U.S. rate has decreased by 21.3 deaths per 100,000 population. The largest drops in mortality occurred in Vermont, down from 889.2 to 775.9 deaths per 100,000 population, and New York, down from 912.0 to 809.8 deaths per 100,000 population. In total, mortality has decreased in 31 states since 1990. The greatest increases in total mortality were experienced by Montana, up from 791.0 to 880.2 deaths per 100,000 population, and Oklahoma, up from 904.5 to 984.7 deaths per 100,000 population.

Infant Mortality

Infant Mortality represents many factors surrounding birth, including but not limited to: the health of the mother, prenatal care, quality of the health services delivered to the mother and child and infant care. In addition, high infant mortality rates are often considered preventable and thus can be influenced by various education and care programs.

Table 34 displays the 2004 ranks, based on 2002 to 2003 data (National Center for Health Statistics, Washington, D.C.). Infant mortality varies greatly among states, from 4.3 and 4.4 deaths per 1,000 live births in Vermont and New Hampshire, respectively, to 10.2 deaths per 1,000 live births in Mississippi and 9.7 deaths per 1,000 live births in Louisiana. The national average is 7.0 deaths per 1,000 live births, up slightly from 6.9 deaths per 1,000 live births in the 2003 Edition.

Since the 2003 Edition, the infant mortality rate dropped by 1.0 or more deaths per 1,000 live births in several small population states, including Alaska, North Dakota, Vermont and Delaware. Infant mortality increased in Wyoming by 1.4 deaths per 1,000 live births. A year-to-year change in states with a small number of births is common. All states have improved since 1990. Vermont, Alaska, Illinois, South Dakota, Washington and New York have experienced the largest decreases in infant mortality rates, declining by 4.4 or more deaths per 1,000 live births.

Premature Death

Premature Death measures the loss of years of productive life due to death before age 75 (as defined by Centers for Disease Control and Prevention's Years of Potential Life Lost [YPLL-75]). Thus the death of a 25-year-old would account for 50 years of lost life, while the death of a 60-year-old would account for 15 years.

Table 35 displays the 2004 ranks, based on 2001 data (Centers for Disease Control and Prevention). The age-adjusted data vary from less than 6,000 years lost per 100,000 population in Minnesota and New Hampshire to more than 10,000 years lost per 100,000 population in Mississippi and Louisiana. The national average is 7,521 years lost per 100,000 population, which is 57 years less per 100,000 population than the 2003 Edition and 1,195 years less per 100,000 population than the 1990 Edition.

Since the 2003 Edition, 33 of the 50 states show decreases in premature death led by decreases of more than 250 years of potential life lost in Mississippi, Tennessee, Iowa and North Carolina. Wyoming shows the greatest increase with an additional 360 years of life lost in the past year.

Since the 1990 Edition, all states have decreased the years of life lost except Wyoming, Oklahoma and Louisiana. New York has shown the greatest decline, with a decrease of 2,689 years from 9,754 to 7,065 years of potential life lost before age 75 per 100,000 population.