The Ten Worst States for Your Health, 2013

Arkansas supplants Oklahoma in the 2013 OHPM rankings as the worst state for your health. 

Arkansas was joined in the bottom ten by five other southern states and four states from the west.  And here's all you need to know about why states in the bottom ten are bad for your health.  Life expectancy in those states is the same as it is in Paraguay - 76.6 years.  This is four years fewer, or an entire Presidential term less, than life expectancy in Massachusetts and Connecticut - the two states at the top of this year's ranking.

Two states – Texas (39, up two places from last year) and West Virginia (38, up five places from last year) – escaped the bottom ten this year.  Kentucky found its way back after one year in 35^th place, and South Carolina entered the bottom ten after dropping eight places from 40^th last year. 

Here are the bottom ten, with the change from last year in parentheses:

41. Kentucky (-6).   Kentucky entered the bottom ten this year not because it did poorly in most rankings (its 44^th place healthy state ranking was its only bottom ten finish), but because it places in the bottom half in every category except Medicaid access.

42. Alabama (+3).  If Alabama’s 35^th place Kids Count health ranking can help to improve its 45^th place healthy state ranking in the future, then it may be poised to escape the bottom ten in the next couple of years.

43. Oklahoma (+7).  Oklahoma moved up from last place this year on the basis of a top 15 performance in Medicaid access and per capita Medicare community spending.  But 43^rd place finishes in both the Healthy State and Kids Count Health rankings cemented its position in the bottom ten.

44. Louisiana (0).  Louisiana is top ten in Medicare community spending and percentage of people on Medicaid, but bottom ten in the Healthy State rankings, the Kids Count health rankings, access to primary care providers, and the percentage of people with employer-based health insurance.

45. New Mexico (+4).  New Mexico is 5^th in percentage of people on Medicaid, and 50^th in percentage of people with employer-based insurance.  Not exactly an indication of a “worker-friendly” environment.

46. Montana (-5). Montana is last in the Kids Count health rankings, and next-to-last in the percentage of people with private health insurance and Medicare community spending.  These offset its middle-of-the-pack healthy state ranking (29^th).

47. Mississippi (0).  At least Mississippi is consistent, finishing 48^th, 47^th, and 47^th during the last three years.  Although it boasts top ten rankings in Medicaid access and Medicare community spending, it is 45th in employer-based insurance, 48^th in the Kids Count health rankings, and 49^th in the Healthy State rankings.  Mississippi has downside potential.  It hasn’t embraced Obamacare Medicaid expansion.  But both Arkansas and Nevada – the bottom two states in the rankings - have.

48. South Carolina (-8). South Carolina’s dive in the rankings is attributable to the fact that it doesn’t do well in any of the categories. In fact, its highest ranking among the states is only 20^th in Medicare community services spending.

49. Nevada (-1). Nevada’s only top thirty ranking is in Medicare community spending.  It is 47^th in the Kids Count health rankings and number of high-quality hospital programs.  But it is one of four bottom ten states to embrace Medicaid expansion.

50. Arkansas (-4).  What is Arkansas’ recipe for failure? Start with a 48^th place Healthy State ranking.  Add in a 49^th place finish in access to primary care providers, a 46^th place ranking in the percentage of people with employer-based health insurance, and a 44^th place finish in number of high quality hospital programs. Arkansas ranks in the top ten in just one indicator.  It is 9^th in the percentage of people on Medicaid.  Of course, that’s a pre-ACA percentage, but it may explain why Arkansas – a conservative state – has embraced Obamacare’s Medicaid expansion.

Some interesting notes:

Colorado has the greatest difference in the two prevention rankings – it is 11^th in the healthy state rankings, and just 42^nd in the Kids Count health rankings.

Hawaii (+23.8) and Vermont (+22.5) are the only two states that rank more than twenty places better on the average of their prevention rankings than on the average of their health care rankings.  Rhode Island (+17.9) and New Hampshire (+17.9) tie for third on this measure.

Mississippi (-22.9) and Louisiana (-20.6) are the only two states that rank more than twenty places worse on the average of their prevention rankings than on the average of their health care rankings.  Tennessee (-18.6) is third on this measure. 

The states that are most balanced in their prevention and health care rankings are Kansas (+0.6), Colorado (+0.5), and Montana (-0.7).

Connecticut (2^nd overall) favors prevention and public health (+8.2, on average), and Florida (34th overall) favors health care (-11.9, on average).

To see the full rankings, click here.

Paul Gionfriddo via email: gionfriddopaul@gmail.com.  Twitter: @pgionfriddo.  Facebook: www.facebook.com/paul.gionfriddo.  LinkedIn:  www.linkedin.com/in/paulgionfriddo/