Texas continued its slide in United Health Foundation’s 2018 “America’s Health Rankings Annual Report,” where it went from 33rd in the nation in 2016 to 37th in 2018. On the brighter side, the report found that high school graduation increased, cancer and drug deaths decreased, smoking rates went down while the number of primary care physicians increased. But the worst insured rate in the nation and increases in diabetes rates, physical activity, cardiovascular deaths and mental distress were enough to bump Texas down a few spots.
The report measures states’ health via 35 measures across five categories: behaviors, community and environment, policy, clinical care and outcomes. Texas was ranked 19th overall in behaviors, scoring fifth in the nation in high school graduation as a percent of students (89.1) and fifth best in drug deaths (10 per 100,000 population). Compared to 2017, high school graduation went down slightly and drug deaths notched up. But Texas ranked 46 in physical inactivity, with 32.1 percent of the population considered physically inactive, up from 25.2 percent in 2017, even though overall obesity rates went down between 2017 and 2018.
The Lone Star State ranked 39th in Community and Environment, where we were 41st in air pollution and 38th in childhood poverty with 20.9 percent of children living in poverty. Both of those measures were worse than the year before. Violent crime, where Texas ranked 25th, also ticked up since 2017.
What really set Texas back was its policy score, where Texas ranked dead last in the country. Texas’ 17 percent uninsured rate was 50th in the country, and Texas also ranked in the 40s in several immunization rates. Texas was 50th in this category last year as well, but saw many of its immunization rates drop relative to 2017. Texas went from 33rd to 41st in childhood immunizations, dropped its public health funding, and the uninsured rated bumped up slightly since 2017. Texas spends $65 per person in public health, while the top in the nation is $281 per person.
Clinical care doesn’t look much better in Texas, where it ranked 42nd. With 113.2 primary care physicians per 100,000 people, Texas was 45th in the country, and its 105.9 mental health providers per 100,000 people put the state 49th in country.
In regard to outcomes, Texas ranked 28th overall. It was 11th best in cancer deaths and top 20 in infant mortality and physical distress. But the 11.9 percent of Texan adults suffering from diabetes dragged the ranking down.
Nationwide, obesity broke the 30 percent mark for the first time ever, premature deaths went up, cardiovascular disease death is going up, more than 30 states aren’t improving their cancer death rates, and suicide has increased 16 percent since 2012. For men, the suicide rate is over 22 deaths per 100,000 people.
But childhood poverty decreased 19 percent nationwide, and mental health providers and primary care physicians saw increases. Hawaii is the nation’s healthiest state, with several New England states ranking close behind, while Louisiana and its neighbors Mississippi, Alabama, Oklahoma, and Arkansas brought up the rear.
The United Health Foundation has been producing this annual report for 29 years, and analyzes health criteria on a state-by-state basis to give a comprehensive look at the nation’s health. United Health Foundation is established by UnitedHealth Group as nonprofit foundation to improve health and health care. Find the entire report here.