Hawaii residents can smile about keeping their teeth longer than residents of any other state, but men in Hawaii came in last when it came to getting a prostate test.

These were some of the results published by the Centers for Disease Control and Prevention recently in a report detailing the healthiest states and cities in America.

The little-publicized survey, which was taken in 2006 and published in August, said the results underscore the need for prevention and health promotion activities at all levels of government.

Hawaii fell in the middle or lower end of the pack in rates of heart disease, obesity, getting mammograms and physical activity but topped some categories showing good health habits.

Only 9.6 percent of Hawaii residents over 64 years in age in the study had lost all their teeth. In contrast, West Virginia had the highest rate of lost teeth at 40.5 percent.

Dr. Max Botticelli, chief executive officer of University Health Alliance, said some residents might have longer-lasting teeth because more of them are insured.

“;The number of uninsured (residents in Hawaii) is lower than other states,”; said Botticelli, a former University of Hawaii medical professor. “;It encourages people to take advantage of the benefits, and the benefits include dental care in a large percentage of those people with health insurance.”;

The survey shows Hawaii has the highest rate of insured adults, at 91.7 percent, compared with other states. The national median was 85.5 percent.

Hawaii Department of Health spokeswoman Janice Okubo joined Botticelli in calling Hawaii's mandatory health coverage for full-time workers “;unique.”;

“;It certainly increases access to health care for people insured,”; she said. In addition, Hawaii has a high ratio of professional dentists, which might boost the quality of dental care, she said.

But Hawaii is not out of the woods, she said.

“;One of our bigger concerns is the tooth decay rate in children being very high,”; she said. “;One of the reasons is because our state does not fluoridate the water.”;

On the downside, fewer men age 40 and up—only 40 percent—had a prostate exam within the previous two years.

Botticelli said the value of the test is arguable and is probably of little import.

“;Most measurements would suggest that people in Hawaii are quite healthy and have relatively good habits except for probably a higher incidence of diabetes,”; he said. “;We could all do better.”;

THE PICTURE OF HEALTH

Here is a look at how Hawaii did in the CDC's report on healthy states, cities and counties:

GOOD OR EXCELLENT
» Seat belt use: Hawaii was in the top three at 92 percent, tying California and Washington.

» Adults over 64 who were vaccinated for influenza within a year: 75.7 percent (No. 2 ranking)

» Residents older than 17 who reported limited activities because of physical, mental or emotional problems: 14.2 percent. Honolulu had the best rate in the nation at 12.8 percent.

» Rate of women over 17 years old who had a Pap smear in three years: 82 percent.

AVERAGE
» Smoking and binge drinking in the isles compared to the national average.

» Hawaii was in the upper end for overweight adults at 36 percent, compared with the national high of 40 percent.

BAD
» Percentage of men over 39 who get a prostate exam within two years: 40 (No. 50 ranking).