Vermont named healthiest state in U.S., Mississippi last.

The United States has a new state at the top of the healthiest list, according to annual rankings released in November in conjunction with APHA's 135th Annual Meeting.

For the first time, Vermont was named the healthiest U.S. state, knocking Minnesota off its four-year perch at the top, according to "America's Health Rankings: A Call to Action for People and Their Communities." Released by the United Health Foundation, APHA and the Partnership for Prevention, the annual report measures the overall healthiness of U.S. states based on indicators such as smoking, obesity, infant mortality, un insurance, violent crime, prenatal care and premature death.

Vermont moved up from the No. 2 slot in the rankings because of its low percentage of children in poverty, low prevalence of obesity, high rate of high school graduation, high immunization coverage and low premature death rate, among other factors. Vermont Gov. Jim Douglas credited "extraordinary, even historic, steps" in recent years on issues such as access to health insurance and disease prevention for the state's new ranking.

"Our responsible, commonsense reforms are improving our health care system, aggressively contain (ing) costs, extending coverage to those currently without it and helping to make Vermont the healthiest state in the country," Douglas said in a news release.

Other states that topped the health rankings were Minnesota, at No. 2, followed by Hawaii, New Hampshire and Connecticut. Among other state highlights, South Carolina had the highest overall health improvement with a 6.3 percent increase. Montana followed with a 4.6 percent increase and Maryland and New Mexico each had a 4.5 percent increase in health status.

Nebraska returned to the top 10 in the rankings for the first time since 1992, in part because of its improvement in high school graduation rates, which are now the highest in the nation. After four years in the bottom 10, Georgia moved up to 40th place because of declines in the infectious disease rate, number of poor physical health days and prevalence of smoking.

At the bottom of the list were Mississippi, at No. 50, preceded by Louisiana, Arkansas, Oklahoma and Tennessee. In Louisiana, Roxane Townsend, MD, secretary of the state's Department of Health and Hospitals, noted that uninsurance rates in both Louisiana and Mississippi increased in the wake of hurricanes Katrina and Rita, and that the subsequent loss of doctors and displacement of families most likely contributed to a drop in childhood immunization rates in her state.

As a whole, the health of the nation declined by 0.3 percent since last year, the new report found. While the rankings showed some reduction in overall U.S. cancer and cardiovascular mortality rates, such improvements were overshadowed by increases in obesity, the number of uninsured people and children in poverty.

"There are still many people who through unhealthy personal behaviors, adverse community environments and difficult access to care are vulnerable to a future life of poor health--which is essentially preventable," said Reed Tuckson, MD, a member of the board of United Health Foundation.

For more information, visit www.americashealth rankings.org.