Hawaii was among the top five healthiest states in the nation, according to this year’s annual “America’s Health Rankings.”
Hawaii and Connecticut tied for fourth place in the United Health Foundation’s annual ranking of states for their overall health, behind Vermont at No. 3, Massachusetts at No. 2 and New Hampshire at No. 1.
The least healthy state ranked by the report was Louisiana.
Hawaii got top marks for public health funding per person, dental visits and high physical activity among adults.
However, the state also faces challenges that bring down its health ranking, such as excessive drinking, a high economic hardship index score and lack of primary care providers.
And the state ranked last for severe housing problems and insufficient sleep among adults.
According to the United Health Foundation, “America’s Health Rankings” was created to show how health varies among states from a holistic point of view encompassing the physical, mental and social well-being of a state’s population and not just the absence of disease.
The point of view is inspired by the World Health Organization’s definition of health.
Measures by which states are ranked are grouped under broader categories such as social and economic factors, the physical environment, access to clinical care and services, and behaviors, in addition to health outcomes.
The rankings are intended to help states determine where they need to make improvements, as well as how they can address disparities in the health of their residents.
Overall, the report painted the picture of Hawaii as a state full of residents that are for the most part physically active in an environment with good air and water quality, and who try to keep their teeth healthy by going to the dentist — but are struggling to pay for housing and get enough sleep at night.
Between 2021 and this year, there were improvements in some areas and declines in others.
For instance, access to high-speed internet improved, with Hawaii rising to a No. 8 spot for this category.
But nonmedical drug use in Hawaii increased to about 15.5% of adults this year, putting the state at No. 27 in this category.
While the smoking rate among adults dropped 28% between 2015 and 2021, the use of e-cigarettes among adults increased, placing Hawaii at No. 33 in this category.
And Hawaii residents with high cholesterol increased by 17% — from about 30% in 2019 to 35% of adults in 2021. Chlamydia cases among residents are also rising, earning the state a No. 30 ranking.
These factors are likely what toppled Hawaii from the top spot, which it actually has held nine times during and between 1991 and 2018.
The year 2019, prior to the pandemic, Hawaii was ranked No. 3, so this year’s ranking is considered a notch lower. No state rankings were published in 2020 and 2021 due to unprecedented health challenges presented by the pandemic, according to the foundation.
The report, which has provided annual assessments of the nation’s health on a state-by-state basis for the past 33 years, also presented a special edition this year focusing on the impact of the COVID-19 pandemic.
Overall, the direct and indirect effects of the pandemic remain a challenge, the report said, especially for racial and ethnic minorities.
The prevalence of multiple chronic conditions such as arthritis, asthma, chronic kidney disease, diabetes and depression increased from pre-pandemic times.
Between 2020 and 2021 the percentage of adults with three or more of these chronic health conditions increased 5%, possibly because many Americans delayed diagnosis and care during the pandemic. Additionally, COVID-19 infections increase the risk of some of these diseases.
The highest percentage of people who lost friends and family members to COVID-19 were among Black and Hispanic respondents.
The report specifically noted that COVID-19 deaths disproportionately affected certain ethnic groups in 2021 — and that it was 4.1 times higher among Hawaiians and Pacific Islanders, at 192.2 deaths per 100,000 people.
This was higher than the rates for American Indians and Alaska Natives, Hispanics and Blacks.
HEALTHIEST STATES IN THE U.S.
>> 1. New Hampshire
>> 2. Massachusetts
>> 3. Vermont
>> 4. Hawaii and Connecticut (tied)
Source: America’s Health Rankings/ United Health Foundation
HAWAII HEALTH RANKING NO. 4
>> Strengths: Low prevalence of frequent mental distress and multiple chronic conditions and physical inactivity.
>> Challenges: High prevalence of excessive drinking, high economic hardship index score, low supply of primary care providers.
>> High rankings: No. 1 for air and water quality, dental visits among adults and number of residents avoiding care due to costs.
>> Medium rankings: Childhood immunizations (No. 24), low birth-weight racial disparity (No. 26) and access to mental health care (No. 27).
>> Low rankings: No. 50 for water fluoridation, severe housing problems, insufficient sleep.
>> Improvements: Access to high-speed internet improved by 8% between 2016 and 2021. Smoking rates among adults dropped 28% between 2015 and 2021.
>> Worse: High cholesterol among adults increased 17% between 2019 and 2021. Drug use increased to 15.5% of adults this year. Hawaii ranked No. 30 in number of new chlamydia cases.
Source: America’s Health Rankings 2022
