Hawaii drops in Hawaii dropped to 14th place -- its lowest showing in 13 years -- in a survey that ranks the overall healthiness of the 50 states.
health ranking
The change is blamed on other states
doing better than previouslyBy Helen Altonn
haltonn@starbulletin.comState Health Director Bruce Anderson attributed the drop to health improvements in other states that Hawaii did not match.
"When you start looking at numbers, we're holding our own," said Anderson yesterday after the report was released. "Our rates are fairly stable, but when you look at improvements in other states, we're not holding our own, and in some areas we're actually slipping."
Hawaii fell from 11th place last year and ninth place in 1990, according to the UnitedHealth Foundation State Health Rankings (2002 Edition). New Hampshire led the nation as the healthiest state, followed by Minnesota, Massachusetts, Utah and Connecticut. In 50th place was Louisiana, the least healthy state; Mississippi was 49th. Other states at the bottom are Oklahoma, Arkansas and South Carolina.
Anderson noted that in one category, support for public health care, Hawaii's ranking fell to 31 from 14 in 1990.
"This is a very crude indicator of funding for public health programs that covers a wide variety of areas." he said. "The fact is, our economy has been flat over the years. We simply haven't invested in public health as other states have in the last few years."
A high number of traffic deaths, low percentage of pregnant women getting prenatal care, low support for public health care and high infant mortality pulled the state's health ranking down, according to the report.
But Hawaii continued to be first in the country in traditional public health programs, with low rates of heart disease, cancer deaths and total mortality. The state also had low rankings for smoking, heart disease and premature deaths.
"When you start folding in other areas not traditionally considered as health, we're not doing so well," Anderson said.
For example, he referred to the number of incoming ninth-graders graduating from high school, which dropped to 64.2 percent this year from 84.5 percent in 1990.
Children in poverty is another factor not traditionally thought of in assessing a "health state," Anderson said, but it affects the likelihood of a child covered with health insurance and having access to medical care.
The percentage of Hawaii youths under age 18 living in poverty dropped to 13.9 percent last year from 20.7 percent in 1990 and rose to 15.5 percent this year. The state's ranking in that area went from 29 in 1990 to 19 in 2001 and to 31 this year.
In health insurance coverage, however, "We're doing better than 10 years ago," Anderson said, moving to 11th this year from 16th place in 1990.
While it is a 2002 survey, the statistics are from 2001 or earlier and do not reflect recent developments such as the state's Healthy Hawaii Initiative, anti-smoking campaigns and county smoking bans, Anderson said.
The number of islanders smoking dropped to 19.7 percent last year from 27.6 percent in 1990 and climbed slightly this year to 20.5 percent, according to the survey. Hawaii's ranking in this area went from 10th in the country to sixth this year.
"What's particularly disturbing -- and this isn't reflected in the statistics, although the rates generally are going down -- the percentage of young kids smoking is increasing," Anderson said.
Infant mortality increased to 7.2 deaths per 1,000 live births from 7.0 in Hawaii, an area in which improvements "have failed to match improvements in other states," the report said.
On the positive side in Hawaii:
>> Infectious diseases dropped to 24.7 cases per 100,000 population from 28.9.
>> Health disparities are among the lowest in the nation for prenatal care and premature death.
>> Violent crime dropped to 7 offenses per 100,000 population in the 2002 survey from 8 in 2001.
"This is a wake-up call for a lot of policy-makers," Anderson said. "It shows where we're doing well; it also shows areas where we need to focus more attention."
Some nontraditional health areas, such as motor vehicle deaths and high school graduates, require efforts from many agencies, he said.
The nonprofit, private UnitedHealth Foundation published the first state health rankings in 1989, using 16 measures to assess healthiness of populations. Several new measures were added in 1990. The project is intended to provide information to guide efforts to create healthier communities.
The rankings were based on data from the U.S. Department of Health and Human Services' Centers for Disease Control and Prevention and Natural Center for Health Statistics, as well as national statistics on budget, safety, census, economic analysis, education and labor.
State of Hawaii
