Nations' health not improving

The nation's overall health is not improving, a recent national report finds. Worrisome increases in obesity, diabetes and the number of children living in poverty are offsetting modest improvements in overall health, according to "America's Health Rankings."

The report, which is published annually, found that for every person who quit smoking in 2011, someone else became obese. Moreover, the number of U.S. children living in poverty continued to climb in 2011, as did the number of Americans who lacked health insurance. "The health of America is in serious, serious trouble," Reed Tuckson, MD, executive vice president and chief of medical affairs at United Health Group, said at a Washington, D.C., news conference releasing the report in December. "This ordinarily would be a celebratory moment, but quite frankly, my heart is heavy. We are delivering a tsunami of preventable chronic illness into the hands of a delivery system that America cannot afford."

Overall, the report is a mixture of good and bad news. Tobacco use has declined 3.4 percent since 2010 and 25.4 percent since 2001. However, while 1.4 million Americans quit smoking last year, another 1.4 million Americans became obese. Overall, the prevalence of obesity has increased 137 percent, rising from 11.6 percent of the population in 1990 to 27.5 percent of the population in 2011. More than one in four American adults — or 65 million people — are considered obese today. If current trends continue, 43 percent of Americans will be obese by 2018.

In 2011, 8.7 percent of American adults, or more than 20 million people, had been told by a physician that they have diabetes. The number is almost double the 4.4 percent diabetes prevalence seen in 1996. If the diabetes trend continues, 10 percent of all health care dollars will be spent managing the complications of diabetes by 2020.

The rankings are published jointly by American Public Health Association, the United Health Foundation and Partnership for Prevention. The report assesses the nation's health based on 23 factors, including binge drinking, prenatal care, violent crime, occupational fatalities and obesity. This is the first time in the report's 22-year history that not a single state has a prevalence of obesity less than 20 percent.

For the fifth year in a row, the report ranked Vermont as the healthiest state, followed by New Hampshire, Connecticut, Hawaii and Massachusetts. Vermont's strengths include a high rate of high school graduation, a low violent crime rate, a low rate of infectious disease, a high usage of early prenatal care, high per capita public health funding, a low rate of uninsured residents and ready availability of primary care physicians. Vermont has low immunization coverage.