Washington ranks 11 in nation in overall health

Washington state ranks No. 11 in the country in overall health, according to a yearly survey that takes into account broad measures of health, including smoking, crime, air pollution and spending on public health.

The good news: The state climbed up one notch from last year. The survey notes that, compared to other states, Washington residents are less likely to smoke or get killed on the job; babies born here don't die nearly as often; and residents are less likely to go to the hospital for preventable conditions.

The bad news: Too many pregnant women don't get early prenatal care; our children don't get immunized as well as other states' kids; we're only so-so in the percent of ninth-graders who graduate within four years; and the percentage of children in poverty increased from 13 percent to 18 percent.

Significantly, we're fatter than we used to be: Over the past 20 years, the percentage of state residents considered obese has grown from 18 percent to nearly 27 percent.

"America's Health Rankings," a broad look at states' health, is now in its 21st year, produced by the American Public Health Association, the United Health Foundation and Partnership for Prevention. It's online at www.americashealthrankings.org.

Using data from a large number of sources, from the Centers for Disease Control and Prevention to the U.S. Environmental Protection Agency, the survey uses a methodology developed by a committee of public-health scholars convened by the University of North Carolina School of Public Health.

First place in this year's survey was Vermont, which has climbed from 17th in 1998. Massachusetts was second, and New Hampshire, third.

Funding for some local health programs that speak to issues cited by the report may be in danger as state lawmakers struggle to cut the budget. Anti-smoking, maternal support and mental-health care are among the many programs at risk.

Dr. David Fleming, director of Public Health — Seattle & King County, said: "At a time when Washington state is ranked 42nd in the nation for access to prenatal care, further cuts to maternity support services would take us in exactly the wrong direction from both a health and health-care cost standpoint."

Even when overall indicators make Washington look relatively good, the numbers can obscure disparities among people of different income levels, ethnicity or areas of residence, noted James Apa, spokesman for the department.

For example, Apa said, while Washington scored well in infant mortality, in King County, the 2003-2007 death rate for American Indian babies was more than 3 ½ times that of whites. Similar disparities exist between high and low neighborhood-poverty levels.

"Once you break it out, there are huge differences," Apa said.

Donn Moyer, spokesman for the Washington state Department of Health, said it was nice to be recognized for some of the progress the state has made in smoking cessation. And despite the report's assessment, he noted that the state is well above the national goal for childhood-vaccine coverage.

"We'd like to find ways to continue to make progress in these categories and many like them," Moyer said. "One thing about reports like this is they inspire conversation and critical thinking about these important public-health issues."

Dr. Manuel Selva, medical adviser for United Health Foundation, said he hopes state lawmakers will consider the report. "What America's Health Rankings is doing is saying maybe we should look at spending more money on prevention and wellness, particularly in obesity."

At the same time, Selva said, not all the responsibility should be on lawmakers or health departments: "America's Health Ranking is a call to everyone in the state — community leaders, physicians, and individuals themselves," he said, to recognize their own health conditions and take action.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com