Texas moved up and is the 34th healthiest state in the latest American Health Rankings from UnitedHealthcare, but the improvement might have little to do with healthier people in Texas. Part of the improvement is because other states’ health is declining at a faster rate than the Lone Star State.
That isn’t to say Texas was without bright spots. The report notes that Texas’ high school graduation rate, low smoking rates, decreased violent crime, improved birthweight and increased number of mental health providers helped boost its ranking from 37 to 34 this year.
But in several other important health measures, Texas is getting worse, despite the improved ranking. Since 2012, obesity has increased from 30.4 percent to 34.8 percent of adults, and drug deaths also bumped up since 2007 from 8.3 to 10.3 deaths per 100,000 people. Diabetes is up from 11.9 to 12.6 percent of adults in Texas. And of course, Texas is the state with the worse rate of health insurance in the country.
Dr. Rhonda Randall is the Chief Medical Officer of UnitedHealthcare’s Employer and Individual market and a board member of UnitedHealthcare foundation, says that Texas’ problems are part of a larger trend. Since the report was first produced in 1990, obesity is up 166 percent nationwide, and diabetes is going up in all 50 states and is at an all time high.
The rankings evaluate several categories and dozens of measures, focusing on behaviors, community and environment, policy, outcomes, and clinical care. Texas’ ranking is really saved by its strong behaviors and outcomes, which are 14th and 25th best in the country respectively. Texas is dead last in policy, 40th in community and environment, and 42nd in clinical care. Texas’ 17.3 percent uninsured rate nearly three times the national average, and towers above the top state at 2.8 percent.
It isn’t unusual to have strong behaviors and poor policy, says Randall. “Generally behaviors and policy don’t have strong correlation, and we are always happy to see individual behaviors ranking high on the list.”
The ranking also have an interesting interactive tool where one can change the ranking and see what would need to change in the state in order for that ranking to happen. For Texas be in the top half of the state rankings, it would need to up its high school graduation rate from 89 percent to 97 percent, reduce the obesity rate from 35 percent to 28 percent, reduce smoking rates from 14 to 9 percent, and bring down cancer deaths per 100,000 people from 180 to 150.
But making that happen is much more difficult than sliding a point over a number line, and Texas will need to address many issues outside of the walls of healthcare facilities, which is why more and more healthcare companies are addressing the social determinants of health to improve the health of local residents before they arrive in the hospital.
The creators of the survey say this report is about more than just ranking the states. “We see this report as a call to action for communities and policy makers to understand where the opportunity is,” Randall says.