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You live in Pennsylvania, and you think you are very healthy. You eat your vegetables, regularly exercise, and  effectively reduce stress. But how do you and all other Keystone State residents  compare to other states?  Are folks in Pittsburgh healthier than persons in Indianapolis? Is Philadelphia a better place to live than Baltimore. With the help of the United Health Foundation’s research and annual report, we will provide some extremely interesting statistics.

Four key components greatly impact health. They are clinical care, community and environment, policy, and behavior.  Statewide and national trends in public health have been studied for more than 25 years by the Foundation. They have correctly observed and predicted  reductions in the number of smokers, along with increases in drug abuse and deaths along with higher incidences of obesity.

How does Pennsylvania rate? Overall, the Keystone State ranks as the 28th healthiest state in the US. Shown below, in order, are the Top 20.






New Hampshire



New Jersey


North Dakota


New York

Rhode Island







Tobacco Use

Smoking in the US has decreased in the last four years from 21.2% of the population to 17.5%. Smoking is the leading cause of preventable death (obesity is second). For the last 50 years, the percentage of smokers has been steadily reducing. Many state smoking cessation programs have helped, and passing legislation that prohibits smoking in public and work-related locations has also contributed to the declining number of smokers. Increasing taxes and providing counseling are additional helpful factors.

College graduates are much less likely to smoke than persons with a high school (only) education, and the trend is not showing any signs of changing. Also among the 10 largest US cities, Philadelphia has the highest percentage of adult smokers at more than 25%. Also, more than 7% of high school students use tobacco. One possible reason is the high percentage of their parents who smoke. Tobacco usage costs the US  more than $170 billion each year in direct and indirect related expenses.

For the last five years, all states have reduced their percentage of smokers. Illinois has experienced the most significant decrease while Tennessee’s drop has been the smallest. The other states with the biggest reductions (in order) are Nevada, Texas, Arizona, Indiana, Wisconsin, Wyoming, Rhode Island, Massachusetts, Pennsylvania, Oklahoma, Georgia, and Kansas. Currently, Pennsylvania ranks 29th of all states when comparing the number of active smokers.


Since 1990, obesity among young adults in the US has increased by a whopping 157%. Currently, about 30% of all adults are considered obese, which is a slight increase from last year. Although the incidence of obesity actually decreased in half of all states, the reductions were generally nominal. Physical inactivity is one of the primary reasons for the weight gain. Small increases in daily exercise can reverse the disturbing trend. NOTE: Adult inactivity, as expected, is much more prevalent at ages 40-60, than 20-39.

As the second-leading cause of preventable death (smoking is number one), obesity also contributes towards  many conditions, including heart disease, diabetes, cancer, stroke, and several respiratory diseases. Education level also has a direct impact on obesity risk. Higher educational levels lead to a lower risk of being overweight, especially for females. College graduates have a 40% lower chance of becoming obese than persons that do not graduate from high school.

Pennsylvania’s annual rate of change in obesity prevalence by education level (age 25 or older) from 2012 to 2016 was the second-highest in the US behind only Vermont. The next five highest states were New York, Alaska, Oklahoma, Nevada, and Iowa. Better nutrition education in schools and at home can help improve the results.

Drug Deaths

The leading cause of deaths by injury in the United States is drug overdoses. More than 40,000 persons die each year, and most of the deaths involve opioids (pain relievers such as oxycodone, morphine, or hydrocodone).   The total cost of illegal drug usage in Pennsylvania is  hundreds of millions of dollars each year. The only states with higher drug deaths (as a percentage of population) are Nevada, Oklahoma, Ohio,  Rhode Island, Utah, Kentucky, New Mexico and West Virginia.

A significantly-higher number of males lose their life from drug overdoses, compared to females. When comparing race and origin, Asians, Alaska natives, and American Indiana have the lowest rates, while Caucasians have the highest percentage of drug deaths. Alcohol misuse  costs the US more than $200 billion each year.

Chronic Drinking

Excessive and binge over-consumption of alcohol are often directly responsible for many medical issues, including liver disorders, hypertension, cardiovascular disease, memory loss, digestive problems, cancer, pancreatitis, brain damage, and osteoporosis. Alcohol misuse  costs the US more than $200 billion each year. The higher the income, the greater the incidence of misuse. There is no significant difference when comparing urban and rural statistics.

Pennsylvania ranks 30th of all US states in excessive drinking. The states with the most serious problems are Alaska, North Dakota, Wisconsin, Montana, and Illinois. The states with the least issues  (per capita) are Tennessee, West Virginia, Utah, Alabama, and Mississippi.

Physical Inactivity

Most of us enjoy relaxing, and perhaps watching TV or sitting in front of our computer. However, when this occurs more than a few hours per day, increased risk of coronary heart disease, type 2 diabetes, breast cancer, and colon cancer occur. Only about one in five persons meet the US Department of Health and Human Services physical activity requirements. Life expectancy increases with increased exercise, especially on a regular basis.

Pennsylvania ranks 37th out of all states for effective physical activity. The five most “active” states are Colorado, Oregon, Washington, California, and Utah. The least “active” states are Mississippi, Arkansas, Oklahoma, Kentucky, and Louisiana. Females, persons over age 65, persons with less than a high-school education, and households with less than $25,000 of income, are the most susceptible.

Occupational Deaths

Pennsylvania does not rank in the top or bottom five of this category. The worst states for occupational fatalities are Wyoming, North Dakota, Mississippi, Oklahoma, and Louisiana. The five states with the least percentage of deaths are Massachusetts, New York, Washington, Connecticut, and California. Note: Statistics included  the following industries: construction, utilities, manufacturing, transportation, and business services.

Air Pollution

Unclean air can cause respiratory disease, asthma, irregular heartbeat, bronchitis, allergies, heart attacks, and several other serious medical conditions. The annual US cost of air pollution  is more than $50 billion, although the Clean Air Act helps reduce some of the expenses. Unfortunately, Pennsylvania is ranked as the second-highest state for air pollution. The other four states are Ohio, California, Indiana, and Illinois. The five states that pollute the least are Wyoming, Vermont, North Dakota, New Mexico, and South Dakota.

Infectious Diseases

Salmonella, Whooping Cough, and Chlamydia are three common preventable diseases that cause death, if left untreated. Children are the most susceptible, although increased treatment and prevention will reduce the number of fatalities. Salmonella causes fever and cramps, and is typically caused by food contamination. Whooping Cough is very contagious and can be slowed by vaccinations. Chlamydia is transmitted by sexual contact, and affects more than 1 million persons each year.

Pennsylvania’s state-ranking is 16th for incidence of Chlamydia, 20th for Whooping Cough, and 11th for Salmonella (lowest is best). The five states with the highest average level of these three conditions are Mississippi, South Carolina, Louisiana, Alabama, and Alaska. The five states with the lowest average levels are West Virginia, Maine, Vermont, Oregon, and Connecticut.

Violent Crime

More than one million violent crimes occur in the US each year, resulting in more than $6 billion of medical expenses. The Keystone State is not one of the top-five or bottom-five ranked states. The five states with the lowest (per capita) number of violent crimes are Vermont, Maine, New Hampshire, Idaho, and Virginia. The five highest-ranked states are Alaska, Nevada, New Mexico, Tennessee, and Louisiana. An estimated $65 billion in production is lost every year to violent crimes.

Immunizations – Children And Adolescents

As children and adolescents get older, often the effectiveness of previously-administered vaccines begins to diminish. The proper use of boosters can greatly reduce the number of many diseases, including HPV, meningitis, septicemia, tetanus, diphtheria, and whooping cough. Up to 14 diseases can be prevented with proper immunizations. Black non-Hispanic children and children from poorer households tend to receive the lowest percentage of available treatment.

The Keystone State is ranked 8th among all states for immunizations for all adolescents, 10th for HPV immunizations, 4th for meningococcal, and 8th for Tdap. The top-ranked states (measured by percentage of children aged 19-35 months, who  received measles, mumps, rubella, polio and hepatitis vaccines) are Connecticut, North Dakota, Delaware, Massachusetts, and Iowa. The states with the lowest ratings are Virginia, West Virginia, Alaska, Arkansas, and Florida.

Cancer-Causing Death

The second-leading cause of death in the United States in cancer. More than 1.5 million new cases are reported each year, with almost 600,000 persons dying from the disease. Although stopping the usage of tobacco helps reduce the incidence of lung cancer, it is still one of the leading causes, along with colon, breast, and prostate. Pennsylvania ranks only 36th in cancer deaths when compared to other states. Regular screening tests allow effective early treatment (if needed).

The five states with the lowest percentage of cancer incidence are Utah, Hawaii, Colorado,  New Mexico, and California. The five states with the highest incidence are Kentucky, Mississippi, Louisiana, West Virginia, and Arkansas. Additional information can be found in this report.

Cardiovascular Deaths

Stroke and heart disease are major causes of death. Black males are 30% more likely to die from cardiovascular diseases than white males. Non-Hispanic blacks also have much higher avoidable deaths than non-Hispanic whites. Pennsylvania ranks 35th among all states for cardiovascular deaths in the US. The five states with the lowest percentage of deaths are Minnesota, Colorado, Massachusetts, Hawaii, and Oregon. The five states with the worst numbers are Mississippi, Alabama, Oklahoma, Arkansas, and Louisiana. Note:  Cardiovascular disease is very effectively treated by Pennsylvania’s best hospitals.


Diabetes is the nation’s seventh leading cause of death. Its chronic condition leads to several other serious conditions, including stroke and heart disease. The three types of diabetes (Type 1, Type 2, and gestational) can be managed with improved diet, increased exercise, and properly managing weight. Medical costs associated with the disease, are very high, which explains why most carriers deny coverage on their medically-underwritten products.

The Keystone State ranks 30th in the US for incidence of Diabetes. The five states with the lowest numbers are Utah, Colorado, Alaska, Minnesota, and Montana. The five states that rank the highest are Mississippi, West Virginia, Alabama, Kentucky and Tennessee.

Health Status Imbalance

Typically,  highly-educated persons tend to be healthier. Thus, staying in school and earning high school, college, and post-graduate degrees may actually improve your health. Every increase in level of education improves health status. More than $1 trillion would be saved if these disparities were substantially diminished.  Pennsylvania ranks 37th in the “disparity index,” compared to other states. Up to $1 trillion can be saved if the imbalance is reduced.

The states with the greatest disparity are California, Vermont, Colorado, Rhode Island, Massachusetts, Delaware, and Florida. The states with the smallest disparity are Hawaii, Oklahoma, Tennessee, Wyoming, Kentucky, Missouri, and Indiana.

Mental Distress

Frequent mental distress (FMD)  is a metric that takes into account emotional and mental disorders, and severe stress caused by environmental factors. Lack of sleep and economic and healthcare hardship can contribute and increase stress levels. Mental health issues that are untreated at young ages, often lead to future adverse events as an adult. Continued and prolonged  untreated illness generally results in serious consequences. When considering the percentage of adults that stated their mental health was not favorable for at least 14 of the last 30 days, Pennsylvania ranks 28th of all states.

The states that reported the highest levels of mental distress are West Virginia, Arkansas, Mississippi, Louisiana, Tennessee, Alabama, Kentucky, and South Carolina. The states that reported the lowest levels are South Dakota, Minnesota, Hawaii, Nebraska, North Dakota, Iowa, Illinois, and Kansas. The true economic cost is more than $300 billion, which does not include early mortality and homelessness. Females are more likely than males to suffer from this ailment.

Physical Distress

Severe and constant physical stress is common with persons (mostly adults) with chronic medical conditions, especially heart disease and stroke. Often it leads to less physician visits and additional or worsening conditions. Pennsylvania ranks in the middle (25th) when comparing state disparities in frequencies of physical distress. States with the highest physical distress are West Virginia, Tennessee, Mississippi, Alabama, and Kentucky. States with the lowest physical distress are North Dakota, Alaska, Minnesota, Utah, and Hawaii.

Infant Mortality

The US infant mortality rate (under five-years-old) continues to rank higher than many developed countries, including Iceland, Finland, Norway, Japan, Sweden, Israel, Spain, Italy, Ireland, Australia, Greece, France, Germany, United Kingdom, and Canada. The leading causes of death are injury, SIDS, birth defects, maternal complications, and pregnancy complications. Unmarried mothers and non-Hispanic Blacks have higher rates. The states with the highest infant mortality ratios are Mississippi, Alabama, Louisiana, Arkansas, and Oklahoma. The states with the lowest infant mortality rates are Vermont, Washington, Iowa, Massachusetts, New Jersey, and California.