America`s Health Rankings<sup>TM</sup> is the longest running annual assessment (over 20 years) of the nation`s health on a state-by-state basis. The ranking is published jointly by United Health Foundation, the American Public Health Association and Partnership for Prevention.  It provides state-specific rankings based on four essential and controllable components. See diagram below.

America`s Health Rankings’^TM unique methodology provides a comprehensive look at numerous core and supplemental health indicators. See list below:

Core Measures:

Behaviors

• Prevalence of Smoking - Percentage of population over age 18 that smokes on a regular basis.
• Prevalence of Binge Drinking - Percentage of population over age 18 that drank excessively in the last 30 days.
• Prevalence of Obesity - Percentage of the population with a body mass index (BMI) of 30.0 or higher.
• High School Graduation - Percentage of incoming ninth graders who graduate in four years from a high school with a regular degree.

Community and Environment

• Violent Crime - The number of murders, rapes, robberies and aggravated assaults per 100,000 population.
• Occupational Fatalities - Number of fatalities from occupational injuries per 100,000 workers.
• Infectious Disease - Number of AIDS, tuberculosis and hepatitis (A and B) cases reported to the Centers for Disease Control and Prevention per 100,000 population.
• Children in Poverty – The percentage of persons under age 18 who live in households at or below the poverty threshold.
• Air Pollution - The average exposure of the general public to particulate matter of 2.5 microns or less in size (PM2.5).

Public and Health Policies

• Lack of Health Insurance - Percentage of the population that does not have health insurance privately, through their employer or the government.
• Public Health Funding - State funding dedicated to public health as well as Federal funding directed to states by the Centers for Disease Control and Prevention and the Health Resources and Services Administration, expressed on a per capita basis.
• Immunization Coverage - Percentage of children ages 19 to 35 months who have received vaccinations.

Clinical Care

• Prenatal Care - Percentage of pregnant women receiving adequate prenatal care.
• Primary Care Physicians - Number of primary care physicians per 100,000 population.
• Preventable Hospitalizations - Discharge rate among the Medicare population for diagnoses that are amenable to non-hospital based care.

Health Outcomes

• Poor Mental Health Days - Number of days in the previous 30 days when a person indicates their activities are limited due to mental health difficulties.
• Poor Physical Health Days - Number of days in the previous 30 days when a person indicates their activities are limited due to physical health difficulties.
• Geographic Disparity - The variation among the overall mortality rates among the counties within a state.
• Infant Mortality - Number of infant deaths (before age 1) per 1,000 live births.
• Cardiovascular Deaths - Number of deaths due to all cardiovascular diseases, including heart disease and strokes, per 100,000 population.
• Cancer Deaths - Number of deaths due to all causes of cancer per 100,000 population.
• Premature Death - Number of years of potential life lost prior to age 75 per 100,000 population.

Supplemental Measures

Behaviors

• Cholesterol Check - Percentage of adults who have had their blood cholesterol checked within the last five years.
• Dental Visit - Percentage of adults who have visited the dentist or dental clinic within the past year for any reason.
• Physical Activity - Percentage of adults who, during the past month, participated in any physical activities.
• Diet - Percentage of adults who consume five or more servings of vegetables and fruit a day.
• Teen Birth Rate - The number of births per 1,000 mothers age 15 to 19.

Chronic Disease

• Cardiac Heart Disease - Percentage of adults who have been told by a health professional that they had angina or coronary heart disease.
• Diabetes - Percentage of adults who have been told by a health professional that they had diabetes (does not include pre-diabetes or diabetes during pregnancy).
• High Cholesterol - Percentage of adults who have had their cholesterol checked and been told that it was high.
• Heart Attack - Percentage of adults who have been told by a health professional that they had a heart attack (myocardial infarction).
• Stroke - Percentage of adults who have been told by a health professional that they had a stroke.
• Hypertension - Percentage of adults who have been told by a health professional that they had high blood pressure.

Economic Factors

• Personal Income - Per capita personal income in current dollars.
• Unemployment Rate August Annual - Total unemployed as a percent of the civilian labor force (U-3 definition).
• Underemployment Rate - Percent of individuals that are not fully employed, are involuntarily working part-time or have stopped looking for employment.
• Income Disparity (Gini coefficient) - Income inequality measure

Refer to the following websites for detailed information.

For America’s Health Ranking:

http://www.americashealthrankings.org/Measure.aspx

For Hawaii’s data:

http://www.americashealthrankings.org/yearcompare/2008/2009/HI.aspx

What should we be concerned with? For one, Hawaii dropped 3 positions to rank 4^th overall. Of the core measures, our worst ranking once again is the prevalence of binge drinking (we ranked 43 of 50 states). Two other areas of concern include infectious disease cases and high school graduation statistics. Other areas which are trending poorly include the percentage of children in poverty (which increased the past year from 11.6 to 14.3) and the prevalence of obesity which has increase from 16.4 to 23.1 in the past five years. Disappointing is the fact that Daily Fruits and Vegetables and Physical Activity appear to be relatively flat. And we all know that eating well and exercising are keys to improving our health condition.

Check out the study and do your part to take us back to No. 1.

***THANK YOU to those who have completed the online general health survey. Thanks to all of you, we are approaching 500 responses! For those who haven’t had a chance yes, I invite you to participate and tell your friends and family so that together we can Build a Healthy Hawaii. Please visit my website www.lifefitnet.com. It is a short 12-question online survey that should take only 2-3 minutes to complete. Mahalo for your support!  Lori

Tags: 2009 America's Health Ranking, Hawaii, health, wellness

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