The state of perfect health? Not anymore

Minnesota can always pride itself on being No. 1 in some things. It's the coldest state -- or at least one of them. It has the most lakes. And almost always, it has the healthiest population.

Well, now we've slipped a little on that last one.

In an annual report on state health rankings released Monday, Minnesota is No. 2 after holding the top spot for four consecutive years. Vermont, the little state that has been nipping at our healthy heels, moved into first place.

Minnesota's numbers fell in part because more of us are obese. Plus, an additional 1.3 percent don't have health insurance compared with last year. Like the rest of the Upper Midwest -- Wisconsin, especially -- we don't do well with binge drinking (We ranked 41).

Our smoking habits did improve. The number of people who smoke has dropped from 20 to 18 percent of the population, moving us up from 18th to 15th in the nation.

The rankings are provided by the nonprofit United Health Foundation, established by UnitedHealth Group. Each year since 1990 it has compared states on 20 health measurements to determine whether the nation is getting healthier -- or unhealthier.

For the first time since the report was introduced, the health of the nation declined, said Dr. Reed Tuckson, senior vice president of the Minnetonka-based foundation.

The major reason is that the nation is fatter. A lot fatter, he said. Since 1990, obesity rates have exploded from 11.6 percent of the population to 25.1 percent, he said. In Minnesota it climbed 0.7 percent in the past year to 24.7 percent.

"This is really beginning to get out of control," he said. That one factor has outweighed improvements in the number of high school graduates and reduced deaths from heart disease, according to the report.

The decline in smoking has stagnated nationally, but Minnesota's 2 percent drop in the past year was a point of pride for Dr. Sanne Magnan, Minnesota's new health commissioner

"I'd love to see it get to less than 10 percent and collapse on its own, so that it's no longer an acceptable behavior and the tobacco industry is nowhere to be found," she said.

Minnesota also did not do well on access to prenatal care. But then, it never has. In 1990, 72 percent of women said they had good prenatal care in the first three months of pregnancy. That number crept up to 76 percent last year and remained there this year.

Magnan said this problem has stumped state health officials. When asked why they don't get care sooner, women in Minnesota say that they either didn't know they were pregnant or couldn't get an appointment, Magnan said.

"We are trying to do some things to address that" with increased funding to family planning organizations, she said.

Binge drinking is also a problem, she acknowledged. Tuckson said binge drinking is defined as having five or more drinks on one sitting for men and four or more for women. The percent of people who admitted having that much at least once in the past year dropped from 18.7 percent in Minnesota to 17.6 percent. But Tuckson said rates may not be comparable because this year a different set of data measured it.

But on that score Minnesota is a clear winner compared with our neighbors on the east and south. Iowa ranked 48th in binge drinking. And the beer-swilling state of Wisconsin? Dead last.

Josephine Marcotty • 612 673-7394

Josephine Marcotty • marcotty@startribune.com