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The Honolulu Advertiser
Posted on: Tuesday, November 12, 2002

Hawai'i falls to No. 14 in national health ranking

 •  Table: Hawai'i's health ranking by category

By Robbie Dingeman
Advertiser Health Writer

Hawai'i is still a healthier state to live in than most — ranked 14 out of 50 this year — but that national ranking by a nonprofit foundation is the lowest the state has received in 13 years of the annual report.

Source: State of Hawai'i
The rankings released yesterday come from a yearly analysis done by Minneapolis-based United Health Foundation on the relative healthiness of the American population. The foundation joins with the American Public Health Association and Partnership for Prevention each year to issue the report.

The report considers at a variety of factors — including traditional health measures — such as deaths from heart disease and cancer, infant mortality and lack of health insurance.

But the report also looks at less common measures such as motor-vehicle deaths, violent crime rates, children living in poverty and high school graduation rates.

State Health Director Bruce Anderson said it's clear that the state is slipping on some key areas. "The areas that were doing poorly in are motor-vehicle deaths, high school graduation rates, children in poverty in support for public health."

Smoking is another area where the numbers went the wrong direction this year. Back in 1990, 27.6 percent of the population smoked cigarettes. By last year, that dropped to 19.7 percent, but this year it increased to 20.5 percent of the population.

Anderson cautioned that most of the data is at least a year old, so smoking-prevention ads and new limits on smoking in restaurants are not reflected. But he said the survey is a helpful tool at measuring health trends.

Since 1990, the state has ranked third in the nation three times —1991, 1992 and 1996. In 1999, the rating dipped to 11, surged back up to 4 the next year and back to 11 last year.

According to this year's report, the top three states are New Hampshire, Minnesota and Massachusetts. The bottom three were South Carolina, Mississippi and Louisiana. Overall, the report says all 50 states have shown improvement over the last 12 years.

The report gave some good news and bad news in the health report card, citing Hawai'i's "strengths are number one ranks for a low rate of heart disease and cancer deaths and low total mortality or the number of deaths per 100,000 people from all causes.

Anderson said he was pleased by the overall rank from the comprehensive health survey and by the No. 1 ranking for low rates of heart disease, cancer and total mortality. He said one of the reasons for this is the high-quality care provided by physicians and other health care professionals in the state.

Anderson said he's disappointed but not surprised that the state public healthcare ranking is declining because Hawai'i has been spending the same amount for the last decade. "Other states are doing better than we are at improving the health status of their communities. I think this is a real wake-up call for health policy makers to focus on areas where we can make significant improvements."

Over the 13 years of the survey, high school graduation rates dropped sharply from 84.5 percent in 1990 to 64.2 percent in this year's survey, which was better than the 59.7 percent tracked last year. However, that measure was for ninth-graders who graduated within four years. Census figures show that many more people than that eventually graduate from high school in Hawai'i. Census figures showed that in 1991 91.8 percent of the population in Hawai'i has graduated from high school, which was one of the best rates in the nation.

Why are high school graduation rates factored in? The survey said that such graduation data provides "an indication of the consumer's ability to learn about, create and maintain a healthy lifestyle and to understand and access health care when required."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.

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