Mississippi dropped to dead last this year among all 50 states in the annual “America’s Health Ranking” released Thursday by the United Health Foundation, a nonprofit arm of insurer United Health Group.
For the fifth straight year, Hawaii was ranked the nation’s healthiest state. Massachusetts finished second followed by Connecticut, Minnesota and Vermont.
As one of the nation’s poorest states, Mississippi has a legacy of poor health because poverty is often a driver, and consequence, of bad health.
In the 27 years that the annual report on resident health status has been released, Mississippi has finished last or next-to-last 25 times. In 2015, the state ranked 49th. In 1998 and 1991, Mississippi ranked 48th.
In this year’s rankings, Mississippi traded places with Louisiana, which moved up from last place in 2015 to 49th this year.
Behind Mississippi and Louisiana, Arkansas was ranked as the third most-unhealthy state followed by Alabama and Oklahoma, which was the nation’s fifth most-unhealthy state.
The state rankings are based on 34 measures involving four health determinants: behaviors, community and environment, policy, and clinical care. The scoring methodology was developed and reviewed by public health experts.
Mississippi ranked last among all states for adult physical inactivity, infectious disease rates, overall adolescent immunization rates, adolescent meningococcal immunization rates, low birth-weight babies, cardiovascular death rate, prevalence of diabetes and infant mortality rate.
The state also finished last in a separate study on the overall health of women and children.
Mississippi ranked next-to-last for chlamydia infection rates, number of dentists, rate of cancer deaths and rate of frequent mental distress among adults.
The state’s bright spots included a low rate of drug deaths, low levels of excessive drinking and a small disparity in health status based on education. In addition, preventable hospitalizations among Mississippi Medicare enrollees fell 38 percent from roughly 110 per 1,000 enrollees in 2008 to about 68 per 1,000 this year.
But the state diabetes rate increased 19 percent from 12.4 percent to 14.7 percent over the last four years. And the rate of adult physical inactivity increased 16 percent in the last year from 31.6 percent to 36.8 percent.
In addition, the meningococcal immunization rate for adolescents ages 13 to 17 increased 20 percent in the last year from 46 percent to 55.3 percent in Mississippi. But it’s still the nation’s lowest rate, the report says.
The Affordable Care Act gives states the option of extending Medicaid coverage to working-age adults who earn at or below 138 percent of the federal poverty level. Under the health care law, commonly known as Obamacare, the federal government paid the entire cost to cover newly eligible Medicaid recipients in 2014, 2015 and 2016 in states that agreed to expand coverage.
Mississippi Gov. Phil Bryant and Republican state lawmakers have vehemently opposed expanding Medicaid, saying it is too costly even though states would pay no more than 10 percent of medical costs for newly eligible enrollees after 2016.
President-elect Donald Trump and congressional Republicans have vowed to repeal and replace Obamacare.
Nationally, the study notes long-term health improvements, including a 41 percent decline in adult smoking rates since 1990 and a 35 percent decline in the rate of Americans without health insurance over the last five years.
But the report also notes, for the first time ever, that the nation’s cardiovascular death rate increased from the previous year from about 251 deaths per 100,000 to nearly 252.
The national death rate from drug overdoses also increased – 9 percent over the last five years and 4 percent from 2015 to 2016. Increasing drug deaths have helped fuel a rise in the nation’s premature death rate for the last two years.
“We have made important strides across the country against public health challenges; however, we are at a crossroads between a healthier future as a nation and a future in which troubling public health measurements become increasingly common,” said a statement from Reed Tuckson, external senior medical adviser to United Health Foundation.
“Of particular concern is the first-time rise in cardiovascular deaths, despite all the medical advances in this area,” he said. “This data provides a road map for states, local communities and the public health sector to work together to get ahead of the challenges coming.”