Last month, United Health Foundation released the 26^th annual report on the state of health in the nation. Hawaii received top honors in “America’s Health Rankings^®,” while Louisiana came in dead last. Although Tennessee moved up two spots from last year, the state still finished near the bottom at 43^rd in the country.

With a starting position of 42^nd in 1990, Tennessee hasn’t managed to gain much traction over the last 26 years despite increased attention and efforts to positively impact the determinants of health. The state’s worst showing came in 2005 with a rank of 49^th, and the best was in 2011 at 41^st.

Rankings were determined by weighting more than 60 core measures and supplemental measures across the broad topics of physical and behavioral health, access to care, clinical quality targets, environment, policy and other societal factors including education and poverty levels. Among core measures, Tennessee makes a good showing in several categories, including having a high rate of high school graduates and low prevalence of excessive drinking. However, we rank in the bottom third for obesity and physical inactivity and near the very bottom for diabetes (48), poor mental health days (50), smoking (47), and violent crime (47).

In the supplemental measures, the state ranks among the best for issues related to binge and chronic drinking and having cholesterol checked. Unfortunately, knowing those lipid numbers haven’t done much to impact the rate of high cholesterol (30), or to slow down heart attacks (46) and heart disease (45). Tennesseans seemingly are among the worst for eating fruits (49) and administering the HPV immunization for females (50),

Unfortunately, Tennessee saw a 20 percent increase in poor mental health days over the last two years and an 11 percent increase in violent crime since the rankings were launched in 1990. With 591 violent offenses per 100,000 population, Tennessee fares far worse than the top state of Vermont with only 121.1 such offenses per 100,000. Tennessee also compares unfavorably with much larger states often portrayed as having big city dangers, including New York (393.7) and California (402.1). Only Nevada (603), New Mexico (613), and Alaska (640.4), have a bigger issue with violent crime than Tennessee.

On the plus side, cardiovascular deaths are down 22 percent over the past decade from 382.3 to 299 per 100,000 population. However, that’s still a far cry from the best state, Minnesota, which as a rate of 186.5 deaths per 100,000 population. Other positives include a 26 percent decrease in preventable hospitalizations over the past five years from 87.7 to 64.8 per 1,000 Medicare beneficiaries, and a significant decrease of 28 percent over the last year in physical inactivity, which is down from 37.2 percent to 26.8 percent of adults self-reporting as inactive.

The State Weighs In

In light of the recent metrics, a spokesperson with the Tennessee Department of Health offered the following commentary on the pluses and minuses of the state’s recent ranking with specific attention to the change in physical activity.

“While the Tennessee Department of Health is pleased to see data indicating an improvement in the number of residents who are self-reporting being more physically active, we must all understand annual fluctuations in calculations and periodic shifting of survey methodology are factors that must be considered when reviewing new numbers. The effort to improve physical activity across Tennessee is an important component of the Big Three Plus One initiative to improve health for all residents. The components include

1.) Reducing excessive caloric intake to reduce overweight/obesity;

2.) Improving physical activity among all residents; and

3.) Reducing the number of Tennesseans who use tobacco products; plus reducing misuse/abuse of both prescribed and illicit drugs.“ 

Department of Health officials went on to point out that in addition to statistical changes that might have been impacted by the way the question was phrased, they believe improvement is also attributable to the contributions of several new programs across the state aimed at enhancing fitness, including:

• Engaging in a partnership with Tennessee Department of Environment and Conservation to convene school running clubs across the state, providing non-competitive physical activity in an after-school setting to interested students.
• Funding for walking tracks at multiple schools across the state.
• Encouragement and support for Go Noodle, which provides fun, physical activities in classroom settings in over 1,000 Tennessee schools.
• Construction on walking trails and greenways across the state.
• Implementing a program to provide free access to recreation centers, as well as an exercise coach for citizens wanting to reduce weight and improve health.
• Encouraging increased physical activity through a series of healthy actions and challenges as part of the Small Starts tools developed and offered by the Governor’s Foundation for Health and Wellness to engage Tennesseans at home, in the workplace and at worship.
• Statewide implementation of the Healthier Tennessee Communities initiative to motivate community-level ownership of population health and to support positive changes among fellow residents.

“These and other efforts focus on the importance of helping all individuals understand the importance of physical activity and encouraging them to take action to become more physically active in meaningful ways,” concluded the TDH official.

The Big Picture

The interactive report, which also includes data specific to seniors, allows comparison of Tennessee to other states and national averages for the broad range of measurable metrics. Custom reports, state infographic and summary, and ‘take action’ resources to improve rankings are all available at AmericasHealthRankings.org.

WEB:

America’s Health Rankings: http://www.americashealthrankings.org