National study finds Vermont is “healthiest” state; Shumlin says work remains

Dr. Harry Chen

Vermont Department of Health Commissioner Harry Chen proposes allowing law enforcement investigators access to the Vermont Prescription Monitoring System. VTD File Photo/Alan Panebaker

Vermont is the healthiest state in the nation for the fourth year in a row, according to an annual national study.

United Health Foundation has conducted health rankings for the last 23 years. Vermont, which started out as 17th in 1998, rose to No. 1 in the rankings and has remained there for four years.

“We are doing well compared to the other 49 states, but we are not doing well enough,” Gov. Peter Shumlin said at a press conference held to announce the rankings Tuesday.

Shumlin and his health commissioner, Dr. Harry Chen, agreed that obesity is high on the agenda of health issues that Vermont must address. Vermont ranks 13th in the nation for its obesity rate; 25.4 percent of adults in Vermont fall in this category.

Chen put it this way: “The whole nation is getting fatter. We’re getting fatter at a slower rate.”

Shumlin identified education as the key to reducing obesity, and he said that Vermont’s new single payer health care should help to address the problem by placing greater emphasis on preventive care and rewarding healthy behavior.

“I believe that the best way that you can deal with questions of obesity is through education and ensuring that we get to both kids and parents to give them the information they need to make healthy choices,” Shumlin said. “We can make great progress there and that’s where I’d start.”

Shumlin pointed to what he says has been considerable progress in this regard, using his own school years as a baseline for comparison — “When I was in school in Vermont … there was no awareness that there was any link between obesity and how many Cokes or how many 7-Ups we drank. … All I’m saying is, the awareness curve on this issue has moved leap years.” Shumlin said he would not support a sugar sweetened beverage tax because of its regressive nature.

Asked if this study, as a testament to Vermont’s high health outcomes, offered an argument against the overhaul of the state’s health care system, Shumlin said no. Vermont may top the charts, he said, “but if we’re the first generation of Americans that might live less long than our parents because of what we eat, we’ve got a lot of room to make improvement.”

The rankings derived from 15 different “determinants” and eight different “outcomes” that United Health Foundation takes into account. Determinants include people’s behavior (the percent of people who smoke, for example), environmental factors (such as violent crime rate), policies (such as the rate of health insurance coverage), and clinical care factors (for instance, the number of preventable hospitalizations). Outcomes include cancer deaths, infant mortality rates, cardiovascular deaths, and the percent of the adult population with diabetes, among others.

The study found that relative to the rest of the nation, Vermont has a very low percentage of people leading sedentary lifestyles, a high rate of health insurance coverage, low rates of infectious diseases, and a low rate of low birth weights. Chen credited expansions in Medicaid, Catamount, and Dr. Dynasaur health insurance programs as the “pivot points” that have enabled Vermont to ascend in the rankings over the past couple of decades.

Vermont has a less luminous record when it comes to binge drinking and the rate of cancer deaths. It ranks 27th for the rate of binge drinking and 28th for cancer fatalities. In reference to the latter, Chen said, “That’s something I don’t have an answer for if you ask why, but we are certainly actively looking at how they did the rankings and what is the underlying cause and what we can do to improve it.”

Vermont ranks 15th for percentage of children in poverty, and this figure jumped from 13.5 percent in 2011 to 16.4 percent in 2012.

A link to the 2012 United Health Foundation rankings can be found here: http://www.americashealthrankings.org/Rankings

Follow Alicia on Twitter @aefreese

Comments

  1. Margaret Newton, :

    We are told in this article that Vermont is the “healthiest state in the nation” for the fourth year in a row. The Annie E. Casey Foundation reports that in 2011-2012, 40.7% of our schoolchildren are eligible for free or reduced-price school meals. Are the measurers of health implying that that hungry children are healthy children? Something is missing from this picture.

    Margaret Newton, MD

    • I would interpret that free/reduced lunch number as saying “we feed hungry kids because that will help them be healthy”: I would not think “hungry children are healthy children”, even meant sarcastically, would be a serious consideration.

  2. Margaret Newton, :

    Add to my above comment about our healthy state and hunger in VT children is that 12 – 15% of our children are reported to be obese, mostly in low income families.
    Healthy? Not by my definition.
    Margaret Newton, MD

  3. Ann Raynolds :

    Ditto Margaret’s comments and I think we look good in these rankings because of our VHAP and CATAMOUNT State upported insurance plans which are about to disappear with the Exchange in 2014 unless … Legislators and Governor: Please support subsidies for those presently on these insurance plans, so we don’t end up with a new pool of uninsuraed. Folks on VHAP & Catamount currently won’t be able to afford insurance on the Exchange and may well opt out & pay the penalty — the sdame low-income people with the hungry children!

  4. Robert Roper :

    A couple of questions for Dr. Newton (or anyone else). 40% of low income kids are eligible for free/reduced price school meals, but you say they are also hungry. Are the kids not getting the meals? In your second note, that 12-15% of kids, mostly low income are obese. Are these kids who, being low income, I assume qualify for free/reduced priced lunch, both hungry and obese? Or, is a more accurate assessment of our food policy that 40% of our kids would be hungry were it not for government programs, and, in fact, those programs might be doing harm in their own way? What percentage of kids is actually hungry at the end of the day?

    A recent study of 1000 kids in Michigan found that students who regularly ate school lunches were 29% more likely to be obese compared to those kids who brought their lunches from home. Eating the govt. provided meal plan was the largest determinate of obesity in kids.

    Dr. Newton is right, we have a problem. But, where is it coming from?

    • The problem is coming from misdirections such as those found in your comment, Rob.

      Low income kids tend to eat low income meals at home. The least expensive foods on the grocery shelf tend to be the highest junk calorie types – thus low income diets tend to have low value high calorie inputs.

      Low income kids will make up a greater portion of school supplied meals because free and reduced price meals are provided and thus make up for financial lack at home – thus there would be some correlation between kids who eat school lunches and obesity.

      But the cause and effect you would like us to believe in is an inaccurate claim at best.

  5. It’s not education that makes fat, it’s not enough money. Go into a low income family and see what’s cooking in a big pot:
    beans, rice, sliced hot dogs, high fat hamburger, turnips, potatoes, tomatoes and whatever is not costly and often canned. Yeah, I know, I have that pot on the stove but I put in chicken rather than hot dogs and hamburger. I keep feeding it more beans or tomatoes or rice when it gets down. Doesn’t matter, since I have dumped most of my money into my book project and my refrigerator doesn’t work due to scam with some repair people, so I have put on about 15 pounds! You eat this day after day until you have to buy more beans. Well, part of it is sitting in front of this computer fighting deadlines, part is stress ameliorated with Ben and Jerry’s Heath Bar Crunch and no exercise. Be much better living in a city where there are sidewalks instead of that very angry and overloaded road, Route 100 in Colbyville!

  6. John Greenberg :

    The governor is quoted as saying: ” “When I was in school in Vermont … there was no awareness that there was any link between obesity and how many Cokes or how many 7-Ups we drank….”

    I am a few years older than he is, but as a chubby kid (not in Vermont) I can state unequivocally that I was quite aware of the relationship between soda with sugar and my burgeoning belly. I suspect that the governor as a kid probably had more or less the physique that he does now, and didn’t have to worry about the issue. At least some of us who did have to worry, did know.

    Just for the record …

  7. The proposed tax on sugar sweetened beverages would be a horrible idea as long as it excludes those with artificial sweeteners, which cause worse metabolic damage than cane sugar and even HFCS. It would basically incentivize the consumption of dangerous excito-toxins by making a case of diet cola considerably cheaper than regular.

    But, a beverage’s sweetener is not the only issue to consider. Recent evidence shows that many food and beverage cans leach BPA into their contents, increasing the consumer’s likelihood of becoming obese.

    http://blogs.smithsonianmag.com/science/2012/09/is-the-can-worse-than-the-soda/

    Then there is also research that indicates that our exposure to electromagnetic fields from the time we are conceived plays a role as well.

    http://www.nature.com/srep/2012/120727/srep00540/full/srep00540.html

    Vermont once had a thriving industry of health-promoting mineral water sales.

    http://www.glswrk-auction.com/contest-4.htm

    It may be that the state’s water is still some of the best in the world and residents are exposed to less EMF than more densely populated areas. Hopefully this remains true in the future.

  8. Lisa Mackenzie :

    Children are born in motion and if left to their inclinations will be actively engaged in movement and play until an adult interrupt them. I humbly suggest recess and plenty of time outdoors in the fresh air as the antidote to obesity. Let them garden as part of the curriculum and learn to love healthy food because they are entranced with the magic of seeing it grow from their very own hands and tender care and have an actual experience of producing healthy food.

  9. Yes, it is a sad state of affairs when we measure “health” as the absence of awful things like cancer, and Vermont with its rate of obesity is still considered the healthiest. We know how to cure obesity: diet and exercise. The problem is we have not figured out how to deliver the cure. 1. Acknowledge the big ag industry tactic of manipulating their product to be an addictive combination of fat salt and sugar. Define food as a ratio of nutrition to calories, and anything under that ratio tax and use it to subsidize small farms to make healthy food affordable. 2. Invest some of the 5 billion (going on 8 billion) dollars Vermont spends on healthcare each year, on a transportation system that lets us stop driving (climate change is a health issue, after all) and start walking and biking to busses and trains.

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