Hawaii among healthiest in nation

Hawaii ranks as one of the healthiest states in the nation in a national survey, but a falling high school graduation rate, limited care for pregnant women and high numbers of overweight residents are having a negative impact.

The annual ranking by United Health Foundation, the American Public Health Association and the Partnership for Prevention puts Hawaii in fifth place, down from fourth place last year.

Factors that make the state healthier include high spending on public health, low smoking rates in the islands, fewer uninsured and a low percentage of children in poverty.

The United Health report says Hawaii's infant mortality rate decreased from 9.1 per 1,000 in 1990 to 6.4 in the latest count.

The national rankings put Minnesota as the healthiest state in the nation, followed by Vermont, New Hampshire, Utah and Hawaii. Five southern states round out the bottom five, with Mississippi in last place, preceded by Arkansas, South Carolina, Tennessee and Louisiana.

The rankings are based on a variety of factors related to smoking, exercise, obesity, nutrition, deaths of people younger than 75 and prenatal care.

Overall, the report finds strong health gains across the country since 1990, but the pace of improvement is slowing. It says that although the health of the nation is stagnant, suffering can be prevented and unnecessary deaths avoided without a massive or immediate effort.

It notes improvements and failures in every state.

On the unhealthy side:

» Hawaii is 37th in the nation for the percentage of incoming ninth-graders who eventually graduate from high school, which is considered a factor affecting general health in the community. In 1990, Hawaii was sixth in the nation for high school graduation, with 84.5 percent of students getting degrees.

» Hawaii's prenatal care is slipping, with just 67.7 percent of pregnant women having access, compared with 71.6 percent last year. Hawaii ranks 45th in the national in care for expectant woman.

» A big problem is a rise in the prevalence of obesity. Last year's report estimated 16.4 percent of Hawaii residents were overweight. This year, it is 20.9 percent. In 1990 only 9.1 percent of island residents were considered obese.

And the good health news:

» Hawaii ranks No. 1 for the lowest percentages of deaths from cancer and cardiovascular problems and also has the lowest total mortality rate in the nation.

» Health spending in the islands has slipped from $523 per person to $499 last year, but that is still the best in the country. The national rate, although rising, is still at just $162 per person.

» An estimated 17.2 percent of Hawaii's population smokes, compared with 20.8 percent nationally. Hawaii has the third-lowest smoking rate in the nation.

» About 9.6 percent of Hawaii residents are uninsured, while the rising national rate is now at 15.7 percent.