Republican presidential candidate Rudy Giuliani might boast of better prostate cancer survival rates, based on dubious data of course, but latest independent figures paint a different picture.
Americans' overall health has declined by 0.3% as measured by key health indicators, says the United Health Foundation (UHF) and there are damaging racial disparities too.
Factors such as obesity, an increasing number of uninsured people, and the 'persistence of risky health behaviors such as tobacco use and binge drinking' are contributing to the present unhappy scenario.
Hispanics too receive poorer quality care than non-Hispanics and that 'the data indicate that this trend is getting worse, not better.' And in terms of preventive care, the UHF said the Hispanic population has the lowest percentage of people availing themselves of regular dental care and colon cancer screenings—'two key indicators of a population's ability to stay healthy.'
The report, called America's Health Rankings, also found Minnesota residents drink too much, but they have a low premature death rate. Mississippians don't overindulge, but only a fifth of the population has health insurance. And Vermont seems to be under a lucky star—few uninsured residents, a very low rate of infectious diseases, and a low premature death rate.
The UHF, which publishes the report in partnership with the American Public Health Assn. and Partnership for Prevention, said it looked at 18 factors to decide which states were healthiest. These included a state's number of smokers, infant mortality rates, per capita public health spending, and immunization coverage.
The UHF also said that the 18 measures 'reflect three essential contributors to health': decisions made by individuals to promote health and prevent disease, the community environment that affects individuals' health, and public health policies that affect the availability of public health and medical resources.
Reed Tuckson, the principal clinical sponsor of the report for the UHF, said the rankings should encourage individuals to 'make appropriate personal health choices, actively support local community-based organizations and institutions, and advocate with elected and public health officials for necessary resources.'
But writing in the September, 2007, issue of the Southern Medical Journa, Lee Friedman, a research assistant professor at the University of Illinois at Chicago's School of Public Health, said. 'The recent America's Health Rankings,' Friedman wrote, 'represents just another attempt at creating global measures of health, which inevitably results in junk science.'
The problem, Friedman continued, is 'ignoring the role of poverty and the environmental and social disadvantages of lower income Americans leads to the wrong conclusion about geographic disparities in health and will likely mislead important state and federal policymakers...The study only promotes stereotypes and disparaging views of the poor states, which are disproportionately located in the South.'
But Dr. Tuckson of UHF argued, 'We look at the percentage of children in poverty as one of our measures. It is also exceedingly important to know the rate of tobacco use in a state and in the country—whether progress is being made in the number one most preventable risk factor in death and disease. And a health care issue like obesity, he said, is important 'in its own right, independent of socioeconomic status.'
Dr. Tuckson said that in the end, 'It's progress that we're looking for.' He cited South Carolina as an example of a state that had improved in the rankings, from 48th on the list in 2006 to 42nd in 2007.
'Every state, regardless of where it ranks, has its share of challenges,' he continued. 'And every state has its share of successes. From our way of thinking, it's not particularly important which state is number one and which state is number 50.'
He encouraged Americans to get involved with their communities and cited Vermont as an example. 'The attitude that we take is that this data is important in highlighting key issues, but we also encourage states and communities and citizens to get with their local health departments...so they can get even more specific about the exact problems and priorities where they live.'