How healthy you are also depends on where you live | Gustafson

Whether you are overweight, have diabetes, high blood pressure or high cholesterol largely depends on your personal lifestyle choices – but not exclusively, according to an annual survey on the health of Americans.

Whether you are overweight, have diabetes, high blood pressure or high cholesterol largely depends on your personal lifestyle choices – but not exclusively, according to an annual survey on the health of Americans.

Where you live also may play a role in your well-being.

A report titled America’s Health Rankings is annually issued by the United Health Foundation under the sponsorship of the UnitedHealth Group to identify state by state which parts of the country are more conducive to healthy living and which are less.

The report is based on telephone interviews with randomly chosen participants about personal lifestyle factors such eating habits, exercise, weight control, smoking, alcohol and drug use as well as social and environmental components like crime rates and air pollution.

According to the survey’s findings, the healthiest state in America is Vermont, followed by Hawaii, New Hampshire, Massachusetts and Minnesota (in that order). Mississippi and Louisiana rank at the bottom.

Washington is ranked 13th.

Not surprisingly, the obesity epidemic continues to be one of the greatest health threats in America. Colorado has the lowest percentage of obese people (20.7 percent), while Mississippi has the highest (34.9 percent). The total number of obese adults is currently about 66 million, roughly a quarter of the entire population.

The higher the percentage of obesity, the greater are the challenges states face in terms of health care costs and loss in productivity. Medical costs for the treatment of diseases associated with weight problems amount to nearly $150 billion annually nationwide.

Likewise, diabetes has become so widespread, it is now considered epidemic. The national median percentage of Americans with diabetes is nearly 10 percent and significantly higher in some states. It is estimated that costs for diabetes treatment will amount to 10 percent of total health care spending by the end of the decade, or about $500 billion annually.

The detrimental health effects of the sedentary lifestyles many Americans adhere to are also mentioned in the report. “Sedentary” means no physical activity or exercise outside work for at least 30 days in a row. In Mississippi more than a third of the population fits in this category. The national median is 26.2 percent.

Smoking still a problem

Compared to other countries, tobacco use has significantly decreased in America. But 45 million still light up, the highest number in Kentucky with 29 percent. Smoking in particular is a cause for many avoidable diseases, including respiratory disease, heart disease, stroke, cancer as well as preterm birth and low birth weight.

While the nation as a whole faces these challenges, there are specific reasons why some states do better than others. One is the availability and affordability of healthful foods. According to the U.S. Department of Agriculture (USDA), the dietary quality of our food supply varies across households throughout the country.

“This is likely the result of a combination of both supply and demand factors,” concludes a recent report by the agency. “On the supply side, the geography of the food environment, as defined by the number and type of food retailers, can vary across markets. On the demand side, there are differences in local and regional preferences.”

In other words, in some regions it can be harder to find enough outlets for healthy foods, sometimes called “food deserts.” But it can also be the local culture that prevents consumers from making changes. Oftentimes, it may be a question of education.

When it comes to exercise, the situation is similar. In some communities, it is easier to find facilities such as public parks, walk and bike paths, gyms and pools and so forth. In others, they are absent or unsafe.

It is no secret that smoking, alcohol and drug use are more prevalent in areas with high unemployment and poverty rates. These are also the places where large parts of the population have insufficient access to health care. Many of the health problems the report focuses on are indeed connected to economic differences in the country.

“As a nation, we’ve made extraordinary gains in longevity over the past decades, but as individuals we are regressing in our health,” said Dr. Reed Tuckson, medical advisor to the United Health Foundation and chief of medical affairs for the UnitedHealth Group. “What worries us in particular about this year’s report is that some key risk factors that are driving up preventable chronic illness are getting worse,” he added in an interview with CBS News.

Still, most experts, including Tuckson, believe that improvements to our public health start at the personal level. We can’t wait for the world around us to change, so it gets easier for us to change our lifestyle. “The most common misconception people have about living healthy is that it’s hard,” he said.

Timi Gustafson RD, LDN, is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun,” which is available on her blog, “Food and Health with Timi Gustafson R.D.” and at amazon.com. You can follow Timi on Twitter and on Facebook.