Health State To State: Why America’s Health Problems Are Nationwide

Just like real estate, health is all about location, location, location.

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The United Health Foundation recently released its annual list of the healthiest and unhealthiest states in the country for 2017. The study looked at 35 core measures covering behaviors, community and environment, policy, clinical care, and outcomes data in order to make its decision. The biggest shock in the study is that there really aren’t any big shocks. As you may have guessed, the states that average the highest incomes in the country are generally healthier than those that are less wealthy. Additionally, the northern states of the country fared much better than the South, as per usual. Just about the only big difference this year is that the healthiest state in the country for the past five years was knocked out of its slot and replaced by one that has a high drug overdose rate. Can you guess who it is?

The Healthiest States

These healthy states are no stranger to the healthy list, as they’ve all been here before. The only difference is their order.


With its cold weather and delightful accent, Massachusetts was ranked No. 1 as the country’s healthiest state. Thanks to the lowest percentage of uninsured at 2.7 of the population and a low prevalence of obesity, the Bay State was able to knock Hawaii out of the top position. The good health of the state likely has much to do with the amount of health professionals available to those who live there. The state has about 200 primary care physicians per every 100,000 people, as well as 80 dentists per 100,000 people. Additionally, smoking in the state decreased from 18.2 percent of the population in 2012 to 13.6 percent in 2017, resulting in a 25 percent drop. Additionally, the percentage of children in poverty has decreased from 38 percent to 11 percent, over the last two years. But even the healthiest state in the country isn’t without some issues. According to the report, Massachusetts experienced a 69 percent increase in fatal drug overdoses since 2012. West Virginia, New Hampshire, Kentucky, Ohio, and Rhode Island have also experienced significant increases over the last few years in fatal drug overdoses as well. The state also has a high preventable hospitalization rate, as well as large disparities in health status due to education.


For the past five years, Hawaii was known as the country’s healthiest state. This year, it came in second. Known for its amazing beaches and picturesque outdoor scene, it makes sense that a state with this much access to the great outdoors is healthy, but the food available also plays a major part, says Hawaii-based nutritional coach Chelsea Newman. “The weather, the surf, and the Aloha spirit all play a part, but in truth, Hawaii has the most expensive food in the United States, and the highest cost of living so it really contradicts the ‘poverty’ blame that often comes along with unhealthy eating,” says Newman. “But generally, here, people really take pride in living close to the earth, supporting local farmers, and they make a big fuss of food. Plus, we’re in bikinis all year round; that definitely helps you be healthy.” The cost of food greatly affects the quality of nutrition a person receives. As such, people who don’t have a lot of money to spend on food tend to go for what is cheaper, and, typically, unhealthy. According to the U.S. National Library of Medicine National Institutes of Health, when income levels decrease, the amount of healthy foods purchased does as well. For instance, high-quality proteins, whole grains, vegetables, and fruit are purchased less often and replaced with low-cost, energy-rich starches, added sugars, and vegetable fats as they are the cheapest way to fill hungry stomachs. And although Newman agrees that poverty levels definitely play a role in the types of foods purchased, she believes that buying healthy food may be more economical than most think. “Learning how to store food properly, eat simply, and eat real food is the key,” she says. “If Hawaii is known as the (formerly) healthiest state and we have the second-most expensive bread in the world, the fifth-most expensive tomatoes, and the most expensive toilet paper in the world, then you can throw the whole notion out the window that you need tons of money to eat healthy.” And, of course, it helps that Hawaii is known for its warm temperatures and gorgeous scenery, which make getting outside to engage in physical activity that much easier, she says. “Weather plays a major part in it; in Hawaii we can get outside all year long,” says Newman. “However, even in really snowy states, there are outdoor activities, but SAD (seasonal affective disorder) is definitely a factor. Vitamin D makes people happier, healthier, and much more likely to have energy.”

The Unhealthiest States

Unfortunately, not every state in the country has the same kind of access to outdoor activity, quality healthcare, and affordable, healthy food. As such, states that are affected the most by this are commonly found in the unhealthy category.


Mississippi was ranked as the least-healthiest state in the nation in the report. A variety of factors contributed to the state’s unhealthy ranking, including the lack of accessible healthcare. For instance, Mississippi has fewer than 45 dentists for every 100,000 people. Compare that to Massachusetts and New Jersey, two of the healthiest states in the country, which have more than 80 dentists per every 100,000. You can see where this lack of dental care could make a difference. Mississippi also has a large obese population at 37.3 percent, as well as many children in poverty. These factors can make living healthy in an area that doesn’t have many healthy options extremely difficult.


The tendency for citizens of Louisiana to engage in unhealthy activities is one of the reasons why it was ranked as the second most unhealthy state in the nation. Like Mississippi, smoking, poverty, and obesity play a factor in the health of those who live there. “Louisiana is the second highest state for obesity, has a high amount of tobacco users and sugar-sweetened beverage drinkers, combined with lower physical activity levels,” says Louisiana-based registered dietician and diabetes educator Lanah Brennan. “With this, there are higher rates of diabetes, heart disease, and cancer in Louisiana.” Brennan also believes that the lower income level of those who live in Louisiana plays a factor in their health. “People with lower income often have less access to fruits and vegetables and are more likely to purchase inexpensive foods that are high in added sugars and fat,” she says. “They also may be more likely to skip meals and overeat when food is available.” Generally speaking, the South is typically less healthy than the North. A variety of factors can play into this, but for Brennan, it’s all about income and the hot weather. “The southern states have a lot in common when it comes to poverty levels, rich foods, tobacco use, hot summers, and lack of physical activity,” she says. And when you add the vibrant food culture of the state, you can have a recipe for disaster. “It is hard not to think about festivals and rich foods like gumbo and jambalaya in Louisiana,” she says. “The norm for food portion sizes is large and there, physical activity is not always a priority. Hot, humid summers in Louisiana make it difficult for many residents to get regular physical activity outdoors.”

Why is the United States riddled with health issues?

You may have noticed that when it comes to health, the United States is lacking compared to other countries in the world. The quality of mental and physical health is poor as people are less able to pay for doctor visits and healthcare, author Roberto A. Ferdman wrote in the Washington Post. But food also plays a pivotal role in the health of the country, and it is only making it worse for itself, says Newman. “It is so clear to me that people don’t understand how to eat properly, but it’s not their fault,” she says. “The United States government has terrible standards for nutrition. So when you raise families like this, not close to growing food, not close to nature, and not understanding what real food is, then you have a massive problem.” Newman also believes that the lack of a healthy food culture in the United States makes eating more about filling up on those empty calories than it is about spending time with those who are important to you, which can make choosing unhealthy food easier. Instead of enjoying meals with friends and family and taking time to select healthy and natural ingredients, Americans usually reach for what is fast and cheap, which is typically unhealthy. “I grew up in the UK, and food had a very different meaning than in the United States,” says Newman. “We had big roast dinners with the family and the neighbors, home-cooked meals at school, and Hawaii has a lot of those values around food as well. We have a beautiful melting pot of cuisines and culture around food within the United States, but the states don’t have an overarching culture for food.” “Cultural food traditions are a beautiful thing, even if they tend to be a bit unhealthy, but what we have now is a boxed food culture, and that’s not really even food that is just a science experiment resulting in a lot of money for some big wigs in suits who really don’t care about the health of people.” “It is a huge problem that I see in moving forward for the United States in the battle for healthy food.”

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