2017 Annual Report: Nation’s Health Faces Rising Rates of Premature Death and Continued Unevenness in Concentration of Health Care Providers


Published December 12, 2017

  • Drug death rate is at its highest level in history of America’s Health Rankings
  • Massachusetts ranks as nation’s healthiest state for the first time ever
  • First ever examination of concentration of mental health providers reveals wide variation

America’s health is challenged by an increase in premature death and uneven concentration of health care providers, according to key findings in United Health Foundation’s America’s Health Rankings® Annual Report.

America’s Health Rankings Annual Report, now in its 28th year, provides a holistic view of the health of the nation and of each state by analyzing 35 measures of behaviors, community and environment, policy, clinical care and outcomes data.

Disturbing Trends in U.S. Mortality: Increases in Premature Deaths, Drug Deaths and Cardiovascular Deaths

The report finds increases in the rates for three key mortality indicators.

  • The premature death rate increased for the third year in a row. The rate increased by 3 percent from 2015. Premature death is defined as the years of potential life lost before age 75.
  • In the past year, the rate of drug deaths continued an upward trend, increasing by 7 percent to its highest level ever as measured by the America’s Health Rankings Annual Report.
  • Cardiovascular deaths increased for the second consecutive year, with the rate among African Americans significantly higher than the rate among whites, Hispanic- and Asian-Americans, and Native Americans.

Even Healthy States Are Experiencing Increases in Mortality

Increases in key mortality indicators are being felt even in the nation’s healthiest states.

  • In the past five years, some of the healthiest states by overall rank have experienced large increases in drug death rates, including New Hampshire (a 118 percent increase, with an additional 13-plus deaths per 100,000 people), Rhode Island (a 56 percent increase, with an additional 8-plus deaths per 100,000 people) and Massachusetts (a 69 percent increase, with an additional 8-plus deaths per 100,000 people). 
  • In the past five years, Utah (ranked as the fourth healthiest state) experienced one of the largest increases in the rate of cardiovascular deaths (10 percent, with additional 21-plus deaths per 100,000 people).

Continued Variation in the Concentration of Health Care Providers

The wide variation in health care providers across the country may contribute to differences in overall health.

  • The state with the highest concentration of mental health care providers, Massachusetts, has six times the number of mental health care providers than the state with the least amount, Alabama.
    • Massachusetts has 547 care providers per 100,000 people vs. Alabama, which has 85 care providers per 100,000 people.
  • There is also a significant variation in primary care physicians, with a nearly two-to-one ratio between the states with the highest and lowest concentrations.
    • Rhode Island, Massachusetts, New York and Connecticut have more than 200 primary care physicians per 100,000 people, compared to fewer than 100 physicians per 100,000 people in Utah and Idaho.
  • Similarly, the concentration of dentists varies by almost two to one across states.
    • Massachusetts and New Jersey have more than 80 dentists per 100,000 people. Arkansas, Mississippi, Alabama and Delaware have fewer than 45 dentists per 100,000 people.

State Rankings in 2017: Massachusetts Ranks 1st, Mississippi Ranks 50th

  • Massachusetts ranks as the healthiest state in 2017 for the first time, followed by Hawaii (2), Vermont (3), Utah (4) and Connecticut (5).
  • Mississippi is ranked 50th for the second year in a row with Louisiana (49), Arkansas (48), Alabama (47) and West Virginia (46) rounding out the states with greatest opportunities for improvement.

“This report serves as an important tool for health care professionals, policymakers and communities in their collaborative efforts to address these challenges, and help build healthier communities across the nation,” said Rhonda Randall, D.O., senior adviser to United Health Foundation, and chief medical officer, UnitedHealthcare Retiree Solutions.  “This is a call to action for each of us to make changes in our own lifestyles that can help improve our overall health and well-being.”

About America’s Health Rankings and the 28th Annual Report

America’s Health Rankings Annual Report is the longest-running annual assessment of the nation’s health on a state-by-state basis. For 28 years, the report has analyzed a comprehensive set of behaviors, community and environment, policy, clinical care and outcomes to provide a holistic view of the health of the nation.

The longevity of the report and wealth of credible data available for analysis provide a unique opportunity to track short- and long-term successes, and identify current and emerging challenges to the nation’s health.

 For more information, visit www.AmericasHealthRankings.org.

About United Health Foundation

Through collaboration with community partners, grants and outreach efforts, United Health Foundation works to improve our health system, build a diverse and dynamic health workforce and enhance the well-being of local communities. United Health Foundation was established by UnitedHealth Group (NYSE: UNH) in 1999 as a not-for-profit, private foundation dedicated to improving health and health care. To date, United Health Foundation has committed nearly $358 million to programs and communities around the world. We invite you to learn more at www.unitedhealthgroup.com/SocialResponsibility.